<table border="0" cellpadding="0" cellspacing="0" width="640"> <tbody><tr> <td nowrap="nowrap" valign="top">Previous</td> <td align="center" valign="top"><table border="0" cellpadding="0" cellspacing="0"> <tbody><tr><th align="right" nowrap="nowrap" valign="top">Volume 355:31-40</th> <td nowrap="nowrap"></td> <th nowrap="nowrap" valign="top">July 6, 2006</th> <td nowrap="nowrap"></td> <th align="left" nowrap="nowrap" valign="top">Number 1</th> </tr></tbody></table></td> <td align="right" nowrap="nowrap" valign="top">Next</td> </tr> </tbody></table>

The Underrecognized Burden of Influenza in Young Children
<center> Katherine A. Poehling, M.D., M.P.H., Kathryn M. Edwards, M.D., Geoffrey A. Weinberg, M.D., Peter Szilagyi, M.D., M.P.H., Mary Allen Staat, M.D., M.P.H., Marika K. Iwane, Ph.D., M.P.H., Carolyn B. Bridges, M.D., Carlos G. Grijalva, M.D., M.P.H., Yuwei Zhu, M.D., David I. Bernstein, M.D., Guillermo Herrera, M.D., M.B.A., Dean Erdman, Ph.D., Caroline B. Hall, M.D., Ranee Seither, M.P.H., Marie R. Griffin, M.D., M.P.H., for the New Vaccine Surveillance Network

ABSTRACT Background The disease burden of influenza infection among children<sup> </sup>is not well established. We conducted a population-based surveillance<sup> </sup>of medical visits associated with laboratory-confirmed influenza.<sup> </sup>
Methods Eligible children were younger than five years of age,<sup> </sup>resided in three U.S. counties, and had a medical visit for<sup> </sup>an acute respiratory tract infection or fever. Nasal and throat<sup> </sup>swabs were tested for the influenza virus by viral culture and<sup> </sup>polymerase-chain-reaction assay. Epidemiologic data were collected<sup> </sup>from parental surveys and chart reviews. Children who were hospitalized<sup> </sup>were enrolled prospectively from 2000 through 2004. Population-based<sup> </sup>rates of hospitalizations associated with influenza were calculated.<sup> </sup>Children who were seen in selected pediatric clinics and emergency<sup> </sup>departments during two influenza seasons (2002?2003 and<sup> </sup>2003?2004) were systematically enrolled. The rates of<sup> </sup>visits to clinics and emergency departments associated with<sup> </sup>influenza were estimated.<sup> </sup>
Results The average annual rate of hospitalization associated<sup> </sup>with influenza was 0.9 per 1000 children. The estimated burden<sup> </sup>of outpatient visits associated with influenza was 50 clinic<sup> </sup>visits and 6 emergency department visits per 1000 children during<sup> </sup>the 2002?2003 season and 95 clinic visits and 27 emergency<sup> </sup>department visits per 1000 children during the 2003?2004<sup> </sup>season. Few children who had laboratory-confirmed influenza<sup> </sup>were given a diagnosis of influenza by the treating physician<sup> </sup>in the inpatient (28 percent) or outpatient (17 percent) settings.<sup> </sup>
Conclusions Among young children, outpatient visits associated<sup> </sup>with influenza were 10 to 250 times as common as hospitalizations.<sup> </sup>Few influenza infections were recognized clinically.<sup> </sup>
<sup> </sup>

Source Information
From the Departments of Pediatrics (K.A.P., K.M.E.), Preventive Medicine (C.G.G., M.R.G.), Biostatistics (Y.Z.), and Medicine (M.R.G.), Vanderbilt University Medical Center, Nashville; the Department of Pediatrics and Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (G.A.W., P.S., C.B.H.); the Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S., D.I.B.); and the National Center for Immunization and Respiratory Diseases (M.K.I., C.B.B., G.H., D.E., R.S.), Centers for Disease Control and Prevention, Atlanta.


<!-- null --> Related Letters:
The Underrecognized Burden of Influenza
Conover C. S., Whitaker E. E., Ages D., Sullo D., Griffin M. R., Edwards K. M., Poehling K. A.
Extract | Full Text | PDF
N Engl J Med 2006; 355:1615-1616, Oct 12, 2006. Correspondence
<!-- null -->
This article has been cited by other articles:
  • Hambidge, S. J., Glanz, J. M., France, E. K., McClure, D., Xu, S., Yamasaki, K., Jackson, L., Mullooly, J. P., Zangwill, K. M., Marcy, S. M., Black, S. B., Lewis, E. M., Shinefield, H. R., Belongia, E., Nordin, J., Chen, R. T., Shay, D. K., Davis, R. L., DeStefano, F., for the Vaccine Safety Datalink Team, (2006). Safety of Trivalent Inactivated Influenza Vaccine in Children 6 to 23 Months Old. JAMA 296: 1990-1997 <nobr> [Abstract] [Full Text] </nobr>
  • Conover, C. S., Whitaker, E. E., Ages, D., Sullo, D., Griffin, M. R., Edwards, K. M., Poehling, K. A. (2006). The Underrecognized Burden of Influenza. NEJM 355: 1615-1616 <nobr> [Full Text] </nobr>
  • (2006). Journal Watch Pediatrics & Adolescent Medicine. Arch. Dis. Child. 91: 949-950 <nobr> [Full Text] </nobr>
  • Paton, J. Y (2006). Review: vaccines prevent influenza and influenza-like illness in healthy children >2 years of age. Evid Based Med 11: 140-140 <nobr> [Full Text] </nobr>
  • Kemp, C. (2006). Flu often unrecognized in children. AAP News 27: 2-2 <nobr> [Full Text] </nobr>
  • (2006). Influenza Is Underrecognized in Children . . . but Does It Matter?. Journal Watch Emergency Medicine 2006: 6-6 <nobr> [Full Text] </nobr>
  • (2006). Influenza: The Burden of Disease in Children. Journal Watch Pediatrics and Adolescent Medicine 2006: 1-1 <nobr> [Full Text] </nobr>
  • (2006). Influenza: The Burden of Disease in Children. Journal Watch (General) 2006: 4-4 <nobr> [Full Text] </nobr>
  • (2006). What Is the True Burden of Influenza in Children?. Journal Watch Infectious Diseases 2006: 1-1 <nobr> [Full Text] </nobr>
  • Tonks, A. (2006). What's new in the other general journals. BMJ 333: 141-142 <nobr> [Full Text] </nobr>
  • Glezen, W. P. (2006). Influenza Control. NEJM 355: 79-81 <nobr> [Full Text] </nobr>

</center>