Clinical characteristics of pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Northern Bavaria, Germany

BMC Research Notes

Johannes G Liese²  Andrea Streng²  Benedikt Weissbrich³  Christina Kohlhauser-Vollmuth¹  Jasmin Benser²  Anna Wieching² 

[1] Department of Pediatrics, Missio Hospital Wuerzburg, Salvatorstr. 7, 97067, Wuerzburg, Germany;University Children’s Hospital, Pediatric Infectiology and Immunology, Julius-Maximilians-University of Wuerzburg, Josef-Schneider-Str. 2, 97080, Wuerzburg, Germany;Institute for Virology and Immunobiology, Julius-Maximilians-University of Wuerzburg, Versbacherstr. 7, 97078, Wuerzburg, Germany

关键词: Hospitalization;    Infectious disease;    Pediatric;    Influenza;   

Others  :  1166283
DOI  :  10.1186/1756-0500-5-304

 received in 2012-05-10, accepted in 2012-06-18,  发布年份 2012

【 摘 要 】

Background

The 2009 pandemic influenza A (H1N1) (PIA) virus infected large parts of the pediatric population with a wide clinical spectrum and an initially unknown complication rate. The aims of our study were to define clinical characteristics and outcome of pandemic influenza A (H1N1) 2009-associated hospitalizations (PIAH) in children <18 years of age. All hospitalized cases of children <18 years of age with laboratory-confirmed pandemic influenza A (H1N1) 2009 in the region of Wuerzburg (Northern Bavaria, Germany) between July 2009 and March 2010 were identified. For these children a medical chart review was performed to determine their clinical characteristics and complications.

Results

Between July 2009 and March 2010, 94 PIAH (62% males) occurred in children <18 years of age, with a median age of 7 years (IQR: 3–12 years). Underlying diseases and predisposing factors were documented in 40 (43%) children; obesity (n = 12, 30%), asthma (n = 10, 25%) and neurologic disorders (n = 8, 20%) were most frequently reported. Sixteen (17%) children received oxygen supplementation; three (3%) children required mechanical ventilation. Six (6%) children were admitted to an intensive care unit, four of them with underlying chronic diseases.

Conclusions

Most PIAH demonstrated a benign course of disease. However, six children (6%) needed treatment at an intensive care unit for severe complications.

【 授权许可】

   
2012 Wieching et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Poehling KA, Edwards KM, Weinberg GA, Szilagyi P, Staat MA, Iwane MK, Bridges CB, Grijalva CG, Zhu Y, Bernstein DI, Herrera G, Erdman D, Hall CB, Seither R, Griffin MR: The underrecognized burden of influenza in young children. N Engl J Med 2006, 355(1):31-40.
• [2]Weigl JA, Puppe W, Schmitt HJ: The incidence of influenza-associated hospitalizations in children in Germany. Epidemiol Infect 2002, 129(3):525-533.
• [3]WHO: Global Alert and Response (GAR) – Pandemic (H1N1) 2009 – update 101. [http://www.who.int/csr/don/2010_05_21/en/ webcite]
• [4]CDC: Updated CDC estimates of 2009 H1N1 influenza cases, hospitalizations and deaths in the United States, April 2009 – April 10, 2010. 2010. http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm webcite
• [5]RKI: Bericht zur Epidemiologie der Influenza in Deutschland Saison 2009/2010. 2010. http://influenza.rki.de/Saisonberichte/2009.pdf webcite
• [6]RKI: Mitteilung der Ständigen Impfkommission (STIKO) am Robert Koch–Institut - Änderung der Empfehlungen zur Impfung gegen Influenza. Epidemiolog Bulletin 2010, 31:299-309.
• [7]Altmann M, Fiebig L, Soyka J, von Kries R, Dehnert M, Haas W: Severe cases of pandemic (H1N1) 2009 in children, Germany. Emerg Infect Dis 2011, 17(2):186-192.
• [8]Boxhammer S, Lepler R, Lenhartz H, Püst B, Höger PH: Influenza A/H1N1–2009 bei Kindern und Jugendlichen in Hamburg. Symptomatik und Verlauf bei 95 stationär behandlungsbedürftigen pädiatrischen Patienten. [Pandemic influenza A/H1N1–2009 in children and adolescents in Hamburg. Symptoms and course of disease in 95 hospitalized pediatric patients]. Monatsschr Kinderheilkd 2011, 159:560-564.
• [9]Bettinger JA, Sauvé LJ, Scheifele DW, Moore D, Vaudry W, Tran D, Halperin SA, Pelletier L: Pandemic influenza in Canadian children: a summary of hospitalized pediatric cases. Vaccine 2010, 28(18):3180-3184.
• [10]Kumar S, Havens PL, Chusid MJ, Willoughby RE, Simpson P, Henrickson KJ: Clinical and epidemiologic characteristics of children hospitalized with 2009 pandemic H1N1 influenza A infection. Pediatr Infect Dis J 2010, 29(7):591-594.
• [11]Libster R, Bugna J, Coviello S, Hijano DR, Dunaiewsky M, Reynoso N, Cavalieri ML, Guglielmo MC, Areso MS, Gilligan T, Santucho F, Cabral G, Gregorio GL, Moreno R, Lutz MI, Panigasi AL, Saligari L, Caballero MT, Egües Almeida RM, Gutierrez Meyer ME, Neder MD, Davenport MC, Del Valle MP, Santidrian VS, Mosca G, Garcia Domínguez M, Alvarez L, Landa P, Pota A, Boloñati N, Dalamon R, Sanchez Mercol VI, Espinoza M, Peuchot JC, Karolinski A, Bruno M, Borsa A, Ferrero F, Bonina A, Ramonet M, Albano LC, Luedicke N, Alterman E, Savy V, Baumeister E, Chappell JD, Edwards KM, Melendi GA, Polack FP: Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. N Engl J Med 2010, 362:45-55.
• [12]Hackett S, Hill L, Patel J, Ratnaraja N, Ifeyinwa A, Farooqi M, Nusgen U, Debenham P, Gandhi D, Makwana N, Smit E, Welch S: Clinical characteristics of paediatric H1N1 admissions in Birmingham. UK. Lancet 2009, 374:605.
• [13]Streng A, Grote V, Liese JG: Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008. BMC Infect Dis 2011, 11:233. BioMed Central Full Text
• [14]Nguyen-Van-Tam JS, Openshaw PJ, Hashim A, Gadd EM, Lim WS, Semple MG, Read RC, Taylor BL, Brett SJ, McMenamin J, Enstone JE, Armstrong C, Nicholson KG: Risk factors for hospitalisation and poor outcome with pandemic A/H1N1 influenza: United Kingdom first wave (May-September 2009). Thorax 2010, 65(7):645-651.
• [15]Poeppl W, Hell M, Herkner H, Stoiser B, Fritsche G, Schurz-Bamieh N, Poeppl G, Gattringer R, Jones N, Maass M, Egle A, Burgmann H: Clinical aspects of 2009 pandemic influenza A (H1N1) virus infection in Austria. Infection 2011.
• [16]RKI: Mitteilung der Ständigen Impfkommission (STIKO) am Robert Koch-Institut- Impfung gegen die Neue Influenza A (H1N1). Epidemiolog Bulletin 2009, 41:403-424.
• [17]Walter D, Böhmer MM, van der Heiden M, Reiter S, Krause G, Wichmann O: Monitoring pandemic influenza A(H1N1) vaccination coverage in Germany 2009/10 – results from thirteen consecutive cross-sectional surveys. Vaccine 2011, 29:4008-4012.