ESPID Education. Heininger U. Jun 7, 2011; 7732
Ulrich Heininger
Ulrich Heininger

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Background: In 2009, pandemic influenza A/H1N1 (piA) caused significant morbidity and mortality worldwide. Here we compare clinical features and epidemiology of pandemic H1N1 infections to those of seasonal influenza A (siA) infections of the two preceding winter seasons in hospitalized children and adolescents.
Methods: Medical records of all hospitalized patients <18 years with RT-PCR-confirmed siA (fall 2007 to spring 2009) or piA infections (April 2009 to March 2010) were analysed retrospectively.
Results: 134 patients (piA: N=55, 58% male; siA: N=79, 58% male) were identified; median age was 2.5 yrs (range 0.07-15.5) in piA patients and 1.5 yrs (range 0.04-17.5) in siA patients. Underlying chronic disease was present in 25% (piA) versus 33% (siA) patients. All patients except one had fever; most common other symptoms were cough (piA/siA: 78%/86%), rhinitis (76%/76%) and pharyngitis (67%/68%). Croup syndrome (15%/3%, p=0.02), conjunctivitis (31%/10%, p=0.002) and febrile seizures (26%/13%, p=0.05) were more frequent in piA patients. Overall, 64% (n=35) of piA and 53% (n=42) of siA patients had >1 complication: pneumonia 15%/22%, AOM 13%/11%, CNS complications 29%/18% (all p>0.05). 5 patients (3/2) were admitted to ICU; one 4.8 month old boy with underlying congenital malformations died due to secondary bacterial pneumonia, all other patients recovered without sequelae. Mean hospitalisation duration was 2.9/3.9 days (p>0.05). Influenza immunization rates were 5%/0%). None of siA but 20% of piA patients were treated with oseltamivir.
Conclusions: Although patients with piA infection presented with more febrile seizures, overall severity of disease was not different compared to siA in previous years.
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