PANDEMIC A/H1N1V INFLUENZA 2009 IN CHILDREN: A MULTICENTRIC BELGIAN SURVEY
ESPID Education. Blumental s. 06/07/11; 7731
sophie Blumental
sophie Blumental

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Abstract
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Background and objectives: During the 2009 influenza A/H1N1v pandemic, children were identified as a particular “at risk” group. We conducted a multicentric trial to describe pattern of A/H1N1v infection among hospitalized children.
Material and methods: From 01/07/09 to 31/01/10, we prospectively collected all proven (positive H1N1v PCR) and probable (positive Influenza A antigen or culture) pediatric cases of H1N1v infections, hospitalized in four tertiary centers in Brussels.
Results: We reported 215 children hospitalized with proven/probable H1N1 infection. Median age was 31 months. 47% had ≥ one co-morbidity. Febrile respiratory illness was the most common presentation. 36% presented initial gastrointestinal symptoms and 10% neurological manifestations. 35% had pneumonia. Compared to PCR, sensitivity of antigen and culture was low (53% and 59%, respectively). Only 23% of patients received oseltamivir. 21 (10%) children had to be admitted to ICU, of whom seven suffered from ARDS. Rate of co-morbidity tended to be higher among ICU than general wards patients (62%><45%,p=0.1). Fatality-rate was 5/215 (2%) and concerned only children suffering from chronic neurological disorders. Children > 2 years old showed a higher propensity to be admitted to ICU (16%><1%,p=0.002) and a higher mortality (4%>< 0%,p=0.06). Infants ≤ 3 months showed a particularly mild pattern of infection, with few respiratory and neurological complications.
Conclusion: Although H1N1 infections were globally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar.
Background and objectives: During the 2009 influenza A/H1N1v pandemic, children were identified as a particular “at risk” group. We conducted a multicentric trial to describe pattern of A/H1N1v infection among hospitalized children.
Material and methods: From 01/07/09 to 31/01/10, we prospectively collected all proven (positive H1N1v PCR) and probable (positive Influenza A antigen or culture) pediatric cases of H1N1v infections, hospitalized in four tertiary centers in Brussels.
Results: We reported 215 children hospitalized with proven/probable H1N1 infection. Median age was 31 months. 47% had ≥ one co-morbidity. Febrile respiratory illness was the most common presentation. 36% presented initial gastrointestinal symptoms and 10% neurological manifestations. 35% had pneumonia. Compared to PCR, sensitivity of antigen and culture was low (53% and 59%, respectively). Only 23% of patients received oseltamivir. 21 (10%) children had to be admitted to ICU, of whom seven suffered from ARDS. Rate of co-morbidity tended to be higher among ICU than general wards patients (62%><45%,p=0.1). Fatality-rate was 5/215 (2%) and concerned only children suffering from chronic neurological disorders. Children > 2 years old showed a higher propensity to be admitted to ICU (16%><1%,p=0.002) and a higher mortality (4%>< 0%,p=0.06). Infants ≤ 3 months showed a particularly mild pattern of infection, with few respiratory and neurological complications.
Conclusion: Although H1N1 infections were globally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar.
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