Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey

Blumental, Sophie;Huisman, Elisabeth;Cornet, Marie-Coralie;Ferreiro, Christine;Lepage, Philippe;et.al.
(2011) BMC Infectious Diseases — Vol. 11, p. 313 [1-9] (2011)

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Authors
  • Blumental, SophieHôpital Universitaire des Enfants Reine Fabiola (HUDERF), Brussels
    Author
  • Huisman, ElisabethUniversitair Ziekenhuis Brussel (UZB), Brussels
    Author
  • Cornet, Marie-CoralieUCLouvain
    Author
  • Ferreiro, ChristineHôpital Universitaire St-Pierre, Brussels
    Author
  • Armano, RuthUCLouvain
    Author
  • Hermans, DominiqueUCLouvain
    Author
  • Moulin, DidierUCLouvain
    Author
  • Lepage, PhilippeHôpital Universitaire des Enfants Reine Fabiola (HUDERF), Brussels
    Author
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Abstract
Background During the 2009 influenza A/H1N1v pandemic, children were identified as a specific "at risk" group. We conducted a multicentric study to describe pattern of influenza A/H1N1v infection among hospitalized children in Brussels, Belgium. Methods From July 1, 2009, to January 31, 2010, we collected epidemiological and clinical data of all proven (positive H1N1v PCR) and probable (positive influenza A antigen or culture) pediatric cases of influenza A/H1N1v infections, hospitalized in four tertiary centers. Results During the epidemic period, an excess of 18% of pediatric outpatients and emergency department visits was registered. 215 children were hospitalized with proven/probable influenza A/H1N1v infection. Median age was 31 months. 47% had ≥ 1 comorbid conditions. Febrile respiratory illness was the most common presentation. 36% presented with initial gastrointestinal symptoms and 10% with neurological manifestations. 34% had pneumonia. Only 24% of the patients received oseltamivir but 57% received antibiotics. 10% of children were admitted to PICU, seven of whom with ARDS. Case fatality-rate was 5/215 (2%), concerning only children suffering from chronic neurological disorders. Children over 2 years of age showed a higher propensity to be admitted to PICU (16% vs 1%, p = 0.002) and a higher mortality rate (4% vs 0%, p = 0.06). Infants less than 3 months old showed a milder course of infection, with few respiratory and neurological complications. Conclusion Although influenza A/H1N1v infections were generally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar.
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Citations

Blumental, S., Huisman, E., Cornet, M.-C., Ferreiro, C., De Schutter, I., Reynders, M., Wybo, I., Kabamba-Mukadi, B., Armano, R., Hermans, D., Nassogne, M.-C., Mahadeb, B., Fonteyne, C., Van Berlaer, G., Levy, J., Moulin, D., Vergison, A., Malfroot, A., & Lepage, P. (2011). Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey. BMC Infectious Diseases, 11, 313 [1-9]. https://doi.org/10.1186/1471-2334-11-313 (Original work published 2011)