Epidemiological and clinical features of respiratory viral infections in hospitalized children during the circulation of influenza virus A(H1N1) 2009.
ABSTRACT Seasonal influenza viruses and respiratory syncytial virus (RSV) are primary causes of acute respiratory tract infections (ARTIs) in children. New respiratory viruses including human metapneumovirus (hMPV), human bocavirus (hBoV), and influenza 2009 A(H1N1) virus have a strong impact on the pediatric population.
To evaluate epidemiological and clinical features of ARTIs in hospitalized children.
From December 1, 2008, to December 31, 2009, all children under age fifteen (n = 575) hospitalized for ARTIs were investigated for influenza A (subtype H1N1, H3N2, and 2009 H1N1) and B, RSV A and B, hMPV, and hBoV by PCR.
Fifty-one percent of samples were positive for these respiratory viruses. The frequencies of virus detection were RSV 34·1%, hBoV 6·8%, hMPV 5%, seasonal influenza A 5%, and seasonal influenza B 0%. From April 2009, 11·6% of collected samples were influenza 2009 A(H1N1) positive. Respiratory syncytial virus activity peaked in January, hBoV in February, and hMPV in April. Seasonal influenza A was detected only between January and April 2009, while influenza 2009 A(H1N1) peaked in November. Respiratory syncytial virus and hMPV were mainly associated with lower respiratory tract infections (LRTIs) and with necessity of O(2) administration. The 2009 pandemic influenza was more frequently detected in elder children (P < 0·001) and was associated with higher, longer-lasting fevers compared with other viral infections (P < 0·05).
All considered viruses were involved in LRTIs. The primary clinical relevance of RSV and a similar involvement of both seasonal influenza and emerging viruses investigated were observed on the pediatric population.
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ABSTRACT: The burden of influenza is unevenly distributed, with more severe outcomes in children aged <5 years than older children and adults. In spite of this, immunisation policies for young children are far from universal. This article provides an overview of the published evidence on the burden of influenza in children worldwide, with a particular interest in the impact of pandemic influenza in 2009-2010 (caused by the H1N1pdm09 virus). In an average season, up to 9.8 % of 0- to 14-year olds present with influenza, but incidence rates can be markedly higher in younger children. Children aged <5 years have greater rates of hospitalisation and complications than their older counterparts, particularly if the children have co-existing illnesses; historically, this age group have had higher mortality rates from the disease than other children, although during the 2009-2010 pandemic the median age of those who died of influenza was higher than in previous seasons. Admissions to hospital and emergency departments appear to have been more frequent in children with H1N1pdm09 infections than during previous seasonal epidemics, with pneumonia continuing to be a common complication in this setting. Outcomes in children hospitalised with severe disease also seem to have been worse for those infected with H1N1pdm09 viruses compared with seasonal viruses. Studies in children confirm that vaccination reduces the incidence of seasonal influenza and the associated burden, underlining the importance of targeting this group in national immunisation policies. Conclusions: Children aged <5 years are especially vulnerable to influenza, particularly that caused by seasonal viruses, and vaccination in this group can be an effective strategy for reducing disease burden.European Journal of Pediatrics 05/2013; · 1.91 Impact Factor
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ABSTRACT: The aim of this study was to try to ascertain whether, in the absence of a pre-organized programme, locally collected data might provide information about the epidemiological and clinical characteristics of the recent A(H1N1) pandemic in Italy. The study was an observational retrospective analysis of the clinic-epidemiological features performed by reviewing medical charts from 141 hospitalized patients with laboratory confirmed pandemic A(H1N1) infection in Umbria, a region of central Italy, in the period July 2009 to March 2010. The pandemic virus was found capable of inducing severe illness requiring hospitalization or intensive care unit admission (ICU), or resulting in death. Age and comorbidity were found to be potential risk factors for severe disease. The mean age of the hospitalized patients was 37 years (range 0 - 93 yrs), however the mean age of ICU admitted patients, including people who did not survive, was higher as compared with those admitted to general medical ward (54 vs 35 yrs). The highest incidence of hospitalization was observed in the youngest group (0 - 17 yrs), the greatest rate of ICU admission in adults (18 - 64 years), and the risk of death in the oldest population (≥ 65 yrs). Comorbity conditions were present in some (55%), but not all hospitalized patients and increased with the age and the severity of the illness. The data obtained are compatible with the identified epidemiological characteristics of the A(H1N1) pandemic derived from partial information previously collected in Italy and from studies conducted in other European and non European countries. The results of our retrospective observational study suggest that locally organized data collection may give information on the epidemiological and clinical characteristics of a pandemic that are compatible with those obtained from more complex and complete studies.Journal of Clinical Medicine Research 08/2013; 5(4):286-93.
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ABSTRACT: SUMMARY Respiratory virus infections cause a significant number of hospitalization and deaths globally. This study investigated the association between single and multiple respiratory virus infections and risk of admission to a general ward, intensive care unit or death in patients aged 0-105 years (mean ± s.d. = 24·4 ± 24·1 years), from North West England, that were tested for respiratory virus infections between January 2007 and June 2012. The majority of infections were in children aged ⩽5 years. Dual or multiple infections occurred in 10·4% (1214/11 715) of patients, whereas single infection occurred in 89·6% (10 501/11 715). Rhinovirus was the most common co-infecting virus (occurring in 69·5%; 844/1214 of co-infections). In a multivariate logistic regression model, multiple infections were associated with an increased risk of admission to a general ward [odds ratio (OR) 1·43, 95% confidence interval (CI) 1·2-1·7, P < 0·0001]. On the other hand, patients with respiratory syncytial virus (RSV) and human parainfluenza virus types 1-3 (hPIV1-3), as a single infection, had a higher risk of being admitted to a general ward (OR 1·49, 95% CI 1·28-1·73, P < 0·0001 and OR 1·34, 95% CI 1·003-1·8, P = 0·05, respectively); admitted to an intensive-care unit or dying (OR 1·5, 95% CI 1·20-2·0, P = 0·001 and OR 1·60, 95% CI 1·02-2·40, P = 0·04, respectively). This result emphasizes the importance of RSV, hPIV and mixed infections and calls for research on vaccines, drugs and diagnostic tests targeting these respiratory viruses.Epidemiology and Infection 02/2014; · 2.87 Impact Factor