Influenza-Related Hospitalizations among Children in Hong Kong

Chiu, Susan S.; Lau, Yu Lung; Chan, Kwok Hung; Wong, Wilfred Hing Sang; Peiris, J. S. Malik

doi:10.1056/nejmoa020546

Cited by 271 publications

(190 citation statements)

References 26 publications

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“…To compile these 2 lists, the study team drew on sev er al sources: the Electronic Surveil lance System for the Early Notifi cation of CommunityBased Epidemics (ES SENCE) II list of ICD-9-CM discharge diagnosis for infl uenza syndromic surveillance in the military, validated in the 2009 H1N1 infl uenza pandemic, [25][26][27][28] and pediatricspecifi c lists of infl uenza-related diagnoses, which remain unvalidated. [29][30][31][32] Chronic comorbid conditions (CCCs; eg, malignancy) were identified using a previously reported classifi cation method. 33 For patients with multiple readmissions, only data from the index rehospitalization were included.…”

Section: Study Defi Nitionsmentioning

confidence: 99%

Hospital Readmissions Among Children With H1N1 Influenza Infection

Brogan

Hall

Sills

et al. 2014

Hospital Pediatrics

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Objectives: To describe readmissions among children hospitalized with H1N1 (influenza subtype, hemagglutinin1, neuraminidase 1) pandemic influenza and secondarily to determine the association of oseltamivir during index hospitalization with readmission. Methods: We reviewed data from 42 freestanding children’s hospitals contributing to the Pediatric Health Information System from May through December 2009 when H1N1 was the predominant influenza strain. Children were divided into 2 groups by whether they experienced complications of influenza during index hospitalization. Primary outcome was readmission at 3, 7, and 30 days among both patient groups. Secondary outcome was the association of oseltamivir treatment with readmission. Results: The study included 8899 children; 6162 patients had uncomplicated index hospitalization, of whom 3808 (61.8%) received oseltamivir during hospitalization, and 2737 children had complicated influenza, of whom 1055 (38.5%) received oseltamivir. Median 3-, 7-, and 30-day readmission rates were 1.6%, 2.5%, and 4.7% for patients with uncomplicated index hospitalizations and 4.3%, 5.8%, and 10.3% among patients with complicated influenza. The 30-day readmission rates did not differ by treatment group among patients with uncomplicated influenza; however, patients with complicated index hospitalizations who received oseltamivir had lower all-cause 30-day readmissions than untreated patients. The most common causes of readmission were pneumonia and asthma exacerbations. Conclusions: Oseltamivir use for hospitalized children did not decrease 30-day readmission rates in children after uncomplicated index hospitalization but was associated with a lower 30-day readmission rate among children with complicated infections during the 2009 H1N1 pandemic. Readmission rates for children who had complicated influenza infection during index hospitalizations are high.

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Section: Study Defi Nitionsmentioning

confidence: 99%

Hospital Readmissions Among Children With H1N1 Influenza Infection

Brogan

Hall

Sills

et al. 2014

Hospital Pediatrics

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“…Their yearly excess rates of hospitalization attributable to influenza were 278.5 and 288.2/10 000 children Ͻ1 year of age, and 218.4 and 219.3/10 000 children aged between 1 and 2 years in 1998 and 1999, respectively. 10 Less data are available on the impact of laboratory confirmed influenza infections in children. Neuzil and co-workers 11 reported a yearly admission rate for proven influenza infections of 3.5/1000 children Ͻ2 years of age.…”

mentioning

confidence: 99%

Risk Factors Associated With Severe Influenza Infections in Childhood: Implication for Vaccine Strategy

et al. 2003

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ABSTRACT. Infections caused by influenza virus lead to an excess rate of hospitalization of children during winter months. Current recommendations for vaccination target only children >6 months who belong to specific risk groups.Objective. To identify possible benefits of universal influenza vaccination, this study aims to determine characteristics of children hospitalized at the Montreal Children's Hospital (MCH) because of an infection attributable to influenza virus as well as risk factors associated with hospitalization.Methods. We retrospectively reviewed records of all children with a laboratory-proven diagnosis of influenza seen at MCH between April 1, 1999, and April 1, 2002. Data were analyzed using the Student t test and logistic regression.Results. We identified 182 patients hospitalized because of influenza and 114 patients who were not. Admission diagnoses were suspected sepsis (31%), lower respiratory tract infections (27%), and asthma or bronchiolitis (15%). Mean age of hospitalized patients was 26.1 month (median: 12 months), which was similar to that of patients not hospitalized, and 34% were <6 months. Seventy percent of those hospitalized did not have any underlying medical disorder and only 18% (33) were vaccine candidates according to current recommendations. Of the latter, less than half had been vaccinated. Factors associated with hospitalization were age <12 months (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.1-4.8), male gender (OR: 1.9; 95% CI: 1.0 -3.7), dehydration (OR: 4.3; 95% CI: 1.2-16.0), and decreased oxygen saturation (OR: 32.1; 95% CI: 4.1-249).Conclusions. Considering that the majority of children hospitalized for influenza do not belong to the specific risk groups targeted by current recommendations, and that one third are <6 months of age, the target population for vaccination needs to be reexamined. Extending vaccination to all young children, to additional high-risk groups, and to pregnant women has potential to reduce the impact of influenza on children. Pediatrics 2003;112:e197-e201. URL: http://www.pediatrics.org/cgi/ content/full/112/3/e197; influenza, vaccine, pediatrics, and hospitalization.ABBREVIATIONS. MCH, Montreal Children's Hospital; NPA, nasopharyngeal aspirate; DFA, direct immunofluorescent antigen assay; SD, standard deviation; ICU, intensive care unit; IV, intravenous; LOS, length of stay; OR, odds ratio; CI, confidence interval. I nfluenza is a common disease of childhood with the highest morbidity occurring in preschool children. 1-3 Excess hospitalization rates attributable to influenza infections have been estimated to be 104/10 000 child-years for children Ͻ6 months of age, 50/10 000 for children between 6 and 12 months of age and 19/10 000 for children between 1 and 3 years of age. 4 In another study, excess hospitalizations for healthy children Ͻ2 years of age was 86 to 112/100 000 child-months, 5 a rate similar to that reported for adults over 65 years of age. 6 Higher hospitalization rates are reported for children with underlying high-r...

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“…For example, in Sri Lanka, influenza virus activity peaks correspond to a peak in rainfall while in Hong Kong SAR, high influenza activity occurs in February-March and July-August. In general influenza viruses in tropical and subtropical regions could be detected at low levels outside the peak periods of viral activity, indicating possible circulation throughout the year with peaks during rainy seasons [17,18]. In contrast, in temperate climates influenza shows a seasonal pattern with high incidents in winter months [16].…”

Section: Seasonal Influenzamentioning

confidence: 99%