Influenza infection in infants aged &lt;6 months during the <scp>H</scp>1<scp>N</scp>1‐09 pandemic: A hospital‐based case series

Esterman, Emilia E; Lahra, Monica M; Zurynski, Yvonne; Booy, Robert; Elliott, Elizabeth J

doi:10.1111/jpc.12266

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…More recently, it has been shown that children under 6 months of age usually only develop a fever but are very likely to be hospitalized with a favorable outcome in most cases, as described by Bender et al 13 Most published articles insist and conclude that influenza rates in infants can be reduced by adopting a cocoon strategy that involves vaccinating close contacts and mothers during pregnancy and even during lactation for those not previously vaccinated. [14][15][16][17][18][19][20][21] It is necessary to promote and stimulate vaccination in all pregnant women, 22 which, in Spain, barely reaches 50% coverage in the best scenario. López-Medina et al 23 showed that during the 2009 pandemic, most Spanish newborns developed a community-acquired influenza infection, which was found to be associated with hospital admissions and favorable short-term results.…”

Section: Discussionmentioning

confidence: 99%

Influenza hospitalizations in children under 1 year old in Spain: the importance of maternal immunization

Montero

Gil-Prieto

Martín

et al. 2020

Human Vaccines & Immunotherapeutics

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This study estimates the burden of influenza in infants up to 12 months of age in Spain over 8 seasons (2009/10-2016/17). The survey was conducted by reviewing the Spanish Surveillance System for Hospital Data. Over the eight seasons, 5,618 hospital admissions were recorded for patients younger than 12 months that included codes related to influenza in any diagnostic position (487–488 ICD-9-CM and J9, J10 and J11 CIE 10). In total, 2,363 admissions (42.1%) were female patients whose median age was 3.05 months. Patients younger than 6 months accounted for 3,856 admissions (68.6%). Among them, 59.2% were male, and 40.8% were female ( p < .05). Overall, 37.1% (2,084 patients) were younger than 2 months. The hospitalization rate for the entire period studied was 156.09 admissions per 100,000 children under 12 months of age (95% CI: 152.4–160.6). The average duration of hospitalization was 6.6 days (95% CI: 6.4–6.8). Eighteen deaths were recorded for hospitalized patients over the entire period. Of these, 12 patients (66.7%) were younger than 6 months. There is a significant burden of influenza disease in children under 1 year of age in Spain, mainly in children under 6 months of age. Improvements to prevention strategies through increased vaccination coverage in family environments and vaccination strategies involving pregnant woman can contribute decisively and effectively to reducing these hospitalizations.

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Section: Discussionmentioning

confidence: 99%

Influenza hospitalizations in children under 1 year old in Spain: the importance of maternal immunization

Montero

Gil-Prieto

Martín

et al. 2020

Human Vaccines & Immunotherapeutics

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The PAndemic INfluenza Triage in the Emergency Department (PAINTED) pilot cohort study

Goodacre

Irving

Wilson

et al. 2015

Health Technology Assessment

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BackgroundResearch needs to be undertaken rapidly in the event of an influenza pandemic to develop and evaluate triage methods for people presenting to the emergency department with suspected pandemic influenza.ObjectivesWe aimed to pilot a research study to be undertaken in a pandemic to identify the most accurate triage method for patients presenting to the emergency department with suspected pandemic influenza. The objectives of the pilot study were to develop a standardised clinical assessment form and secure online database; test both using data from patients with seasonal influenza; seek clinician views on the usability of the form; and obtain all regulatory approvals required for the main study.DesignStudy methods were piloted using an observational cohort study and clinician views were sought using qualitative, semistructured interviews.SettingSix acute hospital emergency departments.ParticipantsPatients attending the emergency department with suspected seasonal influenza during winter 2012–13 and clinicians working in the emergency departments.Main outcome measuresAdverse events up to 30 days were identified, but analysis of the pilot data was limited to descriptive reporting of patient flow, data completeness and patient characteristics.ResultsSome 165 patients were identified, of whom 10 withdrew their data, leaving 155 (94%) for analysis. Follow-up data were available for 129 of 155 (83%), with 50 of 129 (39%) being admitted to hospital. Three cases (2%) were recorded as having suffered an adverse outcome. There appeared to be variation between the hospitals, allowing for small numbers. Three of the hospitals identified 150 of 165 (91%) of the patients, and all 10 withdrawing patients were at the same hospital. The proportion with missing follow-up data varied from 8% to 31%, and the proportion admitted varied from 4% to 85% across the three hospitals with meaningful numbers of cases. All of the deaths were at one hospital. There was less variation between hospitals in rates of missing data, and for most key variables missing rates were between 5% and 30%. Higher missing rates were recorded for blood pressure (39%), inspired oxygen (43%), capillary refill (36%) and Glasgow Coma Scale score (43%). Chest radiography was performed in 51 of 118 cases, and electrocardiography in 40 of 111 cases with details recorded. Blood test results were available for 32 of 155 cases. The qualitative interviews revealed generally positive views towards the standardised assessment form. Concerns about lack of space for free text were raised but counterbalanced by appreciation that it fitted on to one A4 page. A number of amendments were suggested but only three of these were suggested by more than one participant, and no suggestions were made by more than two participants.ConclusionsA standardised assessment form is acceptable to clinicians and could be used to collect research data in an influenza pandemic, but analysis may be limited by missing data.Future workAn observational cohort study to identify the most accurate triage method for predicting severe illness in emergency department attendees with suspected pandemic influenza is set up and ready to activate if, or when, a pandemic occurs.Trial registrationCurrent Controlled Trials ISRCTN56149622.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 3. See the NIHR Journals Library website for further project information.

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Influenza infection in infants aged <6 months during the H1N1‐09 pandemic: A hospital‐based case series

Abstract: These novel data are clinically important. Rates of influenza in infants may be reduced by vaccinating close contacts and minimising exposure to infected contacts and cigarette smoke.

Cited by 2 publications

References 26 publications

Influenza hospitalizations in children under 1 year old in Spain: the importance of maternal immunization

Influenza hospitalizations in children under 1 year old in Spain: the importance of maternal immunization

The PAndemic INfluenza Triage in the Emergency Department (PAINTED) pilot cohort study

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