Sex: F
Vaccine: FLUX
Symptoms: Polymerase chain reaction positive, Vaccination failure, Viral test positive
Clinical narrative: Initial unsolicited report received from the literature on 06-OCT-2016. Following is the verbatim from the article: Background. We describe the impact of early initiation of influenza antiviral treatment among pregnant women hospitalized with laboratory-confirmed influenza during the 2010-2014 influenza seasons. Methods. Severe influenza was defined as illness with less than or equal to 1 of the following: intensive care unit admission, need for mechanical ventilation, respiratory failure, pulmonary embolism, sepsis, or death. Within severity stratum, we used parametric survival analysis to compare length of stay by timing of antiviral treatment, adjusting for underlying conditions, influenza vaccination, and pregnancy trimester. Results. Among 865 pregnant women, the median age was 27 years (interquartile range [IQR], 23-31 years).Most (68%) were healthy, and 85%received antiviral treatment. Sixty-three women (7%) had severe influenza, and 4 died. Severity was associated with preterm delivery and fetal loss. Women with severe influenza were less likely to be vaccinated than those without severe influenza (14%vs 26%; P equal to .03). Among women treated with antivirals 2 days versus those treated more than 2 days from illness onset, the median length of stay was 2.2 days (interquartile range [IQR], 0.9-5.8 days; n equal to 8) versus 7.8 days (IQR, 3.0-20.6 days; n equal to 7), respectively, for severe influenza (P equal to .03) and 2.4 days (IQR, 2.3-2.5 days; n equal to 153) versus 3.1 days (IQR, 2.8-3.5 days; n equal to 62), respectively, for no severe influenza (P less than .01). Conclusions. Early initiation of influenza antiviral treatment to pregnant women hospitalized with influenza may reduce the length of stay, especially among those with severe influenza. Influenza during pregnancy is associated with maternal and infant morbidity, and annual influenza vaccination is warranted.+ Keywords. influenza; pregnancy; influenza antiviral treatment; length of stay; early antiviral treatment This case involves a female patient (age not reported) who was vaccinated with a dose of INFLUENZA VACCINE (manufacturer: unknown, batch number, expiry date, route and site of administration: not reported) on an unspecified date. Patient's medical history and concomitant medications were not reported. On an unspecified date, post vaccination the patient had severe influenza and was hospitalized. On an unspecified date, post vaccination, the patient died (Patient was pregnant when she died). This was a case of vaccination failure. Patient's laboratory data included: influenza virus test-positive result (Reported as patient was more likely to have presence of influenza A ((H1N1) pdm 09). Confirmation included a positive result of reverse transcription polymerase chain reaction analysis, rapid antigen testing, direct or indirect fluorescent antibody staining, or viral culture. Patient received corrective treatment with antiviral medication. It was unknown whether autopsy was performed. List of documents held by sender: none. Sender's Comments: This case corresponds to a poorly documented literature report with a H1N1 influenza infection with a fatal outcome in a pregnant women. Patient was died due to severe influenza infection even though she was received influenza vaccine before for which the name of the manufacturer was unknown. This case is therefore a suspected vaccination failure. Clinical details- such as latency from vaccination, relevant medical history, previous vaccination history, clinical details surrounding the fatal event, the name of the specific vaccine administered, autopsy report and diagnostic work-up- are lacking to allow adequate medical assessment. Reported Cause(s) of Death: severe influenza/ influenza A (H1N1).