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Correspondence
Community Transmission of Oseltamivir-Resistant A(H1N1)pdm09 Influenza
To the Editor: Oseltamivir-resistant prepandemic seasonal influenza A (H1N1) viruses with a H275Y neuraminidase substitution spread globally in 2008, reducing the effectiveness of oseltamivir. Although oseltamivir-resistant pandemic 2009 A (H1N1) viruses, now known as A(H1N1)pdm09, have been…
- December 29, 2011
- N Engl J Med 2011; 365:2541-2542
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Community circulation of an oseltamivir-resistant strain of the novel pandemic influenza A (H1N1) virus has been identified in Australia.
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Clinical Implications of Basic Research
Stalking Influenza Diversity with a Universal Antibody
The back-and-forth battle between influenza viruses and humans is defined by diversity. We fight previously unseen pathogens with a diverse repertoire of antibodies, and influenza viruses evade our immune system by presenting us with diverse surface-protein sequences. Corti and colleagues have…
- October 20, 2011
- Russell C.J.
- N Engl J Med 2011; 365:1541-1542
The genetic shifts and drifts of the influenza virus pose an obstacle to designing antiviral agents and vaccines that are effective over the long term. However, a recent study suggests that this goal is attainable.
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Original Article
Oil-in-Water Emulsion Adjuvant with Influenza Vaccine in Young Children
Children have the highest rates of seasonal influenza infection and illness, with amplification of community viral transmission. Thus, numerous countries recommend routine seasonal vaccination to protect children directly and the entire population indirectly.– Parenteral trivalent inactivated…
- October 13, 2011
- Vesikari T., Knuf M., Wutzler P., et al.
- N Engl J Med 2011; 365:1406-1416
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Over two influenza seasons, 4707 children were randomly assigned to either control (noninfluenza) vaccines or trivalent influenza vaccines with or without adjuvant MF59. The vaccine with MF59 proved efficacious in this vulnerable population.
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Original Article
Safety of Influenza A (H1N1) Vaccine in Postmarketing Surveillance in China
Since the outbreak of the pandemic influenza A (H1N1) virus in 2009, nations around the world have produced a vaccine against this virus. During the summer of 2009, 10 Chinese vaccine manufacturers used the same reassortant strain X-179A (A/California/07/2009-A/PR/8/34) as the seed virus to produce…
- February 17, 2011
- Liang X.-F., Li L., Liu D.-W., et al.
- N Engl J Med 2011; 364:638-647
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With the emergence of the pandemic influenza A (H1N1) strain in 2009, a vaccine was rapidly developed. In this report from the Chinese Center for Disease Control and Prevention, no significant pattern of safety events was observed after nearly 90 million doses were administered.
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Correspondence
Pediatric Hospitalizations Due to Influenza in 2010 in Argentina
To the Editor: Much concern has been raised about the upcoming 2010–2011 flu season in the Northern Hemisphere. In preparation for this event, we investigated the burden of influenza during the 2010 season in the Southern Hemisphere in the same hospitals involved in our report in the Journal (Jan.…
- December 16, 2010
- N Engl J Med 2010; 363:2472-2473
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To the Editor: Much concern has been raised about the upcoming 2010–2011 flu season in the Northern Hemisphere. In preparation for this event, we investigated the burden of influenza during the 2010 season in the Southern Hemisphere in the same hospitals ...
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Perspective
Influenza Vaccine — Safe, Effective, and Mistrusted
On August 10, 2010, the World Health Organization (WHO) declared an end to the 2009 influenza A (H1N1) pandemic. It is fortunate that the virus that had spread worldwide so quickly turned out to be less severe than was first feared. It is worth remembering, though, that an earlier strain of H1N1…
- December 2, 2010
- Harris K.M., Maurer J., Kellermann A.L.
- N Engl J Med 2010; 363:2183-2185
On August 10, 2010, the World Health Organization (WHO) declared an end to the 2009 influenza A (H1N1) pandemic. It is fortunate that the virus that had spread worldwide so quickly turned out to be less severe than was first feared. It is worth ...
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Review Article
Current Concepts: Influenza Vaccines for the Future
Each year, seasonal epidemics of influenza cause serious illness and death throughout the world. In the United States, the annual burden of disease is estimated to be 25 million to 50 million cases of influenza, resulting in an average of 225,000 hospitalizations. Over the past three decades, the…
- November 18, 2010
- Lambert L.C. and Fauci A.S.
- N Engl J Med 2010; 363:2036-2044
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- CME
New technologies can revolutionize influenza vaccine design, production, and delivery. In the near future, advances should reduce vaccine production time, provide enhanced protection, and end mismatches between vaccine strains and circulating viruses.
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Correspondence
Emergence of a Multidrug-Resistant Pandemic Influenza A (H1N1) Virus
To the Editor: Since the outbreak of influenza A (H1N1) virus pandemic, almost 300 cases of infection with an oseltamivir-resistant influenza virus have been reported to the World Health Organization as of June 2010. These strains typically contain a single histidine-to-tyrosine substitution at…
- September 30, 2010
- N Engl J Med 2010; 363:1381-1382
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To the Editor: Since the outbreak of influenza A (H1N1) virus pandemic, almost 300 cases of infection with an oseltamivir-resistant influenza virus have been reported to the World Health Organization as of June 2010.¹ These strains typically contain a ...
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Perspective
Enrolling Pregnant Women in Research — Lessons from the H1N1 Influenza Pandemic
The global H1N1 influenza pandemic disproportionately affected pregnant women, drawing attention to the fact that although they need safe and effective medical treatment, they have always been a marginalized study population. Antiviral agents for treating influenza have been available in the United…
- June 17, 2010
- Goldkind S.F., Sahin L., Gallauresi B.
- N Engl J Med 2010; 362:2241-2243
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The global H1N1 influenza pandemic disproportionately affected pregnant women, drawing attention to the fact that they have always been a marginalized study population. Dr. Sara Goldkind and colleagues argue that it is imperative that pregnant women be ...
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Original Article
Oseltamivir Ring Prophylaxis for Containment of 2009 H1N1 Influenza Outbreaks
The 2009 pandemic influenza A (H1N1) virus has spread rapidly worldwide, despite initial attempts at containment through screening, isolation, and quarantine.– Many countries moved rapidly into the mitigation phase after the outbreak was detected, which affected essential services, especially in…
- June 10, 2010
- Lee V.J., Yap J., Cook A.R., et al.
- N Engl J Med 2010; 362:2166-2174
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Control of the 2009 pandemic influenza A (H1N1) virus has been a difficult challenge. In this article, ring prophylaxis (geographically targeted containment by means of prophylaxis) with oseltamivir (75 mg per day for 10 days) was shown to substantially curtail four outbreaks involving 1175 personnel in the Singapore military. There were 75 cases before intervention and 7 after intervention. The overall reproductive number (the number of new cases attributable to the index case) was reduced from 1.91 before intervention to 0.11 after intervention.
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Original Article
Comparative Epidemiology of Pandemic and Seasonal Influenza A in Households
Households are thought to play a major role in the community spread of influenza virus during annual epidemics and occasional pandemics.– As the pandemic 2009 influenza A (H1N1) virus (hereafter called pandemic virus) spread across the world, many countries implemented mitigation policies,…
- June 10, 2010
- Cowling B.J., Chan K.H., Fang V.J., et al.
- N Engl J Med 2010; 362:2175-2184
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Pandemic 2009 influenza A (H1N1) virus has caused substantial disease around the world during the past year. In this study from Hong Kong, investigators show that the pandemic and seasonal influenza A viruses behave in a similar manner with respect to the pattern of illness, viral shedding, and secondary attack rates.
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Editorial
2009 H1N1 Virus Transmission and Outbreaks
The emergence of 2009 pandemic influenza A (H1N1) virus prompted early questions about how the virus was spreading and how easily it was transmitted, along with uncertainty about disease severity, clinical complications and risk factors for severe disease, and the effectiveness of antiviral…
- June 10, 2010
- Uyeki T.M.
- N Engl J Med 2010; 362:2221-2223
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The emergence of 2009 pandemic influenza A (H1N1) virus prompted early questions about how the virus was spreading and how easily it was transmitted, along with uncertainty about disease severity, clinical complications and risk factors for severe disease,...
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Perspective
The Public's Response to the 2009 H1N1 Influenza Pandemic
In April 2009, a novel influenza A (H1N1) virus emerged in the United States with the key characteristics of a pandemic virus, and within weeks it had spread to every region in the country. Ultimately, the rate of death was lower than was initially predicted, but the numbers of H1N1 cases,…
- June 3, 2010
- SteelFisher G.K., Blendon R.J., Bekheit M.M., Lubell K.
- N Engl J Med 2010; 362:e65
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In April 2009, a novel influenza A (H1N1) virus emerged in the United States with the key characteristics of a pandemic virus, and within weeks it had spread to every region in the country.¹ Ultimately, the rate of death was lower than was initially ...
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Special Report
Information Technology and Global Surveillance of Cases of 2009 H1N1 Influenza
The widespread adoption of increasingly sophisticated forms of information technology has paralleled the increase in rapid and far-reaching international travel. The emergence and global spread of the 2009 pandemic influenza A (H1N1) virus illustrated not only the hazards of an interconnected world,…
- May 6, 2010
- Brownstein J.S., Freifeld C.C., Chan E.H., et al.
- N Engl J Med 2010; 362:1731-1735
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- Interactive/Multimedia
Real-time forms of technology online are creating new ways to detect and track emerging disease threats, even weak signals from diverse areas.
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Review Article
Medical Progress: Clinical Aspects of Pandemic 2009 Influenza A (H1N1) Virus Infection
During the spring of 2009, a novel influenza A (H1N1) virus of swine origin caused human infection and acute respiratory illness in Mexico. After initially spreading among persons in the United States and Canada,, the virus spread globally, resulting in the first influenza pandemic since 1968 with…
- May 6, 2010
- Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza
- N Engl J Med 2010; 362:1708-1719
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As of March 2010, illness caused by the 2009 H1N1 virus had occurred in almost all countries, with more than 16,000 deaths from laboratory-confirmed cases reported to the World Health Organization (WHO). The United States saw an estimated 59 million pandemic H1N1 illnesses, 265,000 hospitalizations, and 12,000 deaths. This review by WHO experts summarizes the virologic, epidemiologic, and clinical data on the 2009 H1N1 virus and assesses future directions.
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Correspondence
Influenza Immunization in Pregnancy — Antibody Responses in Mothers and Infants
To the Editor: Though the use of seasonal trivalent inactivated influenza vaccines is recommended in pregnancy, there are few data on the immunogenicity of current vaccine formulations in pregnant women or on the duration of passive protection in their infants. We present antibody data for mothers…
- April 29, 2010
- N Engl J Med 2010; 362:1644-1646
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The authors present antibody data for mothers and infants from a trial of influenza vaccine in pregnant women. The observations suggest that maternal immunization results in the presence of antibody titers against influenza A vaccine subtypes in a high ...
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Correspondence
Comparative Efficacy of Influenza Vaccines
To the Editor: In their study comparing the efficacy of two vaccines against influenza types A and B, Monto et al. (Sept. 24 issue) report that the absolute efficacy against both types of influenza was 68% for the trivalent inactivated vaccine and 36% for the live attenuated vaccine. The term…
- January 14, 2010
- N Engl J Med 2010; 362:179-181
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To the Editor: In their study comparing the efficacy of two vaccines against influenza types A and B, Monto et al. (Sept. 24 issue)¹ report that the absolute efficacy against both types of influenza was 68% for the trivalent inactivated vaccine and 36% ...
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Correspondence
A Community Cluster of Oseltamivir-Resistant Cases of 2009 H1N1 Influenza
To the Editor: Oseltamivir-resistant infection with the 2009 pandemic influenza A (H1N1) virus has so far been described only rarely and is conferred by the H275Y substitution in the neuraminidase enzyme. Only 3 of the 32 patients with oseltamivir-resistant infection reported on as of this writing…
- January 7, 2010
- N Engl J Med 2010; 362:86-87
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To the Editor: Oseltamivir-resistant infection with the 2009 pandemic influenza A (H1N1) virus has so far been described only rarely and is conferred by the H275Y substitution in the neuraminidase enzyme.¹ Only 3 of the 32 patients with oseltamivir-...
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Original Article
Pediatric Hospitalizations Associated with 2009 Pandemic Influenza A (H1N1) in Argentina
Three times in the past century, pandemic influenza viruses have circulated globally and caused increased morbidity and mortality among persons who were not generally at risk for severe seasonal influenza. In March 2009, a new strain of pandemic influenza A (H1N1) virus emerged in Mexico, where it…
- January 7, 2010
- Libster R., Bugna J., Coviello S., et al.
- N Engl J Med 2010; 362:45-55
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In the global 2009 H1N1 influenza pandemic, children are particularly vulnerable to severe disease. During the winter (May through July 2009) in Buenos Aires, the death rate associated with 2009 H1N1 influenza in children was 10 times that associated with seasonal influenza in 2007 (1.1 vs. 0.1 per 100,000 children).
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Original Article
Severe 2009 H1N1 Influenza in Pregnant and Postpartum Women in California
As in previous influenza epidemics and pandemics, pregnant women with 2009 pandemic influenza A (H1N1) appear to have an increased risk of severe disease.– From April 23 to August 11, 2009, a total of 10% of the 1088 patients who were hospitalized with or died from 2009 H1N1 influenza, as…
- January 7, 2010
- Louie J.K., Acosta M., Jamieson D.J., Honein M.A.
- N Engl J Med 2010; 362:27-35
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Pregnant women are at increased risk for clinically significant complications associated with influenza infection. This study analyzed data reported for 239 women of reproductive age who were hospitalized with 2009 H1N1 influenza in California between April 23 and August 11, 2009; 94 were pregnant and 8 were postpartum. Intensive care was required in 18 pregnant women and 4 postpartum women, and 8 died. Infection with the 2009 H1N1 virus can cause significant morbidity and mortality in pregnant and postpartum women.
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Medical Meetings Pediatrics Conferences and Meetings

2012 Certifying Examinations of the American Board of Pediatrics

The general pediatrics examination will be held in various cities, Oct. 16-18. Registration for first-time applicants is ongoing through May 3. Registration for re-registrants is ongoing through May 24. The following subspecialty examinations will be held in various cities: "Hospice and Palliative Medicine" (Oct. 4); "Pediatric Transplant Hepatology" (Oct. 11); "Pediatric Cardiology" (Nov. 7); "Pediatric Pulmonology" (Nov. 8); "Medical Toxicology" (Nov. 12); and "Pediatric Critical Care Medicine" (Nov. 14). Registration for first-time applicants is ongoing through April 30. Registration for re-registrants is ongoing through June 15.

Contact the American Board of Pediatrics, 111 Silver Cedar Court, Chapel Hill, NC 27514-1513; or call (919) 929-0461; or fax (919) 918-7114 or (919) 929-9255; or see http://www.abp.org .

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