Pandemic influenza: diagnosis and treatment in adults

Although the course of pandemic (H1N1) 2009 virus infection is self-limited in most cases, patients may progress to a more severe illness with complications or fatal outcomes. For laboratory diagnosis of pandemic H1N1 2009 virus infection, the guidance on convenient specimen collection and appropriate transport conditions is essential. While rapid diagnostics tests, direct fluorescent antibody testing, isolation of virus and real-time-reverse transcriptase polymerase chain reaction (RT-PCR) have been used for diagnosis, RT-PCR is recommended for confirmation of H1N1 2009 infection. Clinical management of patients based on necessity for hospitalization and treatment indication is crucial. If antiviral treatment is indicated, oseltamivir is recommended for treatment of adults and children aged one year and older. If oseltamivir is not available or not possible to use or if resistance to oseltamivir exists, patients should be treated with zanamivir in case the virus is known or likely to be susceptible to zanamivir. Main principals for clinical management should also include symptomatic and supportive care, treatment of complications and co-infections. In this review article, laboratory diagnosis and treatment recommendations of H1N1 2009 was discussed.