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Clinical and epidemiological characteristics of patients with influenza A (H1N1) 2009 attended to at the emergency room of a children's hospital

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Abstract

In June 2009, the first influenza pandemic of the twenty-first century, due to the swine origin influenza A (H1N1) 2009 virus, was declared. This study aimed to describe the epidemiological and clinical features, complications, lethality and risk factors for hospital admission of microbiologically confirmed cases of influenza A (H1N1) 2009 infection seen at the emergency department of a children’s hospital. All cases of children with influenza A (H1N1) 2009 viral infection, confirmed microbiologically by real-time reverse transcription polymerase chain reactions and treated in the emergency room between July and December 2009, were prospectively included. Patients were compared according to admission requirement to study variables associated with the risk of hospitalisation. Oseltamivir was the antiviral used for the treatment and its safety was analysed. Four hundred and twelve patients with influenza A (H1N1) 2009 infection were included. The most frequent symptoms were: fever (96%), cough (95%) and coryza (90%). Eighty-five patients (20.6%) were admitted: three to the paediatric intensive care unit and two died. Hospitalised children were younger than those not admitted (median age 5 vs 8 years; p = 0.001). Age under 1 year (OR 6.01; CI 95% 2.77–13.05), pneumonia (OR 7.99; CI 95% 3.50–18.22) and haemoglobinopathy or underlying blood disorders (OR 5.99; CI 95% 1.32–27.30) were statistically significant risk factors for admission. No differences were observed regarding onset of antiviral treatment among admitted and non-admitted patients. Treatment with oseltamivir was well tolerated. In conclusion, the incidence of severe cases and lethality of influenza A (H1N1) 2009 infection were low in our setting, even in a population with risk factors for developing complications.

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Authors and Affiliations

  1. Paediatric Emergency Department, Autonomous University of Barcelona, University Hospital Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Esther Lera, Núria T.Wörner, Mónica Sancosmed, Anna Fàbregas, Alejandro Casquero, Susana Melendo, Mar Miserachs & Rocío Cebrián

  2. Department of Microbiology, Autonomous University of Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain

    Teresa Tórtola & Astrid Borrego

  3. Department of Preventive Medicine and Epidemiology, Autonomous University of Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain

    Magda Campins

  4. Paediatric Infectious Diseases and Immunodeficiencies Unit, Autonomous University of Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain

    Fernando Moraga & Concepció Figueras

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  1. Esther Lera
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  2. Núria T.Wörner
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Correspondence to Esther Lera.

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Lera, E., T.Wörner, N., Sancosmed, M. et al. Clinical and epidemiological characteristics of patients with influenza A (H1N1) 2009 attended to at the emergency room of a children's hospital. Eur J Pediatr 170, 371–378 (2011). https://doi.org/10.1007/s00431-011-1399-4

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  • DOI: https://doi.org/10.1007/s00431-011-1399-4

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