Burden of Influenza in Children in the Community

University of Turku, Turku, Varsinais-Suomi, Finland
The Journal of Infectious Diseases (Impact Factor: 6). 10/2004; 190(8):1369-73. DOI: 10.1086/424527
Source: PubMed


Influenza vaccination of healthy children is encouraged because children are frequently hospitalized for influenza-attributable illnesses. However, most children with influenza are treated as outpatients, and scarce data are available on the burden of influenza in these children.
We performed a prospective study of respiratory infections in preenrolled cohorts of children < or = 13 years old during 2 consecutive respiratory seasons (2231 child-seasons of follow-up). At any sign of respiratory infection, we examined the children and obtained a nasal swab for the detection of influenza. The parents filled out daily symptom diaries. Of all the enrollees, 94% remained active participants in the study.
The average annual rate of influenza was highest (179 cases/1000 children) among children < 3 years old. Acute otitis media developed as a complication of influenza in 39.7% of children < 3 years old. For every 100 influenza-infected children < 3 years old, there were 195 days of parental work loss (mean duration, 3.2 days).
Influenza causes a substantial burden of illness on outpatient children and their families. Vaccination of children < 3 years old might be beneficial for reducing the direct and indirect costs of influenza in children.

Download full-text


Available from: Pasi Lehtinen, Nov 13, 2015
  • Source
    • "Due to the high rate of influenza infection in children and the availability of safe and effective vaccines [1] [2] [3] [4] [5], the US Centers for Disease Control and Prevention recommends influenza vaccination for all children 6 months and older for their own protection [6]. A study by Public Health England researchers that also took into account the role of children in the transmission of influenza concluded that the most efficient use of vaccines to reduce overall influenza morbidity and mortality in England and Wales is to target children in addition to older adults [7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A recent study of inactivated influenza vaccine (IIV) in children aged 3-8 years demonstrated higher efficacy against moderate/severe influenza. A meta-analysis of all previous published randomized clinical trials of live attenuated influenza vaccine (LAIV) that collected information on illness severity in children aged 24-71 months was conducted. Moderate/severe influenza was defined as fever >39°C, acute otitis media, or lower respiratory tract illness; other cases were classified as milder influenza. LAIV efficacy versus placebo was 95.4% [95% confidence interval: 88.5, 98.1] (year 1) and 88.5% [77.4, 94.2] (year 2) against moderate/severe influenza and 91.4% [77.9, 96.7] (year 1) and 84.2% [56.8, 94.3] (year 2) against milder influenza. The relative efficacy of LAIV versus IIV was 52.2% [31.6, 66.6] for moderate/severe influenza and 45.0% [28.6, 57.5] for milder influenza. Efficacy against all influenza illnesses, regardless of severity, is critical to prevent influenza illness and transmission in the community.
    Preview · Article · Aug 2014 · Vaccine
  • Source
    • "Furthermore, pediatric influenza exerts a considerable socioeconomic burden in terms of direct and indirect costs, and excess health-care utilization (6, 7, 8). Children also serve as a reservoir for household transmission of influenza, causing secondary illness in the family (8, 9). "
    [Show abstract] [Hide abstract]
    ABSTRACT: There are limited data evaluating the relationship between influenza treatment and hospitalization duration. Our purpose assessed the association between different treatments and hospital stay among Korean pediatric influenza patients. Total 770 children ≤ 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza at three large urban tertiary care hospitals were identified through a retrospective medical chart review. Demographic, clinical, and cost data were extracted and a multivariable linear regression model was used to assess the associations between influenza treatment types and hospital stay. Overall, there were 81% of the patients hospitalized with laboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% of the patients received oseltamivir monotherapy. The mean treatment-related charges for hospitalizations treated with antibiotics, alone or with oseltamivir, were significantly higher than those treated with oseltamivir-only (P < 0.001). Influenza patients treated with antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and 28.2%, respectively, longer duration of hospitalization compared to those treated with oseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir, were associated with longer hospitalization and significantly higher medical charges, compared to patients treated with oseltamivir alone. In Korea, there is a need for more judicious use of antibiotics, appropriate use of influenza rapid testing. Graphical Abstract
    Full-text · Article · Apr 2014 · Journal of Korean medical science
  • Source
    • "In Finland during 2000–2002, 75 % of children with influenza illness missed school or day care, with an average absenteeism of 3.4 days. Additionally, a parent missed at least 1 day of work in 49.4 % of pediatric influenza illnesses, with absenteeism averaging 2.7 days [7]. The current analysis provides valuable estimates of the incidence of absenteeism among children with influenza illness for additional European countries. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Few data exist regarding the healthcare and societal burden of culture-confirmed influenza illness in European and Israeli children. The current analysis describes this burden in vaccinated and unvaccinated children 2-17 years of age. Healthcare and societal burden outcomes were prospectively collected for culture-confirmed influenza illness in three previous randomized studies: a study of live attenuated influenza vaccine (LAIV) versus placebo in children aged <48 months attending day care (N = 846-973), and studies of LAIV versus inactivated influenza vaccine (IIV) in children aged <72 months with recurrent respiratory infections (N = 1,609) and in children aged 6-17 years with asthma (N = 2,211). The incidence of each endpoint among enrolled subjects and subjects with influenza was determined by treatment group and by country. Among subjects with influenza, 57-91 % missed school or day care, 45-90 % used non-antibiotic medications, 29-55 % of parents missed work, 17-55 % used antibiotics, 11-62 % had additional provider visits, and 9-20 % had acute otitis media. Where evaluated, rates of outcomes were generally similar between countries. Among all children enrolled, LAIV recipients missed 324-902 and 150 fewer days of day care per 1,000 children than those of placebo and IIV recipients, respectively; parents of LAIV recipients missed 197-340 and 76 fewer days of work per 1,000 children than those of placebo and IIV recipients, respectively. Influenza illness in European and Israeli children 2-17 years of age resulted in a considerable absenteeism and healthcare utilization that was similar across the countries studied. These data underscore the potential benefits of annual vaccination of children against influenza.
    Preview · Article · Oct 2013 · European Journal of Clinical Microbiology
Show more