LAUSR

To the editor: We read with concern the reports of two human cases infected with swine influenza virus (SIV) that both occurred in October 2016 in Europe [1,2]. One case was a school-aged child in the Netherlands with history of eczema, while the other was a middle-aged man in Italy with obesity as underlying condition. The similarities of these cases were striking: both developed severe respiratory symptoms with a rapid progression, finally requiring admission to intensive care and use of extracorporeal membrane oxygenation (ECMO). Antiviral treatment was initiated in both cases more than three days after onset of symptoms, and only after the symptoms worsened, invasive mechanical ventilation and ECMO support were initiated. Both cases recovered and were discharged from hospital.