Perbedaan Gambaran Klinis Influenza-Like Illness (ILI) antara Influenza A H1n1, A H3n2, B dan Non Influenza pada Pasien Dewasa

Abstract

ABSTRACT Background Influenza remains a global health problem with a high mortality and morbidity rates. Clinical diagnosis of influenza using ILI criteria is still the preffered method. Although the clinical feature of influenza has been studied in detail, but the differences between influenza subtype clinical feature remains unclear. OBJECTIVE To find out the differences of ILI clinical feature due to influenza A H1N1, A H3N2, B and non-influenza in adult patients METHOD Research carried out retrospectively starting from September 2009 until January 2009. We collect the ILI patients’ medical record which consulted at Tropical and Infectious Disease Clinic at Haji Adam Malik Hospital during September 2004 until April 2008. The data obtained from medical record were anamnesis, physical examination, the results of PCR test, rapid test and culture isolation of the virus. Based on PCR results, the subjects were divided into four groups: influenza A H1N1, A H3N2, B and non-influenza. Furthermore, the comparison was made between the subtypes clinical features. RESULT Total number of research subjects were 666 patients comprises of influenza A H1N1 32 patients, A H3N2 119 patients, B 41 patients and non-influenza 474 patients. Influenza A H3N2 was more severe than influenza A H1N1, influenza B and non influenza in terms of sore throat, hoarseness, decrease of appetite and had fever with a higher temperature. CONCLUSION Clinical features of ILI caused by influenza A H3N2 is more severe than influenza A H1N1, influenza B and non influenza in terms of sore throat, hoarseness, decrease of appetite and had a fever with a higher temperature

Latar Belakang Influenza tetap merupakan suatu masalah kesehatan global dengan angka mortalitas dan morbiditas yang tinggi. Diagnosis secara klinis dengan kriteria ILI masih merupakan pilihan utama. Meskipun gambaran klinis influenza telah dipelajari secara rinci, namun data perbedaan gambaran klinis antar subtipe influenza di Indonesia masih belum ada. Tujuan Untuk mengetahui perbedaan gambaran klinis ILI antara influenza A H1N1, A H3N2, B dan non influenza pada pasien dewasa Metode Penelitian dilakukan dengan metode retrospektif pada bulan September 2008 sampai dengan bulan Juni 2009. Data rekam medik pasien ILI yang berobat ke Poliklinik Penyakit Tropis dan Infeksi RSUP Haji Adam Malik Medan periode September 2004 sampai dengan April 2008 dikumpulkan dan dimasukkan dalam penelitian. Dari rekam medik diambil data mengenai anamnesis penyakit, pemeriksaan fisik, hasil pemeriksaan PCR, rapid test dan isolasi virus. Selanjutnya subjek dibagi dalam 4 kelompok sesuai dengan hasil pemeriksaan PCR yaitu kelompok influenza A H1N1, A H3N1, B dan non influenza. Dilakukan pembandingan gambaran klinis antara keempat kelompok tersebut. Hasil Jumlah total pasien ILI sebanyak 666 pasien dengan perincian influenza A H1N1 sebanyak 32 orang, A H3N2 119 orang, B sebanyak 41 orang dan non influenza 474 orang. Influenza A H3N2 lebih berat dibandingkan dengan ketiga kelompok yang lainnya dalam hal keluhan suara serak, sakit menelan, tidak nafsu makan dan mengalami demam dengan temperatur yang lebih tinggi. Kesimpulan Penelitian ini menemukan bahwa gambaran klinis ILI akibat influenza A H3N2 lebih berat dibandingkan dengan influenza A H1N1, B dan non influen za.