When should a diagnosis of influenza be considered in adults requiring intensive care unit admission? Results of population-based active surveillance in Toronto
Identifieur interne : 000776 ( Pmc/Checkpoint ); précédent : 000775; suivant : 000777When should a diagnosis of influenza be considered in adults requiring intensive care unit admission? Results of population-based active surveillance in Toronto
Auteurs : Stefan P. Kuster [Canada] ; Kevin C. Katz [Canada] ; Joanne Blair [Canada] ; James Downey [Canada] ; Steven J. Drews [Canada] ; Sandy Finkelstein [Canada] ; Rob Fowler [Canada] ; Karen Green [Canada] ; Jonathan Gubbay [Canada] ; Kazi Hassan [Canada] ; Stephen E. Lapinsky [Canada] ; Tony Mazzulli [Canada] ; Donna Mcritchie [Canada] ; Janos Pataki [Canada] ; Agron Plevneshi [Canada] ; Jeff Powis [Canada] ; David Rose [Canada] ; Alicia Sarabia [Canada] ; Carmine Simone [Canada] ; Andrew Simor [Canada] ; Allison Mcgeer [Canada]Source :
- Critical Care [ 1364-8535 ] ; 2011.
Abstract
There is a paucity of data about the clinical characteristics that help identify patients at high risk of influenza infection upon ICU admission. We aimed to identify predictors of influenza infection in patients admitted to ICUs during the 2007/2008 and 2008/2009 influenza seasons and the second wave of the 2009 H1N1 influenza pandemic as well as to identify populations with increased likelihood of seasonal and pandemic 2009 influenza (pH1N1) infection.
Six Toronto acute care hospitals participated in active surveillance for laboratory-confirmed influenza requiring ICU admission during periods of influenza activity from 2007 to 2009. Nasopharyngeal swabs were obtained from patients who presented to our hospitals with acute respiratory or cardiac illness or febrile illness without a clear nonrespiratory aetiology. Predictors of influenza were assessed by multivariable logistic regression analysis and the likelihood of influenza in different populations was calculated.
In 5,482 patients, 126 (2.3%) were found to have influenza. Admission temperature ≥38°C (odds ratio (OR) 4.7 for pH1N1, 2.3 for seasonal influenza) and admission diagnosis of pneumonia or respiratory infection (OR 7.3 for pH1N1, 4.2 for seasonal influenza) were independent predictors for influenza. During the peak weeks of influenza seasons, 17% of afebrile patients and 27% of febrile patients with pneumonia or respiratory infection had influenza. During the second wave of the 2009 pandemic, 26% of afebrile patients and 70% of febrile patients with pneumonia or respiratory infection had influenza.
The findings of our study may assist clinicians in decision making regarding optimal management of adult patients admitted to ICUs during future influenza seasons. Influenza testing, empiric antiviral therapy and empiric infection control precautions should be considered in those patients who are admitted during influenza season with a diagnosis of pneumonia or respiratory infection and are either febrile or admitted during weeks of peak influenza activity.
Url:
DOI: 10.1186/cc10331
PubMed: 21798012
PubMed Central: 3387625
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
PMC:3387625Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">When should a diagnosis of influenza be considered in adults requiring intensive care unit admission? Results of population-based active surveillance in Toronto</title><author><name sortKey="Kuster, Stefan P" sort="Kuster, Stefan P" uniqKey="Kuster S" first="Stefan P" last="Kuster">Stefan P. Kuster</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Katz, Kevin C" sort="Katz, Kevin C" uniqKey="Katz K" first="Kevin C" last="Katz">Kevin C. Katz</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1</wicri:regionArea><wicri:noRegion>M2K 1E1</wicri:noRegion></affiliation></author><author><name sortKey="Blair, Joanne" sort="Blair, Joanne" uniqKey="Blair J" first="Joanne" last="Blair">Joanne Blair</name><affiliation wicri:level="1"><nlm:aff id="I4">Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1</wicri:regionArea><wicri:noRegion>M9P 3T1</wicri:noRegion></affiliation></author><author><name sortKey="Downey, James" sort="Downey, James" uniqKey="Downey J" first="James" last="Downey">James Downey</name><affiliation wicri:level="1"><nlm:aff id="I5">Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7</wicri:regionArea><wicri:noRegion>M4C 3E7</wicri:noRegion></affiliation></author><author><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><affiliation wicri:level="4"><nlm:aff id="I6">ProvLab Calgary, University of Calgary, 3030 Hospital Drive NW, Calgary, AB, T2N 4W4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>ProvLab Calgary, University of Calgary, 3030 Hospital Drive NW, Calgary, AB, T2N 4W4</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Finkelstein, Sandy" sort="Finkelstein, Sandy" uniqKey="Finkelstein S" first="Sandy" last="Finkelstein">Sandy Finkelstein</name><affiliation wicri:level="1"><nlm:aff id="I7">The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3</wicri:regionArea><wicri:noRegion>M1W 3W3</wicri:noRegion></affiliation></author><author><name sortKey="Fowler, Rob" sort="Fowler, Rob" uniqKey="Fowler R" first="Rob" last="Fowler">Rob Fowler</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I8">Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5</wicri:regionArea><wicri:noRegion>M4N 3M5</wicri:noRegion></affiliation></author><author><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Gubbay, Jonathan" sort="Gubbay, Jonathan" uniqKey="Gubbay J" first="Jonathan" last="Gubbay">Jonathan Gubbay</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1</wicri:regionArea><wicri:noRegion>M9P 3T1</wicri:noRegion></affiliation></author><author><name sortKey="Hassan, Kazi" sort="Hassan, Kazi" uniqKey="Hassan K" first="Kazi" last="Hassan">Kazi Hassan</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Lapinsky, Stephen E" sort="Lapinsky, Stephen E" uniqKey="Lapinsky S" first="Stephen E" last="Lapinsky">Stephen E. Lapinsky</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Mcritchie, Donna" sort="Mcritchie, Donna" uniqKey="Mcritchie D" first="Donna" last="Mcritchie">Donna Mcritchie</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1</wicri:regionArea><wicri:noRegion>M2K 1E1</wicri:noRegion></affiliation></author><author><name sortKey="Pataki, Janos" sort="Pataki, Janos" uniqKey="Pataki J" first="Janos" last="Pataki">Janos Pataki</name><affiliation wicri:level="1"><nlm:aff id="I9">Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1</wicri:regionArea><wicri:noRegion>L5M 2N1</wicri:noRegion></affiliation></author><author><name sortKey="Plevneshi, Agron" sort="Plevneshi, Agron" uniqKey="Plevneshi A" first="Agron" last="Plevneshi">Agron Plevneshi</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7</wicri:regionArea><wicri:noRegion>M4C 3E7</wicri:noRegion></affiliation></author><author><name sortKey="Rose, David" sort="Rose, David" uniqKey="Rose D" first="David" last="Rose">David Rose</name><affiliation wicri:level="1"><nlm:aff id="I7">The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3</wicri:regionArea><wicri:noRegion>M1W 3W3</wicri:noRegion></affiliation></author><author><name sortKey="Sarabia, Alicia" sort="Sarabia, Alicia" uniqKey="Sarabia A" first="Alicia" last="Sarabia">Alicia Sarabia</name><affiliation wicri:level="1"><nlm:aff id="I9">Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1</wicri:regionArea><wicri:noRegion>L5M 2N1</wicri:noRegion></affiliation></author><author><name sortKey="Simone, Carmine" sort="Simone, Carmine" uniqKey="Simone C" first="Carmine" last="Simone">Carmine Simone</name><affiliation wicri:level="1"><nlm:aff id="I5">Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7</wicri:regionArea><wicri:noRegion>M4C 3E7</wicri:noRegion></affiliation></author><author><name sortKey="Simor, Andrew" sort="Simor, Andrew" uniqKey="Simor A" first="Andrew" last="Simor">Andrew Simor</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I8">Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5</wicri:regionArea><wicri:noRegion>M4N 3M5</wicri:noRegion></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21798012</idno><idno type="pmc">3387625</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387625</idno><idno type="RBID">PMC:3387625</idno><idno type="doi">10.1186/cc10331</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000628</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000628</idno><idno type="wicri:Area/Pmc/Curation">000628</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000628</idno><idno type="wicri:Area/Pmc/Checkpoint">000776</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000776</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">When should a diagnosis of influenza be considered in adults requiring intensive care unit admission? Results of population-based active surveillance in Toronto</title><author><name sortKey="Kuster, Stefan P" sort="Kuster, Stefan P" uniqKey="Kuster S" first="Stefan P" last="Kuster">Stefan P. Kuster</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Katz, Kevin C" sort="Katz, Kevin C" uniqKey="Katz K" first="Kevin C" last="Katz">Kevin C. Katz</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1</wicri:regionArea><wicri:noRegion>M2K 1E1</wicri:noRegion></affiliation></author><author><name sortKey="Blair, Joanne" sort="Blair, Joanne" uniqKey="Blair J" first="Joanne" last="Blair">Joanne Blair</name><affiliation wicri:level="1"><nlm:aff id="I4">Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1</wicri:regionArea><wicri:noRegion>M9P 3T1</wicri:noRegion></affiliation></author><author><name sortKey="Downey, James" sort="Downey, James" uniqKey="Downey J" first="James" last="Downey">James Downey</name><affiliation wicri:level="1"><nlm:aff id="I5">Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7</wicri:regionArea><wicri:noRegion>M4C 3E7</wicri:noRegion></affiliation></author><author><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><affiliation wicri:level="4"><nlm:aff id="I6">ProvLab Calgary, University of Calgary, 3030 Hospital Drive NW, Calgary, AB, T2N 4W4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>ProvLab Calgary, University of Calgary, 3030 Hospital Drive NW, Calgary, AB, T2N 4W4</wicri:regionArea><orgName type="university">Université de Calgary</orgName><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName></affiliation></author><author><name sortKey="Finkelstein, Sandy" sort="Finkelstein, Sandy" uniqKey="Finkelstein S" first="Sandy" last="Finkelstein">Sandy Finkelstein</name><affiliation wicri:level="1"><nlm:aff id="I7">The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3</wicri:regionArea><wicri:noRegion>M1W 3W3</wicri:noRegion></affiliation></author><author><name sortKey="Fowler, Rob" sort="Fowler, Rob" uniqKey="Fowler R" first="Rob" last="Fowler">Rob Fowler</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I8">Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5</wicri:regionArea><wicri:noRegion>M4N 3M5</wicri:noRegion></affiliation></author><author><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Gubbay, Jonathan" sort="Gubbay, Jonathan" uniqKey="Gubbay J" first="Jonathan" last="Gubbay">Jonathan Gubbay</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1</wicri:regionArea><wicri:noRegion>M9P 3T1</wicri:noRegion></affiliation></author><author><name sortKey="Hassan, Kazi" sort="Hassan, Kazi" uniqKey="Hassan K" first="Kazi" last="Hassan">Kazi Hassan</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Lapinsky, Stephen E" sort="Lapinsky, Stephen E" uniqKey="Lapinsky S" first="Stephen E" last="Lapinsky">Stephen E. Lapinsky</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Mcritchie, Donna" sort="Mcritchie, Donna" uniqKey="Mcritchie D" first="Donna" last="Mcritchie">Donna Mcritchie</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1</wicri:regionArea><wicri:noRegion>M2K 1E1</wicri:noRegion></affiliation></author><author><name sortKey="Pataki, Janos" sort="Pataki, Janos" uniqKey="Pataki J" first="Janos" last="Pataki">Janos Pataki</name><affiliation wicri:level="1"><nlm:aff id="I9">Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1</wicri:regionArea><wicri:noRegion>L5M 2N1</wicri:noRegion></affiliation></author><author><name sortKey="Plevneshi, Agron" sort="Plevneshi, Agron" uniqKey="Plevneshi A" first="Agron" last="Plevneshi">Agron Plevneshi</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation></author><author><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7</wicri:regionArea><wicri:noRegion>M4C 3E7</wicri:noRegion></affiliation></author><author><name sortKey="Rose, David" sort="Rose, David" uniqKey="Rose D" first="David" last="Rose">David Rose</name><affiliation wicri:level="1"><nlm:aff id="I7">The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3</wicri:regionArea><wicri:noRegion>M1W 3W3</wicri:noRegion></affiliation></author><author><name sortKey="Sarabia, Alicia" sort="Sarabia, Alicia" uniqKey="Sarabia A" first="Alicia" last="Sarabia">Alicia Sarabia</name><affiliation wicri:level="1"><nlm:aff id="I9">Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1</wicri:regionArea><wicri:noRegion>L5M 2N1</wicri:noRegion></affiliation></author><author><name sortKey="Simone, Carmine" sort="Simone, Carmine" uniqKey="Simone C" first="Carmine" last="Simone">Carmine Simone</name><affiliation wicri:level="1"><nlm:aff id="I5">Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7</wicri:regionArea><wicri:noRegion>M4C 3E7</wicri:noRegion></affiliation></author><author><name sortKey="Simor, Andrew" sort="Simor, Andrew" uniqKey="Simor A" first="Andrew" last="Simor">Andrew Simor</name><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I8">Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5</wicri:regionArea><wicri:noRegion>M4N 3M5</wicri:noRegion></affiliation></author><author><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><affiliation wicri:level="1"><nlm:aff id="I1">Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5</wicri:regionArea><wicri:noRegion>M5G 1X5</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I2">University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">Critical Care</title><idno type="ISSN">1364-8535</idno><idno type="eISSN">1466-609X</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>There is a paucity of data about the clinical characteristics that help identify patients at high risk of influenza infection upon ICU admission. We aimed to identify predictors of influenza infection in patients admitted to ICUs during the 2007/2008 and 2008/2009 influenza seasons and the second wave of the 2009 H1N1 influenza pandemic as well as to identify populations with increased likelihood of seasonal and pandemic 2009 influenza (pH1N1) infection.</p></sec><sec><title>Methods</title><p>Six Toronto acute care hospitals participated in active surveillance for laboratory-confirmed influenza requiring ICU admission during periods of influenza activity from 2007 to 2009. Nasopharyngeal swabs were obtained from patients who presented to our hospitals with acute respiratory or cardiac illness or febrile illness without a clear nonrespiratory aetiology. Predictors of influenza were assessed by multivariable logistic regression analysis and the likelihood of influenza in different populations was calculated.</p></sec><sec><title>Results</title><p>In 5,482 patients, 126 (2.3%) were found to have influenza. Admission temperature ≥38°C (odds ratio (OR) 4.7 for pH1N1, 2.3 for seasonal influenza) and admission diagnosis of pneumonia or respiratory infection (OR 7.3 for pH1N1, 4.2 for seasonal influenza) were independent predictors for influenza. During the peak weeks of influenza seasons, 17% of afebrile patients and 27% of febrile patients with pneumonia or respiratory infection had influenza. During the second wave of the 2009 pandemic, 26% of afebrile patients and 70% of febrile patients with pneumonia or respiratory infection had influenza.</p></sec><sec><title>Conclusions</title><p>The findings of our study may assist clinicians in decision making regarding optimal management of adult patients admitted to ICUs during future influenza seasons. Influenza testing, empiric antiviral therapy and empiric infection control precautions should be considered in those patients who are admitted during influenza season with a diagnosis of pneumonia or respiratory infection and are either febrile or admitted during weeks of peak influenza activity.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Webb, Sa" uniqKey="Webb S">SA Webb</name></author><author><name sortKey="Pettil, V" uniqKey="Pettil V">V Pettilä</name></author><author><name sortKey="Seppelt, I" uniqKey="Seppelt I">I Seppelt</name></author><author><name sortKey="Bellomo, R" uniqKey="Bellomo R">R Bellomo</name></author><author><name sortKey="Bailey, M" uniqKey="Bailey M">M Bailey</name></author><author><name sortKey="Cooper, Dj" uniqKey="Cooper D">DJ Cooper</name></author><author><name sortKey="Cretikos, M" uniqKey="Cretikos M">M Cretikos</name></author><author><name sortKey="Davies, Ar" uniqKey="Davies A">AR Davies</name></author><author><name sortKey="Finfer, S" uniqKey="Finfer S">S Finfer</name></author><author><name sortKey="Harrigan, Pw" uniqKey="Harrigan P">PW Harrigan</name></author><author><name sortKey="Hart, Gk" uniqKey="Hart G">GK Hart</name></author><author><name sortKey="Howe, B" uniqKey="Howe B">B Howe</name></author><author><name sortKey="Iredell, Jr" uniqKey="Iredell J">JR Iredell</name></author><author><name sortKey="Mcarthur, C" uniqKey="Mcarthur C">C McArthur</name></author><author><name sortKey="Mitchell, I" uniqKey="Mitchell I">I Mitchell</name></author><author><name sortKey="Morrison, S" uniqKey="Morrison S">S Morrison</name></author><author><name sortKey="Nichol, Ad" uniqKey="Nichol A">AD Nichol</name></author><author><name sortKey="Paterson, Dl" uniqKey="Paterson D">DL Paterson</name></author><author><name sortKey="Peake, S" uniqKey="Peake S">S Peake</name></author><author><name sortKey="Richards, B" uniqKey="Richards B">B Richards</name></author><author><name sortKey="Stephens, D" uniqKey="Stephens D">D Stephens</name></author><author><name sortKey="Turner, A" uniqKey="Turner A">A Turner</name></author><author><name sortKey="Yung, M" uniqKey="Yung M">M Yung</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kumar, A" uniqKey="Kumar A">A Kumar</name></author><author><name sortKey="Zarychanski, R" uniqKey="Zarychanski R">R Zarychanski</name></author><author><name sortKey="Pinto, R" uniqKey="Pinto R">R Pinto</name></author><author><name sortKey="Cook, Dj" uniqKey="Cook D">DJ Cook</name></author><author><name sortKey="Marshall, J" uniqKey="Marshall J">J Marshall</name></author><author><name sortKey="Lacroix, J" uniqKey="Lacroix J">J Lacroix</name></author><author><name sortKey="Stelfox, T" uniqKey="Stelfox T">T Stelfox</name></author><author><name sortKey="Bagshaw, S" uniqKey="Bagshaw S">S Bagshaw</name></author><author><name sortKey="Choong, K" uniqKey="Choong K">K Choong</name></author><author><name sortKey="Lamontagne, F" uniqKey="Lamontagne F">F Lamontagne</name></author><author><name sortKey="Turgeon, Af" uniqKey="Turgeon A">AF Turgeon</name></author><author><name sortKey="Lapinsky, S" uniqKey="Lapinsky S">S Lapinsky</name></author><author><name sortKey="Ahern, Sp" uniqKey="Ahern S">SP Ahern</name></author><author><name sortKey="Smith, O" uniqKey="Smith O">O Smith</name></author><author><name sortKey="Siddiqui, F" uniqKey="Siddiqui F">F Siddiqui</name></author><author><name sortKey="Jouvet, P" uniqKey="Jouvet P">P Jouvet</name></author><author><name sortKey="Khwaja, K" uniqKey="Khwaja K">K Khwaja</name></author><author><name sortKey="Mcintyre, L" uniqKey="Mcintyre L">L McIntyre</name></author><author><name sortKey="Menon, K" uniqKey="Menon K">K Menon</name></author><author><name sortKey="Hutchison, J" uniqKey="Hutchison J">J Hutchison</name></author><author><name sortKey="Hornstein, D" uniqKey="Hornstein D">D Hornstein</name></author><author><name sortKey="Joffe, A" uniqKey="Joffe A">A Joffe</name></author><author><name sortKey="Lauzier, F" uniqKey="Lauzier F">F Lauzier</name></author><author><name sortKey="Singh, J" uniqKey="Singh J">J Singh</name></author><author><name sortKey="Karachi, T" uniqKey="Karachi T">T Karachi</name></author><author><name sortKey="Wiebe, K" uniqKey="Wiebe K">K Wiebe</name></author><author><name sortKey="Olafson, K" uniqKey="Olafson K">K Olafson</name></author><author><name sortKey="Ramsey, C" uniqKey="Ramsey C">C Ramsey</name></author><author><name sortKey="Sharma, S" uniqKey="Sharma S">S Sharma</name></author><author><name sortKey="Dodek, P" uniqKey="Dodek P">P Dodek</name></author><author><name sortKey="Meade, M" uniqKey="Meade M">M Meade</name></author><author><name sortKey="Hall, R" uniqKey="Hall R">R Hall</name></author><author><name sortKey="Fowler, Ra" uniqKey="Fowler R">RA Fowler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dominguez Cherit, G" uniqKey="Dominguez Cherit G">G Domínguez-Cherit</name></author><author><name sortKey="Lapinsky, Se" uniqKey="Lapinsky S">SE Lapinsky</name></author><author><name sortKey="Macias, Ae" uniqKey="Macias A">AE Macias</name></author><author><name sortKey="Pinto, R" uniqKey="Pinto R">R Pinto</name></author><author><name sortKey="Espinosa Perez, L" uniqKey="Espinosa Perez L">L Espinosa-Perez</name></author><author><name sortKey="De La Torre, A" uniqKey="De La Torre A">A de la Torre</name></author><author><name sortKey="Poblano Morales, M" uniqKey="Poblano Morales M">M Poblano-Morales</name></author><author><name sortKey="Baltazar Torres, Ja" uniqKey="Baltazar Torres J">JA Baltazar-Torres</name></author><author><name sortKey="Bautista, E" uniqKey="Bautista E">E Bautista</name></author><author><name sortKey="Martinez, A" uniqKey="Martinez A">A Martinez</name></author><author><name sortKey="Martinez, Ma" uniqKey="Martinez M">MA Martinez</name></author><author><name sortKey="Rivero, E" uniqKey="Rivero E">E Rivero</name></author><author><name sortKey="Valdez, R" uniqKey="Valdez R">R Valdez</name></author><author><name sortKey="Ruiz Palacios, G" uniqKey="Ruiz Palacios G">G Ruiz-Palacios</name></author><author><name sortKey="Hernandez, M" uniqKey="Hernandez M">M Hernández</name></author><author><name sortKey="Stewart, Te" uniqKey="Stewart T">TE Stewart</name></author><author><name sortKey="Fowler, Ra" uniqKey="Fowler R">RA Fowler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Farias, Ja" uniqKey="Farias J">JA Farias</name></author><author><name sortKey="Fernandez, A" uniqKey="Fernandez A">A Fernández</name></author><author><name sortKey="Monteverde, E" uniqKey="Monteverde E">E Monteverde</name></author><author><name sortKey="Vidal, N" uniqKey="Vidal N">N Vidal</name></author><author><name sortKey="Arias, P" uniqKey="Arias P">P Arias</name></author><author><name sortKey="Montes, Mj" uniqKey="Montes M">MJ Montes</name></author><author><name sortKey="Rodriguez, G" uniqKey="Rodriguez G">G Rodríguez</name></author><author><name sortKey="Allasia, M" uniqKey="Allasia M">M Allasia</name></author><author><name sortKey="Ratto, Me" uniqKey="Ratto M">ME Ratto</name></author><author><name sortKey="Jaen, R" uniqKey="Jaen R">R Jaén</name></author><author><name sortKey="Meregalli, C" uniqKey="Meregalli C">C Meregalli</name></author><author><name sortKey="Fiquepron, K" uniqKey="Fiquepron K">K Fiquepron</name></author><author><name sortKey="Calvo, Ar" uniqKey="Calvo A">AR Calvo</name></author><author><name sortKey="Siaba, A" uniqKey="Siaba A">A Siaba</name></author><author><name sortKey="Albano, L" uniqKey="Albano L">L Albano</name></author><author><name sortKey="Poterala, R" uniqKey="Poterala R">R Poterala</name></author><author><name sortKey="Neira, P" uniqKey="Neira P">P Neira</name></author><author><name sortKey="Esteban, A" uniqKey="Esteban A">A Esteban</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yang, P" uniqKey="Yang P">P Yang</name></author><author><name sortKey="Deng, Y" uniqKey="Deng Y">Y Deng</name></author><author><name sortKey="Pang, X" uniqKey="Pang X">X Pang</name></author><author><name sortKey="Shi, W" uniqKey="Shi W">W Shi</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author><author><name sortKey="Tian, L" uniqKey="Tian L">L Tian</name></author><author><name sortKey="Zhang, Y" uniqKey="Zhang Y">Y Zhang</name></author><author><name sortKey="Wang, X" uniqKey="Wang X">X Wang</name></author><author><name sortKey="Huang, F" uniqKey="Huang F">F Huang</name></author><author><name sortKey="Raina, Mc" uniqKey="Raina M">MC Raina</name></author><author><name sortKey="Wang, Q" uniqKey="Wang Q">Q Wang</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mcgeer, Aj" uniqKey="Mcgeer A">AJ McGeer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuster, Sp" uniqKey="Kuster S">SP Kuster</name></author><author><name sortKey="Drews, S" uniqKey="Drews S">S Drews</name></author><author><name sortKey="Green, K" uniqKey="Green K">K Green</name></author><author><name sortKey="Blair, J" uniqKey="Blair J">J Blair</name></author><author><name sortKey="Davis, I" uniqKey="Davis I">I Davis</name></author><author><name sortKey="Downey, J" uniqKey="Downey J">J Downey</name></author><author><name sortKey="Fowler, R" uniqKey="Fowler R">R Fowler</name></author><author><name sortKey="Katz, K" uniqKey="Katz K">K Katz</name></author><author><name sortKey="Lapinsky, S" uniqKey="Lapinsky S">S Lapinsky</name></author><author><name sortKey="Mcritchie, D" uniqKey="Mcritchie D">D McRitchie</name></author><author><name sortKey="Pataki, J" uniqKey="Pataki J">J Pataki</name></author><author><name sortKey="Powis, J" uniqKey="Powis J">J Powis</name></author><author><name sortKey="Rose, D" uniqKey="Rose D">D Rose</name></author><author><name sortKey="Sarabia, A" uniqKey="Sarabia A">A Sarabia</name></author><author><name sortKey="Simone, C" uniqKey="Simone C">C Simone</name></author><author><name sortKey="Simor, A" uniqKey="Simor A">A Simor</name></author><author><name sortKey="Stewart, T" uniqKey="Stewart T">T Stewart</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Daneman, N" uniqKey="Daneman N">N Daneman</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author><author><name sortKey="Green, K" uniqKey="Green K">K Green</name></author><author><name sortKey="Low, De" uniqKey="Low D">DE Low</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author><author><name sortKey="Green, Ka" uniqKey="Green K">KA Green</name></author><author><name sortKey="Plevneshi, A" uniqKey="Plevneshi A">A Plevneshi</name></author><author><name sortKey="Shigayeva, A" uniqKey="Shigayeva A">A Shigayeva</name></author><author><name sortKey="Siddiqi, N" uniqKey="Siddiqi N">N Siddiqi</name></author><author><name sortKey="Raboud, J" uniqKey="Raboud J">J Raboud</name></author><author><name sortKey="Low, De" uniqKey="Low D">DE Low</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vanderkooi, Og" uniqKey="Vanderkooi O">OG Vanderkooi</name></author><author><name sortKey="Low, De" uniqKey="Low D">DE Low</name></author><author><name sortKey="Green, K" uniqKey="Green K">K Green</name></author><author><name sortKey="Powis, Je" uniqKey="Powis J">JE Powis</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harrell, Fe" uniqKey="Harrell F">FE Harrell</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Falagas, Me" uniqKey="Falagas M">ME Falagas</name></author><author><name sortKey="Koletsi, Pk" uniqKey="Koletsi P">PK Koletsi</name></author><author><name sortKey="Vouloumanou, Ek" uniqKey="Vouloumanou E">EK Vouloumanou</name></author><author><name sortKey="Rafailidis, Pi" uniqKey="Rafailidis P">PI Rafailidis</name></author><author><name sortKey="Kapaskelis, Am" uniqKey="Kapaskelis A">AM Kapaskelis</name></author><author><name sortKey="Rello, J" uniqKey="Rello J">J Rello</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jefferson, T" uniqKey="Jefferson T">T Jefferson</name></author><author><name sortKey="Demicheli, V" uniqKey="Demicheli V">V Demicheli</name></author><author><name sortKey="Rivetti, D" uniqKey="Rivetti D">D Rivetti</name></author><author><name sortKey="Jones, M" uniqKey="Jones M">M Jones</name></author><author><name sortKey="Di Pietrantonj, C" uniqKey="Di Pietrantonj C">C Di Pietrantonj</name></author><author><name sortKey="Rivetti, A" uniqKey="Rivetti A">A Rivetti</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moscona, A" uniqKey="Moscona A">A Moscona</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yu, H" uniqKey="Yu H">H Yu</name></author><author><name sortKey="Liao, Q" uniqKey="Liao Q">Q Liao</name></author><author><name sortKey="Yuan, Y" uniqKey="Yuan Y">Y Yuan</name></author><author><name sortKey="Zhou, L" uniqKey="Zhou L">L Zhou</name></author><author><name sortKey="Xiang, N" uniqKey="Xiang N">N Xiang</name></author><author><name sortKey="Huai, Y" uniqKey="Huai Y">Y Huai</name></author><author><name sortKey="Guo, X" uniqKey="Guo X">X Guo</name></author><author><name sortKey="Zheng, Y" uniqKey="Zheng Y">Y Zheng</name></author><author><name sortKey="Van Doorn, Hr" uniqKey="Van Doorn H">HR van Doorn</name></author><author><name sortKey="Farrar, J" uniqKey="Farrar J">J Farrar</name></author><author><name sortKey="Gao, Z" uniqKey="Gao Z">Z Gao</name></author><author><name sortKey="Feng, Z" uniqKey="Feng Z">Z Feng</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Yang, W" uniqKey="Yang W">W Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harper, Sa" uniqKey="Harper S">SA Harper</name></author><author><name sortKey="Bradley, Js" uniqKey="Bradley J">JS Bradley</name></author><author><name sortKey="Englund, Ja" uniqKey="Englund J">JA Englund</name></author><author><name sortKey="File, Tm" uniqKey="File T">TM File</name></author><author><name sortKey="Gravenstein, S" uniqKey="Gravenstein S">S Gravenstein</name></author><author><name sortKey="Hayden, Fg" uniqKey="Hayden F">FG Hayden</name></author><author><name sortKey="Mcgeer, Aj" uniqKey="Mcgeer A">AJ McGeer</name></author><author><name sortKey="Neuzil, Km" uniqKey="Neuzil K">KM Neuzil</name></author><author><name sortKey="Pavia, At" uniqKey="Pavia A">AT Pavia</name></author><author><name sortKey="Tapper, Ml" uniqKey="Tapper M">ML Tapper</name></author><author><name sortKey="Uyeki, Tm" uniqKey="Uyeki T">TM Uyeki</name></author><author><name sortKey="Zimmerman, Rk" uniqKey="Zimmerman R">RK Zimmerman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aoki, Fy" uniqKey="Aoki F">FY Aoki</name></author><author><name sortKey="Macleod, Md" uniqKey="Macleod M">MD Macleod</name></author><author><name sortKey="Paggiaro, P" uniqKey="Paggiaro P">P Paggiaro</name></author><author><name sortKey="Carewicz, O" uniqKey="Carewicz O">O Carewicz</name></author><author><name sortKey="El Sawy, A" uniqKey="El Sawy A">A El Sawy</name></author><author><name sortKey="Wat, C" uniqKey="Wat C">C Wat</name></author><author><name sortKey="Griffiths, M" uniqKey="Griffiths M">M Griffiths</name></author><author><name sortKey="Waalberg, E" uniqKey="Waalberg E">E Waalberg</name></author><author><name sortKey="Ward, P" uniqKey="Ward P">P Ward</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baccam, P" uniqKey="Baccam P">P Baccam</name></author><author><name sortKey="Beauchemin, C" uniqKey="Beauchemin C">C Beauchemin</name></author><author><name sortKey="Macken, Ca" uniqKey="Macken C">CA Macken</name></author><author><name sortKey="Hayden, Fg" uniqKey="Hayden F">FG Hayden</name></author><author><name sortKey="Perelson, As" uniqKey="Perelson A">AS Perelson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falagas, Me" uniqKey="Falagas M">ME Falagas</name></author><author><name sortKey="Vouloumanou, Ek" uniqKey="Vouloumanou E">EK Vouloumanou</name></author><author><name sortKey="Baskouta, E" uniqKey="Baskouta E">E Baskouta</name></author><author><name sortKey="Rafailidis, Pi" uniqKey="Rafailidis P">PI Rafailidis</name></author><author><name sortKey="Polyzos, K" uniqKey="Polyzos K">K Polyzos</name></author><author><name sortKey="Rello, J" uniqKey="Rello J">J Rello</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gillissen, A" uniqKey="Gillissen A">A Gillissen</name></author><author><name sortKey="Hoffken, G" uniqKey="Hoffken G">G Hoffken</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hayden, Fg" uniqKey="Hayden F">FG Hayden</name></author><author><name sortKey="Osterhaus, Ad" uniqKey="Osterhaus A">AD Osterhaus</name></author><author><name sortKey="Treanor, Jj" uniqKey="Treanor J">JJ Treanor</name></author><author><name sortKey="Fleming, Dm" uniqKey="Fleming D">DM Fleming</name></author><author><name sortKey="Aoki, Fy" uniqKey="Aoki F">FY Aoki</name></author><author><name sortKey="Nicholson, Kg" uniqKey="Nicholson K">KG Nicholson</name></author><author><name sortKey="Bohnen, Am" uniqKey="Bohnen A">AM Bohnen</name></author><author><name sortKey="Hirst, Hm" uniqKey="Hirst H">HM Hirst</name></author><author><name sortKey="Keene, O" uniqKey="Keene O">O Keene</name></author><author><name sortKey="Wightman, K" uniqKey="Wightman K">K Wightman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ling, Lm" uniqKey="Ling L">LM Ling</name></author><author><name sortKey="Chow, Al" uniqKey="Chow A">AL Chow</name></author><author><name sortKey="Lye, Dc" uniqKey="Lye D">DC Lye</name></author><author><name sortKey="Tan, As" uniqKey="Tan A">AS Tan</name></author><author><name sortKey="Krishnan, P" uniqKey="Krishnan P">P Krishnan</name></author><author><name sortKey="Cui, L" uniqKey="Cui L">L Cui</name></author><author><name sortKey="Win, Nn" uniqKey="Win N">NN Win</name></author><author><name sortKey="Chan, M" uniqKey="Chan M">M Chan</name></author><author><name sortKey="Lim, Pl" uniqKey="Lim P">PL Lim</name></author><author><name sortKey="Lee, Cc" uniqKey="Lee C">CC Lee</name></author><author><name sortKey="Leo, Ys" uniqKey="Leo Y">YS Leo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cunney, Rj" uniqKey="Cunney R">RJ Cunney</name></author><author><name sortKey="Bialachowski, A" uniqKey="Bialachowski A">A Bialachowski</name></author><author><name sortKey="Thornley, D" uniqKey="Thornley D">D Thornley</name></author><author><name sortKey="Smaill, Fm" uniqKey="Smaill F">FM Smaill</name></author><author><name sortKey="Pennie, Ra" uniqKey="Pennie R">RA Pennie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Oliveira, Ec" uniqKey="Oliveira E">EC Oliveira</name></author><author><name sortKey="Lee, B" uniqKey="Lee B">B Lee</name></author><author><name sortKey="Colice, Gl" uniqKey="Colice G">GL Colice</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Salgado, Cd" uniqKey="Salgado C">CD Salgado</name></author><author><name sortKey="Farr, Bm" uniqKey="Farr B">BM Farr</name></author><author><name sortKey="Hall, Kk" uniqKey="Hall K">KK Hall</name></author><author><name sortKey="Hayden, Fg" uniqKey="Hayden F">FG Hayden</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Uyeki, Tm" uniqKey="Uyeki T">TM Uyeki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hurt, Ac" uniqKey="Hurt A">AC Hurt</name></author><author><name sortKey="Alexander, R" uniqKey="Alexander R">R Alexander</name></author><author><name sortKey="Hibbert, J" uniqKey="Hibbert J">J Hibbert</name></author><author><name sortKey="Deed, N" uniqKey="Deed N">N Deed</name></author><author><name sortKey="Barr, Ig" uniqKey="Barr I">IG Barr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rahman, M" uniqKey="Rahman M">M Rahman</name></author><author><name sortKey="Kieke, Ba" uniqKey="Kieke B">BA Kieke</name></author><author><name sortKey="Vandermause, Mf" uniqKey="Vandermause M">MF Vandermause</name></author><author><name sortKey="Mitchell, Pd" uniqKey="Mitchell P">PD Mitchell</name></author><author><name sortKey="Greenlee, Rt" uniqKey="Greenlee R">RT Greenlee</name></author><author><name sortKey="Belongia, Ea" uniqKey="Belongia E">EA Belongia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rothberg, Mb" uniqKey="Rothberg M">MB Rothberg</name></author><author><name sortKey="Haessler, Sd" uniqKey="Haessler S">SD Haessler</name></author><author><name sortKey="Brown, Rb" uniqKey="Brown R">RB Brown</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Crit Care</journal-id><journal-id journal-id-type="iso-abbrev">Crit Care</journal-id><journal-title-group><journal-title>Critical Care</journal-title></journal-title-group><issn pub-type="ppub">1364-8535</issn><issn pub-type="epub">1466-609X</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21798012</article-id><article-id pub-id-type="pmc">3387625</article-id><article-id pub-id-type="publisher-id">cc10331</article-id><article-id pub-id-type="doi">10.1186/cc10331</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>When should a diagnosis of influenza be considered in adults requiring intensive care unit admission? Results of population-based active surveillance in Toronto</article-title></title-group><contrib-group><contrib contrib-type="author" id="A1"><name><surname>Kuster</surname><given-names>Stefan P</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>spkuster@gmail.com</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Katz</surname><given-names>Kevin C</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I3">3</xref><email>kevin.katz@nygh.on.ca</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Blair</surname><given-names>Joanne</given-names></name><xref ref-type="aff" rid="I4">4</xref><email>joanne.blair@oahpp.ca</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Downey</surname><given-names>James</given-names></name><xref ref-type="aff" rid="I5">5</xref><email>jdown@tegh.on.ca</email></contrib><contrib contrib-type="author" id="A5"><name><surname>Drews</surname><given-names>Steven J</given-names></name><xref ref-type="aff" rid="I6">6</xref><email>steven.drews@albertahealthservices.ca</email></contrib><contrib contrib-type="author" id="A6"><name><surname>Finkelstein</surname><given-names>Sandy</given-names></name><xref ref-type="aff" rid="I7">7</xref><email>sfinkelstein@tsh.to</email></contrib><contrib contrib-type="author" id="A7"><name><surname>Fowler</surname><given-names>Rob</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I8">8</xref><email>rob.fowler@sunnybrook.ca</email></contrib><contrib contrib-type="author" id="A8"><name><surname>Green</surname><given-names>Karen</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>kgreen@mtsinai.on.ca</email></contrib><contrib contrib-type="author" id="A9"><name><surname>Gubbay</surname><given-names>Jonathan</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I4">4</xref><email>jonathan.gubbay@oahpp.ca</email></contrib><contrib contrib-type="author" id="A10"><name><surname>Hassan</surname><given-names>Kazi</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>khassan@mtsinai.on.ca</email></contrib><contrib contrib-type="author" id="A11"><name><surname>Lapinsky</surname><given-names>Stephen E</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I2">2</xref><email>slapinsky@mtsinai.on.ca</email></contrib><contrib contrib-type="author" id="A12"><name><surname>Mazzulli</surname><given-names>Tony</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I2">2</xref><email>tmazzulli@mtsinai.on.ca</email></contrib><contrib contrib-type="author" id="A13"><name><surname>McRitchie</surname><given-names>Donna</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I3">3</xref><email>dmcritch@nygh.on.ca</email></contrib><contrib contrib-type="author" id="A14"><name><surname>Pataki</surname><given-names>Janos</given-names></name><xref ref-type="aff" rid="I9">9</xref><email>jpataki@cvh.on.ca</email></contrib><contrib contrib-type="author" id="A15"><name><surname>Plevneshi</surname><given-names>Agron</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>aplevneshi@mtsinai.on.ca</email></contrib><contrib contrib-type="author" id="A16"><name><surname>Powis</surname><given-names>Jeff</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I5">5</xref><email>jpowi@tegh.on.ca</email></contrib><contrib contrib-type="author" id="A17"><name><surname>Rose</surname><given-names>David</given-names></name><xref ref-type="aff" rid="I7">7</xref><email>drose@tsh.to</email></contrib><contrib contrib-type="author" id="A18"><name><surname>Sarabia</surname><given-names>Alicia</given-names></name><xref ref-type="aff" rid="I9">9</xref><email>asarabia@cvh.on.ca</email></contrib><contrib contrib-type="author" id="A19"><name><surname>Simone</surname><given-names>Carmine</given-names></name><xref ref-type="aff" rid="I5">5</xref><email>csimo@tegh.on.ca</email></contrib><contrib contrib-type="author" id="A20"><name><surname>Simor</surname><given-names>Andrew</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I8">8</xref><email>andrew.simor@sunnybrook.ca</email></contrib><contrib contrib-type="author" corresp="yes" id="A21"><name><surname>McGeer</surname><given-names>Allison</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I2">2</xref><email>amcgeer@mtsinai.on.ca</email></contrib></contrib-group><aff id="I1"><label>1</label>Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada</aff><aff id="I2"><label>2</label>University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada</aff><aff id="I3"><label>3</label>North York General Hospital, 4001 Leslie Street, Toronto, ON, M2K 1E1, Canada</aff><aff id="I4"><label>4</label>Ontario Agency for Health Protection and Promotion, 81 Resources Road, Toronto, ON, M9P 3T1, Canada</aff><aff id="I5"><label>5</label>Toronto East General Hospital, 825 Coxwell Avenue, Toronto, ON, M4C 3E7, Canada</aff><aff id="I6"><label>6</label>ProvLab Calgary, University of Calgary, 3030 Hospital Drive NW, Calgary, AB, T2N 4W4, Canada</aff><aff id="I7"><label>7</label>The Scarborough Hospital, 3030 Birchmount Road, Toronto, ON, M1W 3W3, Canada</aff><aff id="I8"><label>8</label>Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada</aff><aff id="I9"><label>9</label>Credit Valley Hospital, 2200 Eglinton Avenue West Mississauga, Mississauga, ON, L5M 2N1, Canada</aff><pub-date pub-type="ppub"><year>2011</year></pub-date><pub-date pub-type="epub"><day>28</day><month>7</month><year>2011</year></pub-date><volume>15</volume><issue>4</issue><fpage>R182</fpage><lpage>R182</lpage><history><date date-type="received"><day>22</day><month>3</month><year>2011</year></date><date date-type="rev-recd"><day>14</day><month>6</month><year>2011</year></date><date date-type="accepted"><day>28</day><month>7</month><year>2011</year></date></history><permissions><copyright-statement>Copyright ©2011 Kuster et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2011</copyright-year><copyright-holder>Kuster et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://ccforum.com/content/15/4/R182"></self-uri><abstract><sec><title>Introduction</title><p>There is a paucity of data about the clinical characteristics that help identify patients at high risk of influenza infection upon ICU admission. We aimed to identify predictors of influenza infection in patients admitted to ICUs during the 2007/2008 and 2008/2009 influenza seasons and the second wave of the 2009 H1N1 influenza pandemic as well as to identify populations with increased likelihood of seasonal and pandemic 2009 influenza (pH1N1) infection.</p></sec><sec><title>Methods</title><p>Six Toronto acute care hospitals participated in active surveillance for laboratory-confirmed influenza requiring ICU admission during periods of influenza activity from 2007 to 2009. Nasopharyngeal swabs were obtained from patients who presented to our hospitals with acute respiratory or cardiac illness or febrile illness without a clear nonrespiratory aetiology. Predictors of influenza were assessed by multivariable logistic regression analysis and the likelihood of influenza in different populations was calculated.</p></sec><sec><title>Results</title><p>In 5,482 patients, 126 (2.3%) were found to have influenza. Admission temperature ≥38°C (odds ratio (OR) 4.7 for pH1N1, 2.3 for seasonal influenza) and admission diagnosis of pneumonia or respiratory infection (OR 7.3 for pH1N1, 4.2 for seasonal influenza) were independent predictors for influenza. During the peak weeks of influenza seasons, 17% of afebrile patients and 27% of febrile patients with pneumonia or respiratory infection had influenza. During the second wave of the 2009 pandemic, 26% of afebrile patients and 70% of febrile patients with pneumonia or respiratory infection had influenza.</p></sec><sec><title>Conclusions</title><p>The findings of our study may assist clinicians in decision making regarding optimal management of adult patients admitted to ICUs during future influenza seasons. Influenza testing, empiric antiviral therapy and empiric infection control precautions should be considered in those patients who are admitted during influenza season with a diagnosis of pneumonia or respiratory infection and are either febrile or admitted during weeks of peak influenza activity.</p></sec></abstract></article-meta><notes><p>See related letter by Holmes et al., <ext-link ext-link-type="uri" xlink:href="http://ccforum.com/content/16/1/401">http://ccforum.com/content/16/1/401</ext-link></p></notes></front></pmc><affiliations><list><country><li>Canada</li></country><region><li>Alberta</li><li>Ontario</li></region><settlement><li>Calgary</li><li>Toronto</li></settlement><orgName><li>Université de Calgary</li><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Kuster, Stefan P" sort="Kuster, Stefan P" uniqKey="Kuster S" first="Stefan P" last="Kuster">Stefan P. Kuster</name></noRegion><name sortKey="Blair, Joanne" sort="Blair, Joanne" uniqKey="Blair J" first="Joanne" last="Blair">Joanne Blair</name><name sortKey="Downey, James" sort="Downey, James" uniqKey="Downey J" first="James" last="Downey">James Downey</name><name sortKey="Drews, Steven J" sort="Drews, Steven J" uniqKey="Drews S" first="Steven J" last="Drews">Steven J. Drews</name><name sortKey="Finkelstein, Sandy" sort="Finkelstein, Sandy" uniqKey="Finkelstein S" first="Sandy" last="Finkelstein">Sandy Finkelstein</name><name sortKey="Fowler, Rob" sort="Fowler, Rob" uniqKey="Fowler R" first="Rob" last="Fowler">Rob Fowler</name><name sortKey="Fowler, Rob" sort="Fowler, Rob" uniqKey="Fowler R" first="Rob" last="Fowler">Rob Fowler</name><name sortKey="Green, Karen" sort="Green, Karen" uniqKey="Green K" first="Karen" last="Green">Karen Green</name><name sortKey="Gubbay, Jonathan" sort="Gubbay, Jonathan" uniqKey="Gubbay J" first="Jonathan" last="Gubbay">Jonathan Gubbay</name><name sortKey="Gubbay, Jonathan" sort="Gubbay, Jonathan" uniqKey="Gubbay J" first="Jonathan" last="Gubbay">Jonathan Gubbay</name><name sortKey="Hassan, Kazi" sort="Hassan, Kazi" uniqKey="Hassan K" first="Kazi" last="Hassan">Kazi Hassan</name><name sortKey="Katz, Kevin C" sort="Katz, Kevin C" uniqKey="Katz K" first="Kevin C" last="Katz">Kevin C. Katz</name><name sortKey="Katz, Kevin C" sort="Katz, Kevin C" uniqKey="Katz K" first="Kevin C" last="Katz">Kevin C. Katz</name><name sortKey="Lapinsky, Stephen E" sort="Lapinsky, Stephen E" uniqKey="Lapinsky S" first="Stephen E" last="Lapinsky">Stephen E. Lapinsky</name><name sortKey="Lapinsky, Stephen E" sort="Lapinsky, Stephen E" uniqKey="Lapinsky S" first="Stephen E" last="Lapinsky">Stephen E. Lapinsky</name><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Mcritchie, Donna" sort="Mcritchie, Donna" uniqKey="Mcritchie D" first="Donna" last="Mcritchie">Donna Mcritchie</name><name sortKey="Mcritchie, Donna" sort="Mcritchie, Donna" uniqKey="Mcritchie D" first="Donna" last="Mcritchie">Donna Mcritchie</name><name sortKey="Pataki, Janos" sort="Pataki, Janos" uniqKey="Pataki J" first="Janos" last="Pataki">Janos Pataki</name><name sortKey="Plevneshi, Agron" sort="Plevneshi, Agron" uniqKey="Plevneshi A" first="Agron" last="Plevneshi">Agron Plevneshi</name><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><name sortKey="Powis, Jeff" sort="Powis, Jeff" uniqKey="Powis J" first="Jeff" last="Powis">Jeff Powis</name><name sortKey="Rose, David" sort="Rose, David" uniqKey="Rose D" first="David" last="Rose">David Rose</name><name sortKey="Sarabia, Alicia" sort="Sarabia, Alicia" uniqKey="Sarabia A" first="Alicia" last="Sarabia">Alicia Sarabia</name><name sortKey="Simone, Carmine" sort="Simone, Carmine" uniqKey="Simone C" first="Carmine" last="Simone">Carmine Simone</name><name sortKey="Simor, Andrew" sort="Simor, Andrew" uniqKey="Simor A" first="Andrew" last="Simor">Andrew Simor</name><name sortKey="Simor, Andrew" sort="Simor, Andrew" uniqKey="Simor A" first="Andrew" last="Simor">Andrew Simor</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/PandemieGrippaleV1/Data/Pmc/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000776 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd -nk 000776 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= PandemieGrippaleV1
|flux= Pmc
|étape= Checkpoint
|type= RBID
|clé= PMC:3387625
|texte= When should a diagnosis of influenza be considered in adults requiring intensive care unit admission? Results of population-based active surveillance in Toronto
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/RBID.i -Sk "pubmed:21798012" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd \
| NlmPubMed2Wicri -a PandemieGrippaleV1
| This area was generated with Dilib version V0.6.34. |  |