Older children hospitalized with pandemic H1N1 influenza in 2009: Study

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Vaccination of children vital in upcoming flu season, study author says

Children hospitalized with pandemic H1N1 influenza in 2009 were older and more likely to have underlying medical conditions than children hospitalized with seasonal influenza during prior flu seasons, according to a study to be presented Tuesday, May 4 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Population-based surveillance of 5.3 million children for laboratory-confirmed influenza was conducted in 10 states during the 2003-2009 influenza seasons and in the early 2009 H1N1 pandemic. Investigators used the data to compare the demographics, medical history and clinical course of children younger than 18 years who were hospitalized with seasonal influenza vs. those hospitalized with H1N1 flu.

Results showed the median age of children hospitalized with H1N1 influenza was 5 years, compared to 1 year for those hospitalized with seasonal flu in 2003-2009. In addition, children with asthma, hemoglobinopathies such as sickle-cell disease and a history of prematurity made up a larger proportion of all children hospitalized with H1N1 influenza than with seasonal flu. However, one-third of children hospitalized with H1N1 influenza were previously healthy.

"Our findings underscore the importance of influenza immunization in children of all ages and particularly in children with underlying medical conditions," said lead author Fatimah S. Dawood, MD, epidemic intelligence service officer, Influenza Division, Centers for Disease Control and Prevention (CDC). "Ensuring immunization of children at risk for hospitalization with influenza will remain critical during the upcoming 2010-2011 influenza season when the 2009 pandemic H1N1 virus may continue to circulate and other seasonal influenza viruses may circulate as well."

The 2010-2011 seasonal flu vaccine will protect against three flu viruses, one of which is a 2009 H1N1-like flu virus.

Results also showed that compared to children hospitalized with seasonal influenza, an even higher proportion of children hospitalized with H1N1 influenza were diagnosed with pneumonia and/or required intensive care.

"These findings also support the use of early antiviral treatment in children with 2009 pandemic H1N1 influenza who require hospitalization," Dr. Dawood said. "Prior studies of seasonal influenza have demonstrated that antiviral treatment may improve outcomes in patients with severe influenza."

Source: American Academy of Pediatrics

http://www.news-medical.net/news/20...th-pandemic-H1N1-influenza-in-2009-Study.aspx

 

[tetano]

Re: Older children hospitalized with pandemic H1N1 influenza in 2009: Study

[4325.3] Complications of Seasonal and Pandemic Influenza in Children Hospitalized with Influenza, 2003-2009

Fatimah S. Dawood, Laurie Kamimoto, Anna Bramley, Arthur Reingold, Ken Gershman, Kimberly Yousey-Hinds, Kathryn Arnold, Monica Farley, Patricia Ryan, Ruth Lynfield, Joan Baumbach, Shelley Zansky, Nancy Bennett, Ann Thomas, William Schaffner , David Kirschke, Lyn Finelli. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA; Emerging Infections Program Network, Atlanta, GA.

BACKGROUND: Influenza results in a substantial number of pediatric hospitalizations during typical influenza seasons. In April 2009, the 2009 Pandemic (H1N1) virus emerged. Characteristics and clinical courses of children hospitalized with 2009 H1N1 versus seasonal influenza may differ.
OBJECTIVE: To compare characteristics of and complications in children hospitalized with seasonal and 2009 H1N1 influenza.
DESIGN/METHODS: During the 2003-09 influenza seasons and early 2009 H1N1 pandemic (April 15-August 30, 2009), population-based surveillance of 5.3 million children aged <18 years for laboratory-confirmed influenza was conducted in 10 states. Hospitalized children were identified retrospectively; clinicians made influenza testing decisions. Data collected from hospital records included demographics, medical history, and clinical course. Characteristics were compared for children hospitalized with seasonal influenza during 2003-09 and influenza A (presumed 2009 H1N1) virus infections during April 15-August 30, 2009.
RESULTS: Overall, 4,798 children were hospitalized with seasonal influenza, and 514 with 2009 H1N1. Compared to children hospitalized with seasonal influenza, children with 2009 H1N1 were older (median age 1 vs. 5 years) and more likely to have underlying medical conditions (44% vs. 61%, p<0.01), particularly asthma (18% vs. 32%, p<0.01), and those aged 2-9 years were more likely to have pneumonia (<2 years, 17% vs. 22%, p=0.2; 2-4 years, 28% vs. 42%, p<0.01; 5-9 years, 28% vs. 41%, p<0.01; 10-17 years, 21% vs. 19%, p=0.6). Additional complications included intensive care unit (ICU) admission (of all children, seasonal 13% vs. 2009 H1N1 20%, p<0.01; of children with underlying conditions, 16% vs. 23%, p<0.01), respiratory failure (of those in ICUs, 33% vs. 27%, p=0.6), bacterial co-infection (2% vs. 2%, p=0.8), and death (0.5% vs. 0.4%, p=0.9).
CONCLUSIONS: Need for intensive care was even more common in children hospitalized with 2009 H1N1, and a higher proportion of children with 2009 H1N1 had underlying medical conditions. These findings underscore the importance of vaccination against 2009 H1N1 in the pediatric population, particularly in children with underlying conditions.
First Author is a Fellow in Training
E-PAS20104325.3

Date: Tuesday, May 4, 2010
Platform Session: Epidemiology II (10:15 AM - 12:15 PM)
Presentation Time: 10:45 AM
Room: 220 - Vancouver Convention Centre
Course Number: 4325

http://www.abstracts2view.com/pas/view.php?nu=PAS10L1_4007&terms