Novel influenza A (H1N1): clinical features of pediatric hospitalizations in two successive waves

Launay, Élise; Ovetchkine, Philippe; Saint-Jean, Maude; Coïc, Léna; Ducruet, Thiérry; Charest, Hugues; Desmarais, Nadia; Lamarre, Valérie; Tapiéro, Bruce

doi:10.1016/j.ijid.2010.08.006

Cited by 19 publications

(21 citation statements)

References 33 publications

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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%

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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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Section: Comparison With Other Studiesmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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“…These two diseases were confirmed to be statistically significant risk factors of hospital admission. Precedent studies also reported asthma and neurologic diseases as risk factors of hospital admission in pediatric patients5,12-15. According to studies, asthma was most found in 22~37% of inpatients as an underlying disease5,12-15.…”

Section: Discussionmentioning

confidence: 99%

“…Precedent studies also reported asthma and neurologic diseases as risk factors of hospital admission in pediatric patients5,12-15. According to studies, asthma was most found in 22~37% of inpatients as an underlying disease5,12-15. In particular, a Canadian study reported that asthma was more important risk factor of hospital admission compared with the case of seasonal influenza, and even mild asthma was a risk factor5.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Pandemic Influenza A (H1N1) 2009 Pediatric Infection in Busan and Gyeongsangnam-do: One Institution

et al. 2012

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BackgroundThis study investigated the clinical characteristics and risk factors of the severity of pandemic influenza A (H1N1) 2009 infection in pediatric patients in Busan and Gyeongsangnam-do.MethodsCases of influenza A (H1N1) 2009 in patients under the age of 18 years, confirmed by reverse transcription polymerase chain reaction, at Pusan National University Hospital and Pusan National University Yangsan Hospital from the last week of August 2009 through the last week of February 2010 were retrospectively analyzed.ResultsOf the 3,777 confirmed cases of influenza A (H1N1) 2009, 2,200 (58.2%) were male and 1,577 (41.8%) were female. The average age of the patients was 8.4±4.8 years. The total cases peaked during 44th to 46th week. Most of the patients were in the 5- to 9-year-old age group. Oseltamivir was administered to 2,959 (78.3%) of the patients. 221 patients (5.9%) were hospitalized, age an average of 6.7±4.5 years. The average duration of hospitalization was 7.4±5.6 days. One hundred cases (45.2%) had pneumonia. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. Children with asthma were at very high risk of hospitalization, over 20 times the non-asthmatic children (odds ratio [OR], 21.684; confidence interval [CI], 13.295~39.791). Likewise the children with neurologic deficits faced a 16 times higher risk (OR, 15.738; CI, 7.961~31.111). Ten of the patients (4.5%) were admitted to the intensive care unit, and eight (3.6%) required mechanical ventilation.ConclusionOf the pediatric patients with pandemic influenza A (H1N1) 2009, most of the patients were in the 5- to 9-year-old age group. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. The most common complication was pneumonia. The very high risk of severe morbidity in children with asthma or neurologic disease shows the critical importance of targeted vaccine coverage, special awareness and swift care by both guardians and primary care providers.

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“…In our study, the prevalence of risk factors was significantly higher in H1N1/09-positive patients than in H1N1/09-negative patients and two thirds of our hospitalized H1N1/09-positive patients had a risk factor compared to only one third among outpatients. Similarly, in case series of hospitalized patients, risk factors-lung diseases being the most prevalent-were highly prevalent [12] and associated with a greater risk of severe disease [5], including that of being admitted to PICU [9]. In an outpatient setting, Mahut et al showed that ILI and severe exacerbation are significantly and strongly associated in the H1N1 influenza pandemic in asthmatic children [15].…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical presentation of respiratory tract infections in H1N1/09-positive and H1N1/09-negative patients

et al. 2011

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Novel influenza A (H1N1): clinical features of pediatric hospitalizations in two successive waves

Cited by 19 publications

References 33 publications

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

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

Clinical Characteristics of Pandemic Influenza A (H1N1) 2009 Pediatric Infection in Busan and Gyeongsangnam-do: One Institution

Comparison of clinical presentation of respiratory tract infections in H1N1/09-positive and H1N1/09-negative patients

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