Prevention and Treatment of Seasonal Influenza

In February 2007, fever developed in a previously healthy 15-year-old girl, with a peak temperature of 102°F (38.9°C) and mild upper respiratory congestion. The next day she was seen by her primary care physician. A rapid screening test for group A streptococcus was negative, and oseltamivir was prescribed. After two doses, she continued to have fever and also had nausea and emesis, malaise, and restlessness but could not get out of bed. Two days later, she was taken to the local emergency room, where she was found to be hypotensive. Despite intensive resuscitative efforts, she died 12 hours later; the postmortem examination showed necrotizing pneumonia and extensive alveolar hemorrhage. A viral culture confirmed an influenza A (H1N1) infection, and methicillin-resistant Staphylococcus aureus was isolated from a tracheal aspirate. Could this death have been prevented? Copyright © 2008 Massachusetts Medical Society.