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Characterization of 2009 H1N1 pandemic influenza in a population of Dutch children with influenza-like signs and symptoms

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Editor, Senior Moderator
Source: Acta Paediatr | Posted 3 hours ago
Characterization of 2009 H1N1 pandemic influenza in a population of Dutch children with influenza-like signs and symptoms; Smit PM, Bongers KM, Kuiper RJ, von Rosenstiel IA, Smits PH, Brandjes DP; Acta P?diatrica (Jul 2011)

Tags:
Influenza A (H1N1)
oseltamivir
Respiratory Infections
Viral Infections

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Aim:  To determine causative respiratory pathogens and describe epidemiological and clinical characteristics in a paediatric population with influenza-like illness during the 2009 H1N1-pandemic. Methods:  Observational study of 412 children visiting an outpatient clinic of a Dutch teaching hospital. Results:  From August to December 2009, 412 children were tested at the clinic; 32% proved H1N1-positive, confirmed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR). Pathogens were detected in 65% of samples. Influenza A(H1N1) (n=132), human rhinovirus (n=55), respiratory syncytial virus (n=45) and adenovirus (n=34) were mostly identified. Co-infections were seen in 34 children (8.3%). Mean age was 6.8 and 4.2 years in H1N1-positive and -negative cases, respectively (p<0.01). H1N1-positive outpatient children reported fever, cough and rhinorrhoea more frequently than their H1N1-negative counterparts. Of 72 hospitalized children 31% proved H1N1-positive; all showed a relatively mild clinical illness. None of the children had been admitted to the intensive care unit or died. Oseltamivir treatment was initiated in 72 children and discontinued in 42 (63%) when RT-PCR results turned negative. Conclusion:  The 2009 H1N1-pandemic showed a mild clinical course in a Dutch paediatric outpatient clinic population. Respiratory pathogens were detected in the majority of children with influenza-like illness and influenza A(H1N1) virus was identified in one third. Testing symptomatic children during an influenza pandemic has effectively limited the use of oseltamivir.

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