Pediatrics: Pediatrics |

Outbreaks of a H1N1 Virus Infection During Two Influenza Consecutive Seasonal Epidemics in Children From South Eastern Part of Romania: 2014-2016 FREE TO VIEW

Simona Cambrea, PhD; Ana Iancu, MD; Paraschiva Postolache, PhD; Oana Arghir
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Ovidius University of Constanta, Constanta, Romania

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):967A. doi:10.1016/j.chest.2016.08.1070
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To assess the clinical data of children addmitted in Constanta Clinical Infectious diseases Hospital in Pediatric Department and diagnosed with AH1N1 influenza viral infection.

METHODS: All children 0-14 year-old who required hospital admission for influenza from fall till the end of March two seasons consecutively (2014-2015 and 2015-2016) were enrolled in a retrospective cohort study. The profile of influenza viral infections was determined and the impact of influenza A H1N1 virus infection was evaluated.

RESULTS: 178 children, mean aged 8.6 year-old, were diagnosed with influenza. Male predominance (102 boys and 76 girls) was noticed. No one child was previously vaccinated against flu. The peak of B influenza illness was most pronounced in February 2015 and the peak of A type was greater in March in both years 2015 and 2016. The clinical patterns included acute febrile onset with variable degrees of illness severity, ranging from mild astenia to pneumonia and respiratory failure. Only 20 children (11.2%) had meningism or miositis. For the diagnosis and evaluation of the type of influenza (A or B) viral culture of nasopharyngeal and/or throat samples and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) assay were performed in children. 71 cases (39.8%) were diagnosed with A H1N1 infection and 101 with B influenza infection (56.7%). Pneumonia was the most frequent complication of influenza (n=91/178; 56.1%) and it was highly reported in A H1N1 cases versus B type (54/71; 76 % versus 37/101; 36.6%; RR = 2.076 (1.557- 2.768); OR = 5.494 (2.787-10.83); Mantel- Haenszel chi square = 25.85; p = 0.0000001). Therapy with oseltamivir (150 mg twice daily) and added antibiotics improved the outcome in all children with pneumonia. No death was reported.

CONCLUSIONS: School aged children were mostly affected by flu. The prevalence of A H1N1 viral infection was lower than B type of flu but pneumonia represented the major complication of A H1N1 influenza viral infection.

CLINICAL IMPLICATIONS: Influenza A H1N1 is a highly contagious respiratory infection among unvaccinated children worldwide and can cause seasonal epidemics during fall, winter to spring time. Influenza is a serious viral respiratory contagious disease which requires hospitalization and can lead to severe complications, sometimes even death. Seasonal flu vaccine is recommended in all children greater 6 months and especially in those who are attending kindergarden or school.

DISCLOSURE: The following authors have nothing to disclose: Simona Cambrea, Ana Iancu, Paraschiva Postolache, Oana Arghir

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