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than the general population (RR = 1.70, 95 percent CI 1.51-192 p 0.0000). Of the 85 pregnant women hospitalized, 30 deaths were confirmed cases of 2009-H1N1 influenza A, of which 19 developed pneumonia and acute respiratory distress, and 9 required mechanical ventilation in the intensive care unit. The rest of the fatalities were studied by examining medical records following the instrument suggested by WHO and with modifications by PAHO consultants used in Chile. It was applied to 246 deaths in various localities. The underlying conditions predominated in all age groups, ranging from 62 to 93 percent (Figure A13-15).

Figure A13-16 shows the time elapsed between the onset of disease and death, which stands between the date of onset of symptoms and the start of antiviral treatment, which was 6.1 days on average; despite query, the health system treatment implementation was delayed 3.5 days (Figures A13-16 and A13-17). Only 23 percent of deaths showed no underlying conditions. For the age groups and underlying conditions presented, it is shown that the group under 15 years of age predominated neonatal pathology, oncology, immune deficiency, neurological, and congenital conditions. In the 15- to 44-year-old group, obesity, oncology, immune deficiency, and pregnancy predominated. In the 45-year old and over group, metabolic, immune deficiency, and oncology were the most frequent underlying conditions (Table A13-1).

In order to determine the secondary attack rate, a telephone survey was performed, collecting information from1 in 10 confirmed cases (subjects who

FIGURE A13-15 Fatal cases by underlying conditions and age.

FIGURE A13-15 Fatal cases by underlying conditions and age.

SOURCE: Ministry of Health National Surveillance System.



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