Burden of paediatric influenza in Western Europe: a systematic review

Abstract

BackgroundInfluenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden) in children in Western Europe via a systematic literature review.MethodsWe conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011) and extracted data on influenza burden in children (defined as aged ≤ 18 years) from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness).ResultsChildren with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%), medical visits (1.7-2.8 visits per case), antibiotic prescriptions (7%-55%), and antipyretic or other medications for symptomatic relief (76%-99%); young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median) length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children.ConclusionsInfluenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in European countries.

Prevalence of antibodies against influenza A and B viruses in children in Germany, 2008 to 2010

“…Furthermore, infants and children with underlying disease are at increased risk of severe influenza and influenza-associated mortality [5][6][7]. Several studies have shown that influenza in childhood has considerable socioeconomic impact on the children's households [4,8,9] because children are regarded as the main and most efficient transmitters for spreading influenza in the community.…”

Effect of Pediatric Influenza on Caregivers’ Burden—A Literature Review

“…Parents may face additional burdens as influenza spreads throughout their home. A systematic literature review of pediatric influenza in Western Europe found that siblings of children with influenza missed between 1.3 and 6.0 days of school and day care (Antonova et al, 2012). Caretakers may face additional losses of productivity, work, and other emotional or social burdens through these additional illnesses.…”

“…Utilizing the Pediatric Asthma Quality of Life Questionnaire, researchers have shown that influenza lowers quality of life (QoL) in pediatric patients with asthma (Antonova, Rycroft, Ambrose, Heikkinen, & Principi, 2012;Bueving, Van der Wouden, Raat, Bernsen, & De Jongste, 2004). It has also been demonstrated that caregiver QoL is affected by pediatric influenza.…”

Influenza und ambulant erworbene Pneumonie in hausärztlich tätigen Arztpraxen in Deutschland

“…Pneumonie mit Vorund Folgeerkrankungen erwartet. Zwar existieren zahlreiche Publikationen, die sich verstärkt nach der Pandemie 2009, ausgelöst durch Influenza-A(H1N1)-pdm2009-Viren, mit Fragen zu Risikofaktoren und möglichen Komplikationen von Influenzaerkrankungen beschäftigt haben [13][14][15][16][17][18], ein Großteil dieser Studien wurde aber im stationären Bereich durchgeführt, sodass vorwiegend schwere Krankheitsverläufe erfasst wurden. Für den ambulanten Bereich hingegen existieren bislang nur wenige longitudinale Studien zu der Fragestellung, ob ein erhöhtes Risiko für Influenza und Pneumonie aufgrund von Vorerkrankungen besteht, sowie zu Komplikationen und langfristigen Folgeerkrankungen, die durch Influenza und Pneumonie geför-dert werden [17,[19][20][21][22][23].…”