tetano
Editor, Senior Moderator
Clin Infect Dis
. 2022 Apr 19;ciac296.
doi: 10.1093/cid/ciac296. Online ahead of print.
Epidemiology, Clinical Characteristics, and Outcomes of Influenza-Associated Hospitalizations in U.S. Children Over 9 Seasons Following the 2009 H1N1 Pandemic
Satoshi Kamidani[SUP] 1 2 [/SUP], Shikha Garg[SUP] 3 [/SUP], Melissa A Rolfes[SUP] 3 [/SUP], Angela P Campbell[SUP] 3 [/SUP], Charisse N Cummings[SUP] 3 4 [/SUP], Julia C Haston[SUP] 5 [/SUP], Kyle P Openo[SUP] 6 7 [/SUP], Emily Fawcett[SUP] 6 7 [/SUP], Shua J Chai[SUP] 8 9 [/SUP], Rachel Herlihy[SUP] 10 [/SUP], Kimberly Yousey-Hindes[SUP] 11 [/SUP], Maya L Monroe[SUP] 12 [/SUP], Sue Kim[SUP] 13 [/SUP], Ruth Lynfield[SUP] 14 [/SUP], Chad Smelser[SUP] 15 [/SUP], Alison Muse[SUP] 16 [/SUP], Christina B Felsen[SUP] 17 [/SUP], Laurie Billing[SUP] 18 [/SUP], Ann Thomas[SUP] 19 [/SUP], H Keipp Talbot[SUP] 20 [/SUP], William Schaffner[SUP] 20 [/SUP], Ilene Risk[SUP] 21 [/SUP], Evan J Anderson[SUP] 1 2 6 7 [/SUP]
Affiliations
Abstract
Background: Recent population-based data are limited regarding influenza-associated hospitalizations in U.S. children.
Methods: We identified children <18 years hospitalized with laboratory-confirmed influenza during 2010-2019 seasons through CDC's Influenza Hospitalization Surveillance Network. Adjusted hospitalization and in-hospital mortality rates were calculated, and multivariable logistic regression was conducted to evaluate risk factors for pneumonia, intensive care unit (ICU) admission, mechanical ventilation, and death.
Results: Over 9 seasons, adjusted influenza-associated hospitalization incidence rates ranged from 10-375 per 100,000 persons each season and were highest among infants <6 months. Rates decreased with increasing age. The highest in-hospital mortality rates were observed in children <6 months (0.73 per 100,000 persons). Over time, antiviral treatment significantly increased from 56% to 85% (P < .001) and influenza vaccination rates increased from 33% to 44% (P = .003). Among the 13,235 hospitalized children, 2,676 (20%) of hospitalized children were admitted to the ICU, 2,262 (17%) had pneumonia, 690 (5%) required mechanical ventilation, and 72 (0.5%) died during hospitalization. As compared with those <6 months of age, hospitalized children ≥13 years had higher odds of pneumonia (adjusted odds ratios [aOR], 2.7; 95% confidence interval [CI], 2.1-3.4), ICU admission (aOR, 1.6; 95% CI, 1.3-1.9), mechanical ventilation (aOR, 1.6; 95% CI, 1.1-2.2), and death (aOR, 3.3; 95% CI, 1.2-9.3).
Conclusions: Hospitalization and death rates were greatest in younger children at the population level. Among hospitalized children, however, older children had a higher risk of severe outcomes. Continued efforts to prevent and attenuate influenza in children are needed.
Keywords: Influenza; epidemiology; pediatrics; vaccines.
. 2022 Apr 19;ciac296.
doi: 10.1093/cid/ciac296. Online ahead of print.
Epidemiology, Clinical Characteristics, and Outcomes of Influenza-Associated Hospitalizations in U.S. Children Over 9 Seasons Following the 2009 H1N1 Pandemic
Satoshi Kamidani[SUP] 1 2 [/SUP], Shikha Garg[SUP] 3 [/SUP], Melissa A Rolfes[SUP] 3 [/SUP], Angela P Campbell[SUP] 3 [/SUP], Charisse N Cummings[SUP] 3 4 [/SUP], Julia C Haston[SUP] 5 [/SUP], Kyle P Openo[SUP] 6 7 [/SUP], Emily Fawcett[SUP] 6 7 [/SUP], Shua J Chai[SUP] 8 9 [/SUP], Rachel Herlihy[SUP] 10 [/SUP], Kimberly Yousey-Hindes[SUP] 11 [/SUP], Maya L Monroe[SUP] 12 [/SUP], Sue Kim[SUP] 13 [/SUP], Ruth Lynfield[SUP] 14 [/SUP], Chad Smelser[SUP] 15 [/SUP], Alison Muse[SUP] 16 [/SUP], Christina B Felsen[SUP] 17 [/SUP], Laurie Billing[SUP] 18 [/SUP], Ann Thomas[SUP] 19 [/SUP], H Keipp Talbot[SUP] 20 [/SUP], William Schaffner[SUP] 20 [/SUP], Ilene Risk[SUP] 21 [/SUP], Evan J Anderson[SUP] 1 2 6 7 [/SUP]
Affiliations
- PMID: 35438769
- DOI: 10.1093/cid/ciac296
Abstract
Background: Recent population-based data are limited regarding influenza-associated hospitalizations in U.S. children.
Methods: We identified children <18 years hospitalized with laboratory-confirmed influenza during 2010-2019 seasons through CDC's Influenza Hospitalization Surveillance Network. Adjusted hospitalization and in-hospital mortality rates were calculated, and multivariable logistic regression was conducted to evaluate risk factors for pneumonia, intensive care unit (ICU) admission, mechanical ventilation, and death.
Results: Over 9 seasons, adjusted influenza-associated hospitalization incidence rates ranged from 10-375 per 100,000 persons each season and were highest among infants <6 months. Rates decreased with increasing age. The highest in-hospital mortality rates were observed in children <6 months (0.73 per 100,000 persons). Over time, antiviral treatment significantly increased from 56% to 85% (P < .001) and influenza vaccination rates increased from 33% to 44% (P = .003). Among the 13,235 hospitalized children, 2,676 (20%) of hospitalized children were admitted to the ICU, 2,262 (17%) had pneumonia, 690 (5%) required mechanical ventilation, and 72 (0.5%) died during hospitalization. As compared with those <6 months of age, hospitalized children ≥13 years had higher odds of pneumonia (adjusted odds ratios [aOR], 2.7; 95% confidence interval [CI], 2.1-3.4), ICU admission (aOR, 1.6; 95% CI, 1.3-1.9), mechanical ventilation (aOR, 1.6; 95% CI, 1.1-2.2), and death (aOR, 3.3; 95% CI, 1.2-9.3).
Conclusions: Hospitalization and death rates were greatest in younger children at the population level. Among hospitalized children, however, older children had a higher risk of severe outcomes. Continued efforts to prevent and attenuate influenza in children are needed.
Keywords: Influenza; epidemiology; pediatrics; vaccines.