Characteristics and mortality risk of children with life-threatening influenza infection admitted to paediatric intensive care in England 2003–2015

Hardelid, Pia; Kapetanstrataki, Melpo; Norman, Lee; Fleming, Sarah; Lister, Paula; Gilbert, Ruth; Parslow, Roger C

doi:10.1016/j.rmed.2018.02.012

Cited by 16 publications

(26 citation statements)

References 30 publications

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“…Influenza-related admissions were identified as an admission where an influenza-associated Read code had been recorded as either the primary, secondary or comorbidity diagnosis. 16 Note that the Read codes are selected by PICU staff responsible for data entry, and it is not possible to determine whether a child has laboratory-confirmed influenza infection based on the Read code. Therefore, admissions were defined as influenza related based on diagnostic coding alone.…”

Section: Methodsmentioning

confidence: 99%

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Impact of the introduction of a universal childhood influenza vaccination programme on influenza-related admissions to paediatric intensive care units in England

et al. 2018

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IntroductionA universal childhood influenza vaccination programme was introduced in the UK in September 2013. We examine the impact of the gradual introduction of this programme on influenza-related paediatric intensive care unit (PICU) admission rates in England.MethodsWe extracted data on all influenza-related admissions to PICUs in England in resident children aged 0–15 years old between October 2003 and March 2017 from the Paediatric Intensive Care Audit Network (PICANet) database. We estimated influenza-associated PICU admission rates per 100 000 children by age group, sex and winter season (October to March), and used Poisson regression models to estimate incidence rate ratios (IRRs) in the winter seasons since the introduction of universal childhood vaccination compared with the two winters before the introduction of the programme (2011–2013).ResultsWe identified 929 influenza-related PICU admissions among 873 children. 48.3% of admissions were among children aged less than 2 years old. The influenza-associated PICU admission rate was 1.32 per 100 000 children (95% CI 1.23 to 1.40). We identified a significant increase in influenza PICU admissions in the winters following the introduction of the universal childhood vaccination programme compared with the winters of 2010/2011–2012/2013 among children aged <5 years old: IRR 1.58 (1.05, 2.37) in children <1 year, 2.71 (1.43, 5.17) in 1 year-olds and 1.98 (1.18, 3.31) in children 2–4 years old. No significant difference was found among children aged 5–15 years.ConclusionThe universal childhood influenza vaccination has not yet reduced the influenza-associated burden on PICUs in England during its early phase of introduction. Monitoring of influenza PICU admission rates needs to continue in England to assess the long-term impact of universal paediatric influenza vaccination. Linkage between PICANet and national infection surveillance databases would better enable such monitoring.

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Section: Methodsmentioning

confidence: 99%

“…As for influenza diagnoses, chronic conditions are entered by PICU staff based on information on children’s clinical notes, and a previous study has shown that chronic conditions are under-reported in PICANet. 16 …”

Section: Methodsmentioning

confidence: 99%

Impact of the introduction of a universal childhood influenza vaccination programme on influenza-related admissions to paediatric intensive care units in England

et al. 2018

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“…Influenza viruses cause a significant disease burden and due to the associated complications, children with influenza may require admission to the Paediatric Intensive Care Unit (PICU) (58,59). Children at a higher risk of complications are considered to be those under 59 months of age and with concomitant medical conditions (cardiac, pulmonary, renal, metabolic, neurodevelopmental, liver and haematological diseases), or suffer from immunosuppression, such as patients with HIV/AIDS, malignancies, or those receiving chemotherapy, or steroids (60,61). According to the data from the Centers for Disease Control and Prevention (CDC), 172 influenza-related paediatric deaths were reported in the USA during the season 2017–2018 (62,63).…”

Section: Influenza As a Cause Of Admission To The Picumentioning

confidence: 99%

A paediatric influenza update 100 years after the Skyros island Spanish flu outbreak

et al. 2019

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This year marks the 100th anniversary of the 1918 Spanish flu outbreak on the Greek Aegean Sea island of Skyros, which devastated its population in less than 30 days. According to Constantinos Faltaits's annals published in 1919, the influenza attack on the island of Skyros commenced acutely ‘like a thunderbolt’ on the 27th of October, 1918 and was exceptionally severe and fatal. At that time, the viral cause of the influenza had not been detected, while the total number of victims of the Spanish flu outbreak has been estimated to have surpassed 50 million, worldwide. Almost one century after this Aegean Sea island's tragedy, the ‘4th Workshop on Paediatric Virology’, organised on the 22nd of September, 2018 in Athens, Greece, was dedicated to the 100 years of the ‘Spanish’ flu pandemic. This review article highlights the plenary and key lectures presented at the workshop on the recent advances on the epidemiology, clinical management and prevention of influenza in childhood.

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“…Higher female mortality rate is documented in many types of viral infections including Hantaviruses, Influenza A viruses (including children) and Measles. 3,[7][8][9] The Global Health 50/50 organization is collecting and constantly updating COVID-19 numbers of individuals infected and deceased, by country and by sex. 10 Forty-one countries include sex information in their data, thus enabling sexdisaggregating.…”

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confidence: 99%

“…Higher female mortality rate is documented in many types of viral infections including Hantaviruses, Influenza A viruses (including children) and Measles. 3,7 -9…”

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confidence: 99%

Contemplating on the Etiology of COVID-19 Severity and Mortality Sex Differences

Shweiki

2020

Gender and the Genome

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COVID-19 displays a sex-biased behavior with a higher rate of intensity and mortality in men. In that sense, COVID-19 deflects-off the typical trend of many viral infections which are characterized by a higher rate of intensity and prevalence in males, yet a higher female mortality rate. Severity and mortality rates of COVID-19 are associated with several underlying diseases, which exhibit significant self-sufficient male-biased dimorphism, thus are at times hypothesized to be the ones responsible to tilt mortality balance toward higher men death in COVID-19. Yet, similar comorbidities prevail in other viral infections, raising curiosity to what makes COVID-19 unique? The answer may lay in the involvement of renin-angiotensin system and ACE2 receptor in COVID-19 progression, 2 players which are significant contributors to the fatality of COVID-19. A structured difference is evident in the expression and function of RAS and ACE2 between the sexes, presumably tipping over mortality rate tendency toward male-risk factor.

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Characteristics and mortality risk of children with life-threatening influenza infection admitted to paediatric intensive care in England 2003–2015

Cited by 16 publications

References 30 publications

Impact of the introduction of a universal childhood influenza vaccination programme on influenza-related admissions to paediatric intensive care units in England

Impact of the introduction of a universal childhood influenza vaccination programme on influenza-related admissions to paediatric intensive care units in England

A paediatric influenza update 100 years after the Skyros island Spanish flu outbreak

Contemplating on the Etiology of COVID-19 Severity and Mortality Sex Differences

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