Korean J Radiol.  2010 Aug;11(4):417-424. 10.3348/kjr.2010.11.4.417.

Radiological and Clinical Characteristics of a Military Outbreak of Pandemic H1N1 2009 Influenza Virus Infection

Affiliations
  • 1Department of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do 412-510, Korea.
  • 2Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 110-744, Korea. cmpark@radiol.snu.ac.kr
  • 3Department of Family Medicine, Armed Force Byukjae Hospital, Gyeonggi-do 412-510, Korea.
  • 4Department of Family Medicine, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangwon-do 210-711, Korea.
  • 5Department of Internal Medicine, Armed Force Byukjae Hospital, Gyeonggi-do 412-510, Korea.
  • 6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul 110-744, Korea.
  • 7Department of Family Medicine, Chungnam National University School of Medicine, Daejeon 301-721, Korea.

Abstract


OBJECTIVE
To describe detailed clinical and radiological features of the pandemic H1N1 2009 influenza viral infection among healthy young males in a semi-closed institutionalized setting.
MATERIALS AND METHODS
A total of 18 patients confirmed with the pandemic H1N1 2009 influenza virus infection from July 18 to July 30, 2009 were enrolled in this study. Each patient underwent an evaluation to determine detailed clinical and radiological features.
RESULTS
All patients presented with high fever (> 38.0degrees C), with accompanying symptoms of cough, rhinorrhea, sore throat, myalgia and diarrhea, and increased C-reactive protein (CRP) values with no leukocytosis nor elevated erythrocyte sedimentation rate (ESR). All patients, including one patient who progressed into acute respiratory distress syndrome, were treated with oseltamivir phosphate and quickly recovered from their symptoms. Chest radiographs showed abnormalities of small nodules and lobar consolidation in only two out of 18 patients. However, six of 12 patients who underwent thin-section CT examinations showed abnormal findings for small ground-glass opacities (GGOs) in addition to poorly-defined nodules with upper lobe predominance.
CONCLUSION
In a population of healthy young adults, elevated CRP with normal ESR and white blood cell levels combined with GGOs and nodules on thin-section CT scans may indicate early signs of infection by the pandemic H1N1 2009 influenza virus.

Keyword

Swine flu; Pandemic H1N1 2009; Influenza virus; Chest radiograph; Computed tomography (CT)

MeSH Terms

*Disease Outbreaks
Humans
*Influenza A Virus, H1N1 Subtype
Influenza, Human/*epidemiology/*radiography/therapy
Male
*Military Personnel
*Radiography, Thoracic
Republic of Korea/epidemiology
Tomography, X-Ray Computed
Young Adult
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