Comparison of the Clinical Features of Children Hospitalized With Pandemic 2009 A:H1N1 and Seasonal Influenza

Ostovar, Gholamabbas Amin; Rubin, Lorry G.; Rajan, Sujatha; Sood, Sunil K.; Kohn, Nina

doi:10.1177/0009922810390512

Cited by 15 publications

(21 citation statements)

References 17 publications

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“…Despite the high proportion of children with an underlying chronic medical condition, only 3% of children were admitted to the ICU, which is quite below a higher rate of 20–26% reported in other studies [16,17]. This low percentage might reflect the milder form of the infection among children in Kuwait and that half of the admitted children had previously been healthy.…”

Section: Discussionmentioning

confidence: 70%

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

et al. 2011

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Objective: To describe the epidemiological and clinical characteristics of children hospitalized for the 2009 influenza A H1N1 infection in Kuwait. Materials and Methods: A retrospective chart review of hospitalized children with laboratory-confirmed influenza A H1N1 infection in two hospitals in Kuwait was conducted. Epidemiological characteristics, clinical features, risk factors for severe disease, complications and mortality were analyzed. Results: The medical records of 197 children hospitalized for the 2009 pandemic H1N1 infection from August 2009 to January 2010 were reviewed. The majority of the children (104; 52.8%) were admitted during the month of October. The median age was 2 years. Most of the admitted children were in two age categories: 64 infants ≤1 year (32%) and 62 schoolchildren >5 years (31%). The most frequent presentations were fever in 193 (98%), cough in 155 (79%) and runny nose in 105 (53%) cases. The majority of the admitted children (109; 55%) had been previously healthy. All children received an antiviral agent (oseltamivir), and antibiotics were administered to 147 (75%). Bacterial co-infections occurred in 3 (1.5%) of all hospitalized children. Six (3%) children were admitted to the intensive care unit, of whom 4 (66%) required artificial ventilation. There was only 1 mortality. Conclusions: The pandemic H1N1 infection was associated with a wide spectrum of clinical manifestations. The majority of hospitalized children had previously been healthy. Most of the admitted children had an uncomplicated clinical course.

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Section: Discussionmentioning

confidence: 70%

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

et al. 2011

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“…This is in contrast with most previous studies which reported higher rates of asthma in children with pH1N1 children, with percentages up to 50%. 3,4 However, in a study in Argentina, only 6% of children hospitalised with pH1N1 had a history of asthma. 11 Four of seven children in the ICU had an underlying illness and three of them a neurological disorder, which has been shown to be an important risk factor for admission to an ICU.…”

Section: Discussionmentioning

confidence: 99%

“…Several paediatric studies 1-5 comparing pH1N1 with seasonal influenza had demonstrated greater morbidity and mortality with pH1N1 4,5 while others had revealed a mild course comparable with seasonal influenza. [1][2][3] Nowadays, pH1N1 is considered to be a seasonal influenza subtype. However, in clinical and epidemiological practice it is helpful to understand the differences between these two types.…”

Section: Introductionmentioning

confidence: 99%

Pandemic influenza Avsseasonal influenza A in hospitalized children in Athens

Stripeli¹,

Logotheti²,

Vraila³

et al. 2013

Paediatrics and International Child Health

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“…This high number of cases reported in the ongoing ESPED study may be partly due to an increased awareness in physicians regarding the new subtype of influenza with unclear severity at the start of the pandemic, resulting in more frequent laboratory testing and diagnosis of influenza [5,24]. Additionally, the higher number of PICU admissions may be due to a truly higher severity of the pandemic influenza A (H1N1) 2009 subtype in children compared to previous seasonal influenza subtypes [e.g., [18,25]], although not all studies report such a difference in severity [26,27], or found a difference only regarding risk groups [28]. Thus, a comparison of both ESPED studies on the absolute number of severe influenza cases [24] has to be regarded with caution, and may underestimate the importance of severe seasonal influenza caused by non-pandemic influenza virus subtypes in children in Germany.…”

Section: Discussionmentioning

confidence: 99%

Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008

2011

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BackgroundData on complications in children with seasonal influenza virus infection are limited. We initiated a nation-wide three-year surveillance of children who were admitted to a paediatric intensive care unit (PICU) with severe seasonal influenza.MethodsFrom October 2005 to July 2008, active surveillance was performed using an established reporting system for rare diseases (ESPED) including all paediatric hospitals in Germany. Cases to be reported were hospitalized children < 17 years of age with laboratory-confirmed influenza treated in a PICU or dying in hospital.ResultsTwenty severe influenza-associated cases were reported from 14 PICUs during three pre-pandemic influenza seasons (2005-2008). The median age of the patients (12 males/8 females) was 7.5 years (range 0.1-15 years). None had received vaccination against influenza. In 14 (70%) patients, the infection had been caused by influenza A and in five (25%) by influenza B; in one child (5%) the influenza type was not reported. Patients spent a median of 19 (IQR 12-38) days in the hospital and a median of 11 days (IQR 6-18 days) in the PICU; 10 (50%) needed mechanical ventilation. Most frequent diagnoses were influenza-associated pneumonia (60%), bronchitis/bronchiolitis (30%), encephalitis/encephalopathy (25%), secondary bacterial pneumonia (25%), and ARDS (25%). Eleven (55%) children had chronic underlying medical conditions, including 8 (40%) with chronic pulmonary diseases. Two influenza A- associated deaths were reported: i) an 8-year old boy with pneumococcal encephalopathy following influenza infection died from cerebral edema, ii) a 14-year-old boy with asthma bronchiale, cardiac malformation and Addison's disease died from cardiac and respiratory failure. For nine (45%) patients, possibly permanent sequelae were reported (3 neurological, 3 pulmonary, 3 other sequelae).ConclusionsInfluenza-associated pneumonia and secondary bacterial infections are relevant complications of seasonal influenza in Germany. The incidence of severe influenza cases in PICUs was relatively low. This may be either due to the weak to moderate seasonal influenza activity during the years 2005 to 2008 or due to under-diagnosis of influenza by physicians. Fifty% of the observed severe cases might have been prevented by following the recommendations for vaccination of risk groups in Germany.

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Comparison of the Clinical Features of Children Hospitalized With Pandemic 2009 A:H1N1 and Seasonal Influenza

Abstract: There was no significant difference between the groups in measures of severity during hospitalization.

Cited by 15 publications

References 17 publications

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

Pandemic influenza Avsseasonal influenza A in hospitalized children in Athens

Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008

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