Hospitalization of Children With Influenza A(H1N1) Virus in Israel During the 2009 Outbreak in Israel

Stein, Michal; Tasher, Diana; Glikman, Daniel; Shachor-Meyouhas, Yael; Barkai, Galia; Yochai, Avihu Bar; Leibovitz, Eugene; Hausman-Kedem, Moran; Hess, Amit; Megged, Orli; Kassis, Imad; Gresario, Galia; Somekh, Eli

doi:10.1001/archpediatrics.2010.195

Cited by 27 publications

(25 citation statements)

References 17 publications

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“…Similarly, high rates of fever and cough were reported from a more recent study of hospitalised children and adolescents with H1N1pdm09 influenza [91]. Studies of hospitalised influenza patients also report neurological symptoms, such as febrile convulsions [97, 115, 119], although these are often reported as complications of the disease rather than symptoms (see next section). As well as the neurological system, other non-respiratory systems can be commonly affected in influenza: in some epidemics, up to 50 % of children have presented with gastrointestinal symptoms such as vomiting and diarrhoea, particularly those who are admitted to hospital, and affecting children of all age groups [1, 11, 67, 69, 90, 134].…”

Section: Clinical Manifestations Of Diseasementioning

confidence: 81%

The burden of seasonal and pandemic influenza in infants and children

2013

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The burden of influenza is unevenly distributed, with more severe outcomes in children aged <5 years than older children and adults. In spite of this, immunisation policies for young children are far from universal. This article provides an overview of the published evidence on the burden of influenza in children worldwide, with a particular interest in the impact of pandemic influenza in 2009–2010 (caused by the H1N1pdm09 virus). In an average season, up to 9.8 % of 0- to 14-year olds present with influenza, but incidence rates can be markedly higher in younger children. Children aged <5 years have greater rates of hospitalisation and complications than their older counterparts, particularly if the children have co-existing illnesses; historically, this age group have had higher mortality rates from the disease than other children, although during the 2009–2010 pandemic the median age of those who died of influenza was higher than in previous seasons. Admissions to hospital and emergency departments appear to have been more frequent in children with H1N1pdm09 infections than during previous seasonal epidemics, with pneumonia continuing to be a common complication in this setting. Outcomes in children hospitalised with severe disease also seem to have been worse for those infected with H1N1pdm09 viruses compared with seasonal viruses. Studies in children confirm that vaccination reduces the incidence of seasonal influenza and the associated burden, underlining the importance of targeting this group in national immunisation policies. Conclusions: Children aged <5 years are especially vulnerable to influenza, particularly that caused by seasonal viruses, and vaccination in this group can be an effective strategy for reducing disease burden.

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Section: Clinical Manifestations Of Diseasementioning

confidence: 81%

The burden of seasonal and pandemic influenza in infants and children

2013

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“…According to reports from other countries, critically ill patients were older than those who were not critically ill (6, 23). We considered the possibility that younger patients were treated earlier, but actually the average time from symptom onset to initiation of antiviral agents in the younger patients was longer, and fewer of them received prescriptions within two days of the onset of illness.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Hospitalized Children with 2009 Pandemic Influenza A (H1N1): A Multicenter Study in Korea

Kim²,

Kang

et al. 2012

J Korean Med Sci

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The majority of Korean patients with pandemic influenza A (H1N1) during the 2009 epidemic were under 20 yr of age. The limited data on the clinical characteristics of these children led us to conduct a case note-based investigation of children admitted to 6 university hospitals with 2009 H1N1 influenza. A total of 804 children was enrolled. The median age was 5 yr; 63.8% were males; and 22.4% had at least one chronic underlying disease. Ninety-five of the patients (11.8%) were critically ill and they suffered more from shortness of breath, dyspnea and lymphopenia than the other patients. Among all the patients, 98.8% were treated with antivirals and 73% received treatment within 48 hr of illness onset. All the enrolled patients are alive and appear to have had good outcomes, probably due to the early intervention and antiviral treatment. This study deals with hospitalized children whose diagnoses of influenza A (H1N1) were confirmed, and therefore provides important new information about the clinical patterns of children with influenza A (H1N1) in Korea.

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“…3 6 7 9 10 Several smaller studies have described paediatric patients admitted to intensive care units by city (Denver, n=80) state (California, n=96), and country (Australia and New Zealand, n=83; Argentina, n=147). [3][4][5][6][7][8][9][10][11][12][13][14][15] However, these studies typically described demographic data and comorbidities and did not focus on clinical predictors of severity. [5][6][7][8] Intensive care unit cohorts from California and Denver were compared with pH1N1 hospital admissions to non-intensive care.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…1 Several studies from around the world have included children and adults admitted to hospital or intensive care units with pH1N1 infection. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, these data vary in format and emphasis, making direct comparison between studies difficult. Furthermore, data on severe outcomes (including death) and risk factors for severe outcomes are limited.…”

Section: Introductionmentioning

confidence: 99%

Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study

Dalziel

Thompson

Macias

et al. 2013

BMJ

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Objective To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness.Design Multicentre retrospective case-control study.Setting 79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks in 12 countries.Participants 265 children (<16 years), presenting between 16 April and 31 December 2009, who fulfilled Centers for Disease Control and Prevention criteria for influenza-like illness and developed severe outcomes from laboratory confirmed H1N1 infection. For each case, two controls presenting with influenza-like illness but without severe outcomes were included: one random control and one age matched control.Main outcome measures Severe outcomes included death or admission to intensive care for assisted ventilation, inotropic support, or both. Multivariable conditional logistic regression was used to compare cases and controls, with effect sizes measured as adjusted odds ratios.Results 151 (57%) of the 265 cases were male, the median age was 6 (interquartile range 2.3-10.0) years, and 27 (10%) died. Six factors were associated with severe outcomes in children presenting with influenza-like illness: history of chronic lung disease (odds ratio 10.3, 95% confidence interval 1.5 to 69.8), history of cerebral palsy/developmental delay (10.2, 2.0 to 51.4), signs of chest retractions (9.6, 3.2 to 29.0), signs of dehydration (8.8, 1.6 to 49.3), requirement for oxygen (5.8, 2.0 to 16.2), and tachycardia relative to age). ConclusionThese independent risk factors may alert clinicians to children at risk of severe outcomes when presenting with influenza-like illness during future pandemics. IntroductionIn June 2009 the World Health Organization declared the first global influenza pandemic in 41 years.1 From early in the pandemic, children-particularly those aged under 5 years 2 -were considered a population at higher risk of morbidity and mortality from pandemic H1N1 (pH1N1) infection. 1Several studies from around the world have included children and adults admitted to hospital or intensive care units with pH1N1 infection. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] However, these data vary in format andCorrespondence to: S R Dalziel sdalziel@adhb.govt.nzExtra material supplied by the author (see

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Hospitalization of Children With Influenza A(H1N1) Virus in Israel During the 2009 Outbreak in Israel

Cited by 27 publications

References 17 publications

The burden of seasonal and pandemic influenza in infants and children

The burden of seasonal and pandemic influenza in infants and children

Characteristics of Hospitalized Children with 2009 Pandemic Influenza A (H1N1): A Multicenter Study in Korea

Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study

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