Hospitalization of children with influenza A(H1N1) virus in israel during the 2009 outbreak in Israel: A multicenter survey

Michal Stein, Diana Tasher, Daniel Glikman, Yael Shachor-Meyouhas, Galia Barkai, Avihu Bar Yochai, Eugene Leibovitz, Moran Hausman-Kedem, Amit Hess, Orli Megged, Imad Kassis, Galia Gresario, Eli Somekh

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Objectives: To describe the clinical characteristics of children hospitalized with 2009 influenza A(H1N1) infection in Israel and the risk factors associated with this infection. Design: Prospective collection of data on children hospitalized with 2009 influenza A(H1N1) infection. Setting: Seven medical centers around Israel. Patients: From July 12, 2009, to December 24, 2009, all patients 18 years or younger hospitalized with acute respiratory or acute unspecified febrile illness were screened for 2009 influenza A(H1N1) virus by reverse transcription-polymerase chain reaction. Intervention: Prospective data collection for patients with confirmed infection. Main Outcome Measures: Clinical characteristics of patients and hospitalization rates. Results: The mean age of 478 patients studied was 6.1 years. Forty-two patients (8.8%) were admitted to the pediatric intensive care unit; 3 patients (0.6%) died. The most frequent clinical presentations were pneumonia, influenza- like illness, wheezing exacerbation, and convulsions. Predisposing underlying illnesses were detected in 48.7% of patients. Patients with metabolic and neurologic disorders were at highest risk for severe complications (relative risk, 6.5 and 2.9, respectively). In addition, patients with cyanotic heart lesions and infants 3 months or younger who were born at 33 weeks' gestation or earlier tended to require higher rates of mechanical ventilation. The hospitalization rate for 2009 influenza A(H1N1) was 0.7 per 1000 children. The mortality rate was 3.6 per 1 000 000 children. Conclusions: The severity variables for 2009 influenza A(H1N1) were similar to the figures reported for seasonal influenza. Patients with underlying metabolic and neurologic metabolic disorders and presumably patients with cyanotic heart lesions and infants born prematurely are at highest risk for severe complications following 2009 influenza A(H1N1) infection.

Original languageEnglish
Pages (from-to)1015-1022
Number of pages8
JournalArchives of Pediatrics and Adolescent Medicine
Volume164
Issue number11
DOIs
StatePublished - 1 Nov 2010
Externally publishedYes

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