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

Abstract

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.

Efficacy of intravenous immunoglobulin treatment in immunocompromised children with H1N1 influenza: a clinical observation

“…He also mentioned that secondary complications including myocarditis, encephalitis and clinical diagnosis of early presumed methicillin-resistant S. aureus co-infection of the lung were found as mortality risk factors (15). In other reports, bronchial asthma was found to be a significant risk factor for children with H1N1 (16,17). Although we could not determine the risk factors which influence on mortality because of low numbers of patients, the mortality rate, need for PICU and MV, oseltamivir use rate, the rate of chronic health condition, the distribution of the sex and ages were similar with the literature (11,15,16).…”

Determinants of individuals’ risks to 2009 pandemic influenza virus infection at household level amongst Djibouti city residents - A CoPanFlu cross-sectional study

“…The first pandemic wave is presumed to have begun with the reports of the first cases in the region, which were in Kuwait in May 2009 and in the United Arab Emirates (UAE) in July 2009 [28,29], before spreading to other member states. Once infection was introduced to these two nations it gradually progressed to allow community transmission, peaking in August 2009 for UAE, and in October 2009 for Kuwait [28,29]. The second wave was more pronounced and better documented than the first, probably due to more awareness of the infection.…”

Burden of acute respiratory disease of epidemic and pandemic potential in the WHO Eastern Mediterranean Region: A literature review

“…Rates of hospitalization for confirmed cases ranged from 13% in a paediatric population in Saudi Arabia (58) to 91.7% in the Kurdistan province of the Islamic Republic of Iran (59 ). Admission to the intensive care unit for influenza A(H1N1)pdm09 ranged from 3% of 255 patients admitted for influenza in Kuwait (60) to 53% in Tabriz, Islamic Republic of Iran (61). The average length of hospital stay for influenza A(H1N1)pdm09 was lowest in Saudi Arabia (25), Kuwait (60) and Oman (62) and highest in Pakistan (26).…”

“…Admission to the intensive care unit for influenza A(H1N1)pdm09 ranged from 3% of 255 patients admitted for influenza in Kuwait (60) to 53% in Tabriz, Islamic Republic of Iran (61). The average length of hospital stay for influenza A(H1N1)pdm09 was lowest in Saudi Arabia (25), Kuwait (60) and Oman (62) and highest in Pakistan (26).…”