Although in the majority of cases of H1N1 2009 influenza affects the upper respiratory system, the most common complication is that of influenza-related pneumonia. This has occurred in 40% of hospitalised patients in the United States, usually with bilateral infiltrates apparent in the chest X-ray [9, 10] . Amongst patients with H1N1 influenza admitted to ICUs in New Zealand and Australia, 49% had viral pneumonitis or ARDS and 20% had secondary bacterial pneumonia. The most common bacterial pathogens reported included Streptococcus pneumonia, S. pyogenes, Staphylococcus aureus, S. mitis and Haemophilus influenzae [11] .