Characteristic findings of pediatric inpatients with pandemic (H1N1) 2009 virus infection among severe and nonsevere illnesses

Okada, Takemichi; Morozumi, Miyuki; Matsubara, Keita; Komiyama, Osamu; Ubukata, Kimiko; Takahashi, Takashi; Iwata, Satoshi

doi:10.1007/s10156-010-0115-z

Cited by 26 publications

(19 citation statements)

References 16 publications

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“…Guidelines from the Public Health Agency of Canada highlighted children <2 years of age as a high-risk group for pH1N1 15. However, our results of a median age of 6.5 years in hospitalised patients with pH1N1 are remarkably similar to studies from California16 (median age 6 years) and Japan17 (median age 7 years). While we found the proportion of hospitalised cases higher in older age categories in pH1N1, in the absence of community population-based epidemiological data, we are not able to comment on any differences that may exist in age-specific attack, hospitalisation or ICU admission rates in our study population.…”

Section: Discussionsupporting

confidence: 90%

“…In a large California study of 345 children hospitalised or who died of pH1N1, 31% of hospitalised children and 34% of ICU and/or fatal cases had asthma 16. In Japan, 14% of non-severe cases of pH1N1 and 47% of severe cases had asthma,17 while a UK study found that asthma was present in 16% of children <16 years and 31% of adults 18. None of these studies examined severity of asthma or the differences between pH1N1 and seasonal influenza.…”

Section: Discussionmentioning

confidence: 99%

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A retrospective cross-sectional study of risk factors and clinical spectrum of children admitted to hospital with pandemic H1N1 influenza as compared to influenza A

et al. 2012

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ObjectiveTo compare risk factors for severe disease as measured by admission to hospital and intensive care unit (ICU) and other clinical outcomes in children with pandemic H1N1 (pH1N1) versus those with seasonal influenza.DesignRetrospective analysis of children admitted to hospital with pH1N1 versus seasonal influenza A.SettingCanadian tertiary referral children's hospital.ParticipantsAll laboratory-identified cases of pH1N1 in children younger than 18 years admitted to hospital in 2009 (n=176) and all seasonal influenza A cases admitted to hospital from influenza seasons 2004–2005 to 2008–2009 (n=200). Children with onset of symptoms more than 3 days after admission were excluded.Primary and secondary outcome measuresPrimary outcomes include admission to hospital and ICU and need for mechanical ventilation. Secondary outcomes include length of stay in hospital and duration of supplemental oxygen requirement.ResultsChildren admitted with pH1N1 were older than seasonal influenza A admissions (hospital admission: 6.5 vs 3.3 years, p<0.01; ICU admission: 7.3 vs 3.6 years, p=0.02). Children hospitalised with pH1N1 were more likely to have a pre-existing diagnosis of asthma (15% vs 5%, p<0.01); however, there was no difference in the severity of pre-existing asthma between the two groups. After controlling for obesity, asthma (OR 4.59, 95% CI 1.42 to 14.81) and age ≥5 years (OR 2.87, 95% CI 1.60 to 5.16) were more common risk factors in admitted children with pH1N1. Asthma was a significant predictor of the need for intensive care in patients with pH1N1 (OR 4.56, 95% CI 1.16 to 17.89) but not in patients with seasonal influenza A.ConclusionWhile most pH1N1 cases presented with classic influenza-like symptoms, risk factors for severe pH1N1 disease differed from seasonal influenza A. Older age and asthma were associated with increased admission to hospital and ICU for children with pH1N1.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

A retrospective cross-sectional study of risk factors and clinical spectrum of children admitted to hospital with pandemic H1N1 influenza as compared to influenza A

et al. 2012

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“…For example, in the USA, 13% of post mortem lung samples from patients with fatal pandemic 2009 H1N1 showed a concurrent infection with S. pneumoniae [32]. In Japan and Argentina, an even stronger association was found, where approximately 50% of the severe cases tested positive for S. pneumoniae [33,34]. Clinical evidence also suggests that an increased incidence of pneumococcal disease occurs during seasonal outbreaks of IAV.…”

Section: Pneumococcal-influenza Virus Coinfectionsmentioning

confidence: 95%

Interactions Between Streptococcus Pneumoniae and Influenza Virus: A Mutually Beneficial Relationship?

et al. 2012

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Historically, most research on infectious diseases has focused on infections with single pathogens. However, infections with pathogens often occur in the context of pre-existing viral and bacterial infections. Clinically, this is of particular relevance for coinfections with Streptococcus pneumoniae and influenza virus, which together are an important cause of global morbidity and mortality. In recent years new evidence has emerged regarding the underlying mechanisms of influenza virus-induced susceptibility to secondary pneumococcal infections, in particular regarding the sustained suppression of innate recognition of S. pneumoniae. Conversely, it is also increasingly being recognized that there is not a unidirectional effect of the virus on S. pneumoniae, but that asymptomatic pneumococcal carriage may also affect subsequent influenza virus infection and the clinical outcome. Here, we will review both aspects of pneumococcal influenza virus infection, with a particular focus on the age-related differences in pneumococcal colonization rates and invasive pneumococcal disease.

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“…The pathogenesis of the influenza virus infection is influenced by the host’s genetic, immune, physical, and viral factors [1–3]. Among these factors, an epidemiological study revealed that asthma is one of the physical risk factors for a complicated clinical condition resulting from influenza virus infection [4, 5]. On the other hand, it has been reported that hospitalized patients with asthma are less likely to die due to influenza A virus infection [6].…”

Section: Introductionmentioning

confidence: 99%

Mice with Asthma Are More Resistant to Influenza Virus Infection and NK Cells Activated by the Induction of Asthma Have Potentially Protective Effects

et al. 2011

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PurposeThis study was conducted in order to investigate whether the virulence of the influenza virus infection is affected by asthma in mice.MethodsMice with asthma or control mice were infected with influenza virus. The survival rate, body weight, virus titer, cytokine profile, and cell infiltration in bronchoalveolar lavage fluid (BALF) were measured. The NK cell cytotoxicity was determined by a co-culture system with YAC-1 cells, and the effects of NK cells were observed by depletion of NK cells using anti-asialoGM1 serum. The virus-specific CD8+ T cell killing assay was also performed.ResultsWhen asthmatic or control mice were infected with non- and sub-lethal doses of influenza virus, the asthmatic mice were more resistant to the virus than control mice with regard to the survival rate, the remission of body weight loss, and the virus burden. Anti-viral cytokines and the NK cell number were increased in the BALF of asthmatic mice before the infection. The NK cell cytotoxicity in the asthmatic mice was significantly enhanced compared to that in control mice, and the depletion of NK cells in asthmatic mice was abrogated both the improved survival rate and the recovery of the body weight loss. The antigen-specific CD8+ T cell killing activity in asthmatic mice was also significantly increased following the infection compared to that in control mice.ConclusionNK cell activated by the induction of asthma and the subsequently activated antigen-specific CD8+ T cells could promptly eliminate the viral-infected cells, thus leading to improvements in the morbidity and mortality of influenza virus infection.

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Characteristic findings of pediatric inpatients with pandemic (H1N1) 2009 virus infection among severe and nonsevere illnesses

Cited by 26 publications

References 16 publications

A retrospective cross-sectional study of risk factors and clinical spectrum of children admitted to hospital with pandemic H1N1 influenza as compared to influenza A

A retrospective cross-sectional study of risk factors and clinical spectrum of children admitted to hospital with pandemic H1N1 influenza as compared to influenza A

Interactions Between Streptococcus Pneumoniae and Influenza Virus: A Mutually Beneficial Relationship?

Mice with Asthma Are More Resistant to Influenza Virus Infection and NK Cells Activated by the Induction of Asthma Have Potentially Protective Effects

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