Burden of Influenza in Children in the Community

Heikkinen, Terho; Silvennoinen, Heli; Peltola, Ville; Ziegler, Thedi; Vainionpää, Raija; Vuorinen, Tytti; Kainulainen, Leena; Puhakka, Tuomo; Jartti, Tuomas; Toikka, Pia; Lehtinen, Pasi; Routi, Taina; Juvén, Taina

doi:10.1086/424527

Cited by 245 publications

(218 citation statements)

References 28 publications

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“…The symptoms were least accurate among children aged less than one year. This finding is in accordance with the clinical experience of diagnosis of respiratory infections among infants, although the burden of influenza is greater in this age group [23,24] . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 9 In the present study, influenza infection was identified in 18% of children aged 6 months to 14 years who were hospitalized with fever and/or respiratory symptoms.…”

Section: Discussionsupporting

confidence: 91%

Performance of rapid influenza testing in hospitalized children

Stripeli

Sakkou

Papadopoulos

et al. 2010

Eur J Clin Microbiol Infect Dis

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Section: Discussionsupporting

confidence: 91%

Performance of rapid influenza testing in hospitalized children

Stripeli

Sakkou

Papadopoulos

et al. 2010

Eur J Clin Microbiol Infect Dis

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“…Although estimated rates may be difficult to compare because of differences in study design, populations studied, seasons included, and geography, rate ratios between age groups should be similar. Here our findings are consistent with those from other studies12, 14, 15, 16, 17, 23: Young children bear the brunt of the outpatient influenza burden. Finally, although our study included >7 million persons, a larger population than other US studies, all data were from integrated health systems.…”

Section: Discussionsupporting

confidence: 93%

“…By contrast, influenza‐associated outpatient visits are plentiful, so rates of laboratory‐confirmed visits should be easier to document. However, relatively few studies have made population‐based estimates of influenza‐confirmed outpatient visit rates 12, 13, 14, 15, 16, 17. Most have focused on children, typically in a single site 12, 14, 15, 16, 17.…”

Section: Introductionmentioning

confidence: 99%

“…While a key characteristic of influenza is season‐to‐season variability in intensity and severity, most studies have focused on a few seasons,12, 13, 17, 18 or reported summary estimates from multiple seasons 14, 15, 16. Finally, studies testing for influenza per protocol are not common,12, 13, 15, 17 as prospective studies are resource‐intensive. Thus, such studies are rarely conducted in large populations including persons of all ages, in multiple sites, or during multiple influenza seasons.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Estimated rates of influenza‐associated outpatient visits during 2001‐2010 in 6 US integrated healthcare delivery organizations

Zhou

Thompson

Belongia

et al. 2018

Influenza Resp Viruses

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BackgroundPopulation‐based estimates of influenza‐associated outpatient visits including both pandemic and interpandemic seasons are uncommon. Comparisons of such estimates with laboratory‐confirmed rates of outpatient influenza are rare.ObjectiveTo estimate influenza‐associated outpatient visits in 6 US integrated healthcare delivery organizations enrolling ~7.7 million persons.MethodsUsing negative binomial regression methods, we modeled rates of influenza‐associated visits with ICD‐9‐CM‐coded pneumonia or acute respiratory outpatient visits during 2001‐10. These estimated counts were added to visits coded specifically for influenza to derive estimated rates. We compared these rates with those observed in 2 contemporaneous studies recording RT‐PCR‐confirmed influenza outpatient visits.ResultsOutpatient rates estimated with pneumonia visits were 39 (95% confidence interval [CI], 30‐70) and 203 (95% CI, 180‐240) per 10 000 person‐years, respectively, for interpandemic and pandemic seasons. Corresponding rates estimated with respiratory visits were 185 (95% CI, 161‐255) and 542 (95% CI, 441‐823) per 10 000 person‐years. During the pandemic, children aged 2‐17 years had the largest increase in rates (when estimated with pneumonia visits, from 64 [95% CI, 50‐121] to 381 [95% CI, 366‐481]). Rates estimated with pneumonia visits were consistent with rates of RT‐PCR‐confirmed influenza visits during 4 of 5 seasons in 1 comparison study. In another, rates estimated with pneumonia visits during the pandemic for children and adults were consistent in timing, peak, and magnitude.ConclusionsEstimated rates of influenza‐associated outpatient visits were higher in children than adults during pre‐pandemic and pandemic seasons. Rates estimated with pneumonia visits plus influenza‐coded visits were similar to rates from studies using RT‐PCR‐confirmed influenza.

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“…Studies conducted in North America, Europe, and Asia have documented that children have particularly high rates of morbidity and influenza‐related complications, particularly those aged <2 years 1, 2, 3. Although effectiveness varies by season through the interaction of viral and host factors, annual influenza vaccination remains the most effective method for preventing seasonal influenza and related complications 4, 5, 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and factors associated with severe acute respiratory infection and influenza among children in Jingzhou, China

Yang¹,

Guan

Liu

et al. 2016

Influenza Resp Viruses

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BackgroundInfluenza is an important cause of respiratory illness in children, but data are limited on hospitalized children with laboratory‐confirmed influenza in China.MethodsWe conducted active surveillance for severe acute respiratory infection (SARI; fever and at least one sign or symptom of acute respiratory illness) among hospitalized pediatric patients in Jingzhou, Hubei Province, from April 2010 to April 2012. Data were collected from enrolled SARI patients on demographics, underlying health conditions, clinical course of illness, and outcomes. Nasal swabs were collected and tested for influenza viruses by reverse transcription polymerase chain reaction. We described the clinical and epidemiological characteristics of children with influenza and analyzed the association between potential risk factors and SARI patients with influenza.ResultsDuring the study period, 15 354 children aged <15 years with signs and symptoms of SARI were enrolled at hospital admission. severe acute respiratory infection patients aged 5–15 years with confirmed influenza (H3N2) infection were more likely than children without influenza to have radiographic diagnosis of pneumonia (11/31, 36% vs 15/105, 14%. P<.05). Only 16% (1116/7145) of enrolled patients had received seasonal trivalent influenza vaccination within 12 months of hospital admission. Non‐vaccinated influenza cases were more likely than vaccinated influenza cases to have pneumonia (31/133, 23% vs 37/256, 15%, P<.05). severe acute respiratory infection cases aged 5–15 years diagnosed with influenza were also more likely to have a household member who smoked cigarettes compared with SARI cases without a smoking household member (54/208, 26% vs 158/960, 16%, P<.05).ConclusionsInfluenza A (H3N2) virus infection was an important contributor to pneumonia requiring hospitalization. Our results highlight the importance of surveillance in identifying factors for influenza hospitalization, monitoring adherence to influenza prevention and treatment strategies, and evaluating the disease burden among hospitalized pediatric SARI patients. Influenza vaccination promotion should target children.

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Burden of Influenza in Children in the Community

Abstract: Influenza causes a substantial burden of illness on outpatient children and their families. Vaccination of children < 3 years old might be beneficial for reducing the direct and indirect costs of influenza in children.

Cited by 245 publications

References 28 publications

Performance of rapid influenza testing in hospitalized children

Performance of rapid influenza testing in hospitalized children

Estimated rates of influenza‐associated outpatient visits during 2001‐2010 in 6 US integrated healthcare delivery organizations

Clinical characteristics and factors associated with severe acute respiratory infection and influenza among children in Jingzhou, China

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