Intended for healthcare professionals

Letters A/H1N1 flu pandemic

A/H1N1 and other viruses affecting cystic fibrosis

BMJ 2009; 339 doi: (Published 29 September 2009) Cite this as: BMJ 2009;339:b3958
  1. Paul Whitaker, SpR in respiratory medicine1,
  2. Christine Etherington, associate specialist1,
  3. Miles Denton, consultant microbiologist2,
  4. Steven Conway, consultant physician1,
  5. Daniel Peckham, consultant physician1
  1. 1Regional Adult Cystic Fibrosis Unit, St James’s Hospital, Leeds LS9 7TF
  2. 2Department of Microbiology, Leeds General Infirmary, Leeds LS1 3EX
  1. drpaulwhitaker{at}

    For over 12 months all patients attending our regional cystic fibrosis unit have had throat swabs analysed routinely for viruses with the polymerase chain reaction before starting intravenous antibiotics. We assessed the prevalence of A/H1N1 flu virus1 in acute severe exacerbations of cystic fibrosis.

    The first case of A/H1N1 flu in Leeds was confirmed on the 7 June 2009. Since then, 187 adult patients have had pulmonary exacerbations requiring intravenous antibiotics. Fifteen had positive viral swabs. Four of them tested positive for A/H1N1 flu virus, one of whom was immunosuppressed after lung transplantation and presented with fever, breathlessness, vomiting, and headache. Eight patients were positive for rhinovirus, two for adenovirus, and one for parainfluenza virus. Repeat swabs remained positive in two patients with A/H1N1 flu virus four and six weeks later.

    A/H1N1 flu virus has caused only a few acute pulmonary exacerbations of cystic fibrosis. If the prevalence of viral infections was similar in the community, antiviral drugs are likely to have been overprescribed and people might decline vaccination because they believe that they have already had the infection. Prolonged infection in at risk patients needs further investigation2 but shows the importance of vaccination in vulnerable groups.


    Cite this as: BMJ 2009;339:b3958


    • Competing interests: None declared.