Central European Journal of Medicine

, Volume 7, Issue 3, pp 296–301 | Cite as

Pandemic (H1N1) 2009 influenza — real threat or unjustified panic? The experience of one pediatric hematology-oncology center

  • Ninela Irga
  • Marcelina Osak
  • Radoslaw Jaworski
  • Marek Bronk
  • Wojciech Kosiak
  • Elzbieta Adamkiewicz-Drozynska
Research Article



On June 11, 2009, the World Health Organization (WHO) announced a pandemic influenza caused by pandemic (H1N1) 2009 virus. The aim of the current study was to analyze the clinical course of the pandemic (H1N1) 2009 influenza in children with neoplastic diseases or severe aplastic anemia. As a final point, an attempt to identify risk factors predictive for the severity of the clinical course of the disease was also undertaken.


Thirty-seven children undergoing antineoplastic treatment were enrolled in the study. The analysis comprised an assessment of the number of episodes of AH1N1 pandemic (H1N1) 2009 influenza in the group of patients and an evaluation of clinical signs and symptoms of the infection. We also analyzed the relation between the presence of lymphocytopenia and its duration prior to infection and until? eventual contraction of the pandemic (H1N1) 2009 virus, as well as severity of clinical course of the disease.


Pandemic (H1N1) 2009 influenza was diagnosed in 20 of 37 children. In the analyzed group no death related to pandemic (H1N1) 2009 influenza was reported.


The clinical manifestations of pandemic (H1N1) 2009 influenza in immunoincompetent children are analogous to symptoms observed in the general population. A severe clinical course of the disease was observed among patients with hematological disorders, especially those presenting with preceding lymphocytopenia.


Pandemic (H1N1) 2009 influenza Children Oncohematological disorders 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. [1]
    Launes C, Rives S, Catala A, Berrueco R, Toll T, Camos M, et al. Pandemic influenza A (2009 H1N1) in children with acute lymphoblastic leukaemia. Br J Haematol 2010; 149:874–878PubMedCrossRefGoogle Scholar
  2. [2]
    O’Riordan S, Barton M, Yau Y, Read SE, Allen U, Tran D. Risk factors and outcomes among children admitted to hospital with pandemic H1N1 influenza. CMAJ 2010; 182:39–44PubMedCrossRefGoogle Scholar
  3. [3]
    Wenzel JJ, Panning M, Kaul KL, Mangold KA, Revell PA, Luna RA. Analytical performance determination and clinical validation of the novel Roche RealTime Ready Influenza A/H1N1 Detection Set. J Clin Microbiol 2010; 48:3088–3094PubMedCrossRefGoogle Scholar
  4. [4]
    Flynn P. The handling of the H1N1 pandemic: adoption of the report by the Committee. February 6, 2010. Available at: Accessed February 28, 2011
  5. [5]
    Chisholm J, Howe K, Taj M, Zambon M. Influenza immunisation in children with solid tumours. Eur J Cancer 2005; 41:2280–2287PubMedCrossRefGoogle Scholar
  6. [6]
    Casper C, Englund J, Boeckh M. How I treat influenza in patients with hematologic malignancies. Blood 2010; 115:1331–1342PubMedCrossRefGoogle Scholar
  7. [7]
    Guinard A, Grout L, Durand C, Schwoebel V. Outbreak of influenza A(H1N1)v without travel history in a school in the Toulouse district, France, June 2009. Euro Surveill 2009; 14Google Scholar
  8. [8]
    Dotis J, Roilides E. H1N1 influenza A infection: an update. Hippokratia 2009; 13:254PubMedGoogle Scholar
  9. [9]
    Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, et al. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA 2009; 302:1872–1879PubMedCrossRefGoogle Scholar
  10. [10]
    Peris A, Zagli G, Barbani F, Tutino L, Biondi S, di-Valvasone S, et al. The value of lung ultrasound monitoring in H1N1 acute respiratory distress syndrome. Anaesthesia 2010; 65:294–297PubMedCrossRefGoogle Scholar
  11. [11]
    Redelman-Sidi G, Sepkowitz KA, Huang CK, Park S, Stiles J, Eagan J, et al. 2009 H1N1 influenza infection in cancer patients and hematopoietic stem cell transplant recipients. J Infect 2010; 60:257–263PubMedCrossRefGoogle Scholar
  12. [12]
    Cui W, Zhao H, Lu X, Wen Y, Zhou Y, Deng B, et al. Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China. BMC Infect Dis 2010; 10:145PubMedCrossRefGoogle Scholar
  13. [13]
    Lapinsky SE. H1N1 novel influenza A in pregnant and immunocompromised patients. Crit Care Med 2010; 38:e52–e57PubMedCrossRefGoogle Scholar
  14. [14]
    Nichols WG, Guthrie KA, Corey L, Boeckh M. Influenza infections after hematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis 2004; 39:1300–1306PubMedCrossRefGoogle Scholar
  15. [15]
    WHO. Antiviral use and the risk of drug resistance; Pandemic (H1N1) 2009 briefing note 12. September 25, 2009. Available at: Accessed February 28, 2011
  16. [16]
    Metan G, Bozkurt I, Agkus C, Coskun R, Alp E, Sungur M, et al. Hospitalized pandemic influenza A (H1N1) patients in a university hospital. Cent Eur J Med 2010; 6:83–88CrossRefGoogle Scholar
  17. [17]
    Seiter K, Nadelman RB, Liu D, Ahmed T, Montecalvo MA. Novel influenza A (H1N1) in patients with hematologic malignancies. J Clin Oncol 2010; 28:e27–e29PubMedCrossRefGoogle Scholar

Copyright information

© © Versita Warsaw and Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Ninela Irga
    • 1
  • Marcelina Osak
    • 1
  • Radoslaw Jaworski
    • 2
  • Marek Bronk
    • 3
  • Wojciech Kosiak
    • 1
  • Elzbieta Adamkiewicz-Drozynska
    • 1
  1. 1.Department of Pediatrics, Hematology, Oncology and EndocrinologyMedical University of GdanskGdanskPoland
  2. 2.Department of Pediatric Cardiac SurgeryPomeranian Centre of TraumatologyGdanskPoland
  3. 3.Department of Clinical MicrobiologyClinical Center of Medical University of GdanskGdanskPoland

Personalised recommendations