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Clinical and socioeconomic impact of different types and subtypes of seasonal influenza viruses in children during influenza seasons 2007/2008 and 2008/2009

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  • Clinical and socioeconomic impact of different types and subtypes of seasonal influenza viruses in children during influenza seasons 2007/2008 and 2008/2009

    BMC Infect Dis. 2011 Oct 12;11(1):271. [Epub ahead of print]
    Clinical and socioeconomic impact of different types and subtypes of seasonal influenza viruses in children during influenza seasons 2007/2008 and 2008/2009.
    Esposito S, Molteni CG, Daleno C, Valzano A, Fossali E, Da Dalt L, Cecinati V, Bruzzese E, Giacchino R, Giaquinto C, Lackenby A, Principi N, Isgi FT.
    Abstract

    ABSTRACT:
    BACKGROUND:

    There are few and debated data regarding possible differences in the clinical presentations of influenza A/H1N1, A/H3N2 and B viruses in children. This study evaluates the clinical presentation and socio-economic impact of laboratory-confirmed influenza A/H1N1, A/H3N2 or B infection in children attending an Emergency Room because of influenza-like illness.
    METHODS:

    Among the 4,726 children involved, 662 had influenza A (143 A/H1N1 and 519 A/H3N2) and 239 influenza B infection detected by means of real-time polymerase chain reaction. Upon enrolment, systematic recordings were made of the patients' demographic characteristics and medical history using standardised written questionnaires. The medical history of the children was re-evaluated 5-7 days after enrolment and until the resolution of their illness by means of interviews and a clinical examination by trained investigators using standardised questionnaires. During this evaluation, information was also obtained regarding illnesses and related morbidity among households.
    RESULTS:

    Children infected with influenza A/H1N1 were significantly younger (mean age, 2.3 yrs) than children infected with influenza A/H3N2 (mean age, 4.7 yrs; p<0.05)) or with influenza B (mean age, 5.2 yrs; p<0.05). Adjusted for age and sex, children with influenza A/H3N2 in comparison with those infected by either A/H1N1 or with B influenza virus were more frequently affected by fever (p<0.05) and lower respiratory tract involvement (p<0.05), showed a worse clinical outcome (p<0.05), required greater drug use (p<0.05), and suffered a worse socio-economic impact (p<0.05). Adjusted for age and sex, children with influenza B in comparison with those infected by A/H1N1 influenza virus had significantly higher hospitalization rates (p<0.05), the households with a disease similar to that of the infected child (p<0.05) and the need for additional household medical visits (p<0.05).
    CONCLUSIONS:

    Disease due to influenza A/H3N2 viral subtype is significantly more severe than that due to influenza A/H1N1 subtype and influenza B virus, which indicates that the characteristics of the different viral types and subtypes should be adequately considered by health authorities when planning preventive and therapeutic measures.

    PMID:
    21992699
    [PubMed - as supplied by publisher]

    Disease due to influenza A/H3N2 viral subtype is significantly more severe than that due to influenza A/H1N1 subtype and influenza B virus, which indicates that the characteristics of the different viral types and subtypes should be adequately considered by health authorities when planning preventiv …
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