RESUMO
INTRODUCTION: On May 3, 2009, a first case of influenza A/H1N1 infection occurred in the federal state of Saxony-Anhalt, Germany. In order to stop the possible spread of the virus and to study the epidemiological and clinical characteristics of the infection, an investigation was launched by the local health authorities and the RKI. METHODS: Standardised questionnaires were used to assess demographic and clinical data. Specimens were collected from case patients and close contacts and were analysed for influenza A/H1N1 using real-time PCR. RESULTS: The index patient showed fever and coughing 3.5 days after returning from a holiday in Mexico. The local health authorities were informed on May 3, and measures were rapidly implemented. These measures included a trace-back of possible contact persons, isolation of the case and close contacts, prophylactic treatment with Oseltamivir. Virological investigations showed that the case shedded viral genome up until the last day of antiviral therapy. Viral genome was also detected in the spouse and the son of the patient. Both showed no symptoms under a prophylactic treatment with antiviral medication. No viral genome was detected in three other family members, and in six other contact persons outside of the family. DISCUSSION: The spread of the virus was contained due to the fast response of the local health authorities. Two secondary cases occurred in the family. These cases remained asymptomatic, possibly due to antiviral prophylaxis. Epidemiological and virological results suggest that the influenza A/H1N1 virus has a longer incubation period and that viral shedding may probably be prolonged when compared with seasonal influenza.
Assuntos
Surtos de Doenças/prevenção & controle , Saúde da Família , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Influenza Humana/transmissão , Medição de Risco/métodos , Viagem/estatística & dados numéricos , Adolescente , Adulto , Análise por Conglomerados , Surtos de Doenças/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Influenza Humana/genética , Influenza Humana/virologia , Masculino , México , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Adulto JovemRESUMO
Eleven males participated in a hiking expedition over a period of 6 weeks during which they walked an average of 15 km per day, resting days included. The participants completed a seven-day estimated dietary record before and during the expedition. Their habitual dietary intake before the expedition was typical of a Western diet. During the expedition most animal products, with the exception of canned fish, were excluded from the diet. The dietary intake of fat and carbohydrate changed from 36.9% and 40.6% to 14.0% and 76.4% respectively. Cholesterol intake dropped from 557 mg to 92 mg. Mean plasma total cholesterol (TC) decreased from 190.9 mg/100 ml to 142.0 mg/100 ml. These changes were mainly due to changes in low density lipoprotein cholesterol (LDL-C). Although high density lipoprotein cholesterol (HDL-C) did not change, the ratio of HDL-C to TC increased significantly. It can be concluded that drastic dietary changes, together with increased physical activity and weight loss resulted in major plasma lipoprotein changes. The expected fall in HDL-C due to a high carbohydrate diet was counteracted by the increased physical activity and weight loss.