Giuseppe
Emeritus
[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]
Complications and associated bacterial co-infections among children hospitalized with seasonal or pandemic influenza, United States, 2003-2010
Fatimah S. Dawood 1, Sandra S. Chaves 1, Alejandro P?rez 1, Arthur Reingold 2, James Meek 3, Monica M. Farley 4, Patricia Ryan 5, Ruth Lynfield 6, Craig Morin 6, Joan Baumbach 7, Nancy M. Bennett 8, Shelley Zansky 9, Ann Thomas 10, Mary Lou Lindegren 11, William Schaffner 11, Lyn Finelli 1, for the Emerging Infections Program Network
Author Affiliations: <SUP>1</SUP>Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA <SUP>2</SUP>California Emerging Infections Program, Oakland, California, USA <SUP>3</SUP>Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA <SUP>4</SUP>Emory University School of Medicine, the Atlanta Veterans Affairs Medical Center, and the Georgia Emerging Infections Program, Atlanta, Georgia, USA <SUP>5</SUP>Maryland Department of Health and Mental Hygiene, Baltimore, MD <SUP>6</SUP>Minnesota Department of Health, St. Paul, Minnesota, USA <SUP>7</SUP>New Mexico Department of Health, Santa Fe, New Mexico, USA <SUP>8</SUP>Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA <SUP>9</SUP>Emerging Infections Program, New York State Department of Health, Albany, NY, USA <SUP>10</SUP>Oregon Public Health Division, Portland, Oregon, USA <SUP>11</SUP>Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Corresponding Author: Fatimah S. Dawood, Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA 30333, United States; telephone: (404) 639-0431; fax (404) 639-3866; email: fdawood@cdc.gov.
Alternate Corresponding Author: Lyn Finelli, DrPH, Tel: 404.639.2554, Email: lyf8@cdc.gov.
Abstract
Background.
Data on the range and severity of influenza-associated complications among children are limited. We describe the frequency and severity of complications in hospitalized children aged <18 years with seasonal influenza (2003-2009) and influenza A(H1N1)pdm09 (2009-2010).
Methods.
Population-based surveillance for laboratory-confirmed influenza hospitalizations was conducted among 5.3 million children in 10 states. Complications were identified by ICD-9 codes in medical records.
Results.
During 2003-2010, 7,293 children hospitalized with influenza were identified, of whom 6,769 (93%) had complete ICD-9 code data. Among the 6,769 children, the median length of hospitalization was 3 days (interquartile range 2-4), 975 (14%) required intensive care, 359 (5%) had respiratory failure, and 40 (1%) died. The most common complications were pneumonia (28%), asthma exacerbations (793/3616 children >2 years, 22%), and dehydration (21%). Lung abscess/empyema, tracheitis, encephalopathy, bacteremia/sepsis, acute renal failure, and myocarditis were rare (<2%) but associated with median hospitalization >6 days and 48-70% of children required intensive care. Positive bacterial cultures were identified in 2% of children (107/6769); Staphylococcus aureus and Streptococcus pneumoniae were most commonly identified.
Conclusion.
Complications add substantially to the burden of hospitalized children with influenza through intensive care requirements and prolonged hospitalization, highlighting the importance of primary prevention with influenza vaccination.
Received June 26, 2013. Revision received July 26, 2013. Accepted August 1, 2013.
Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2013.
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Complications and associated bacterial co-infections among children hospitalized with seasonal or pandemic influenza, United States, 2003-2010
Fatimah S. Dawood 1, Sandra S. Chaves 1, Alejandro P?rez 1, Arthur Reingold 2, James Meek 3, Monica M. Farley 4, Patricia Ryan 5, Ruth Lynfield 6, Craig Morin 6, Joan Baumbach 7, Nancy M. Bennett 8, Shelley Zansky 9, Ann Thomas 10, Mary Lou Lindegren 11, William Schaffner 11, Lyn Finelli 1, for the Emerging Infections Program Network
Author Affiliations: <SUP>1</SUP>Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA <SUP>2</SUP>California Emerging Infections Program, Oakland, California, USA <SUP>3</SUP>Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA <SUP>4</SUP>Emory University School of Medicine, the Atlanta Veterans Affairs Medical Center, and the Georgia Emerging Infections Program, Atlanta, Georgia, USA <SUP>5</SUP>Maryland Department of Health and Mental Hygiene, Baltimore, MD <SUP>6</SUP>Minnesota Department of Health, St. Paul, Minnesota, USA <SUP>7</SUP>New Mexico Department of Health, Santa Fe, New Mexico, USA <SUP>8</SUP>Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA <SUP>9</SUP>Emerging Infections Program, New York State Department of Health, Albany, NY, USA <SUP>10</SUP>Oregon Public Health Division, Portland, Oregon, USA <SUP>11</SUP>Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Corresponding Author: Fatimah S. Dawood, Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Rd MS A-32, Atlanta, GA 30333, United States; telephone: (404) 639-0431; fax (404) 639-3866; email: fdawood@cdc.gov.
Alternate Corresponding Author: Lyn Finelli, DrPH, Tel: 404.639.2554, Email: lyf8@cdc.gov.
Abstract
Background.
Data on the range and severity of influenza-associated complications among children are limited. We describe the frequency and severity of complications in hospitalized children aged <18 years with seasonal influenza (2003-2009) and influenza A(H1N1)pdm09 (2009-2010).
Methods.
Population-based surveillance for laboratory-confirmed influenza hospitalizations was conducted among 5.3 million children in 10 states. Complications were identified by ICD-9 codes in medical records.
Results.
During 2003-2010, 7,293 children hospitalized with influenza were identified, of whom 6,769 (93%) had complete ICD-9 code data. Among the 6,769 children, the median length of hospitalization was 3 days (interquartile range 2-4), 975 (14%) required intensive care, 359 (5%) had respiratory failure, and 40 (1%) died. The most common complications were pneumonia (28%), asthma exacerbations (793/3616 children >2 years, 22%), and dehydration (21%). Lung abscess/empyema, tracheitis, encephalopathy, bacteremia/sepsis, acute renal failure, and myocarditis were rare (<2%) but associated with median hospitalization >6 days and 48-70% of children required intensive care. Positive bacterial cultures were identified in 2% of children (107/6769); Staphylococcus aureus and Streptococcus pneumoniae were most commonly identified.
Conclusion.
Complications add substantially to the burden of hospitalized children with influenza through intensive care requirements and prolonged hospitalization, highlighting the importance of primary prevention with influenza vaccination.
Received June 26, 2013. Revision received July 26, 2013. Accepted August 1, 2013.
Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2013.
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