tetano
Editor, Senior Moderator
Acad Pediatr. 2011 January - February;11(1):66-74.
Natural History of Pandemic H1N1 2009 Influenza Infection in Healthy Pediatric Outpatients.
Hawkes M, Schuh S, Ipp M, Bitnun A, Richardson SE, Parkin PC, Stephens D, Tran D.
Divisions of Infectious Diseases (Drs Hawkes, Bitnun, and Tran), Paediatric Emergency Medicine (Dr Schuh), and Paediatric Medicine (Drs Ipp and Parkin), Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada; Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada (Dr Richardson); Divison of Biostatistics, Clinical Research Support Unit, The Hospital for Sick Children, Toronto, Canada (Mr Stephens); Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada (Drs Schuh, Bitnun, Parkin, and Tran, and Mr Stephens); Physiology and Experimental Medicine, Research Institute, The Hospital for Sick Children, Toronto, Canada (Dr Richardson); Department of Health Policy, Management and Evaluation, University of Toronto, Canada (Dr Parkin); Department of Pediatric Laboratory Medicine and Pathobiology, University of Toronto, Canada (Dr Richardson); Division of Biostatistics, Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Canada (Mr Stephens); Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada (Dr Tran); and University of Toronto, Canada (Drs Hawkes, Schuh, Ipp, Bitnun, and Tran).
Abstract
OBJECTIVE: The pandemic influenza H1N1 2009 (pH1N1) virus is expected to remain a prominent circulating strain in the current and subsequent influenza seasons. The objective of this study was to compare the clinical course of infection with laboratory-confirmed pH1N1 and seasonal influenza A and B in a cohort of previously healthy children managed in the outpatient setting without antiviral therapy.
METHODS: Previously healthy children 17 years of age or younger were prospectively enrolled during the first wave of the 2009 pandemic (May-July 2009) and the 2 preceding influenza seasons from a single primary care physician office and a tertiary children's hospital emergency department. Inclusion criteria were: age ≤17 years; laboratory-confirmed influenza; and not receiving antiviral agents. Follow-up telephone interviews were conducted approximately 2 days and 14 days after presentation to assess symptom duration.
RESULTS: A total of 251 patients (101 with pH1N1, 90 with seasonal influenza A, 60 with seasonal influenza B) were included. Presenting symptoms and duration of symptoms associated with pH1N1 were similar to those with seasonal influenza. Median fever duration in pH1N1 was 3 days and had resolved within 8 days in 95% of patients. Among patients with pH1N1, abnormalities on chest auscultation (10 of 101), the hospitalization rate (2 of 101), the proportion of children receiving intravenous fluid therapy (1 of 101) or supplemental oxygen (1 of 101) were not significantly different from patients with seasonal influenza.
CONCLUSIONS: In most children without underlying risk factors for severe influenza, pH1N1 virus causes an uncomplicated respiratory tract illness, no more severe than seasonal influenza.
Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
PMID: 21272826 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21272826
Natural History of Pandemic H1N1 2009 Influenza Infection in Healthy Pediatric Outpatients.
Hawkes M, Schuh S, Ipp M, Bitnun A, Richardson SE, Parkin PC, Stephens D, Tran D.
Divisions of Infectious Diseases (Drs Hawkes, Bitnun, and Tran), Paediatric Emergency Medicine (Dr Schuh), and Paediatric Medicine (Drs Ipp and Parkin), Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada; Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada (Dr Richardson); Divison of Biostatistics, Clinical Research Support Unit, The Hospital for Sick Children, Toronto, Canada (Mr Stephens); Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada (Drs Schuh, Bitnun, Parkin, and Tran, and Mr Stephens); Physiology and Experimental Medicine, Research Institute, The Hospital for Sick Children, Toronto, Canada (Dr Richardson); Department of Health Policy, Management and Evaluation, University of Toronto, Canada (Dr Parkin); Department of Pediatric Laboratory Medicine and Pathobiology, University of Toronto, Canada (Dr Richardson); Division of Biostatistics, Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Canada (Mr Stephens); Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada (Dr Tran); and University of Toronto, Canada (Drs Hawkes, Schuh, Ipp, Bitnun, and Tran).
Abstract
OBJECTIVE: The pandemic influenza H1N1 2009 (pH1N1) virus is expected to remain a prominent circulating strain in the current and subsequent influenza seasons. The objective of this study was to compare the clinical course of infection with laboratory-confirmed pH1N1 and seasonal influenza A and B in a cohort of previously healthy children managed in the outpatient setting without antiviral therapy.
METHODS: Previously healthy children 17 years of age or younger were prospectively enrolled during the first wave of the 2009 pandemic (May-July 2009) and the 2 preceding influenza seasons from a single primary care physician office and a tertiary children's hospital emergency department. Inclusion criteria were: age ≤17 years; laboratory-confirmed influenza; and not receiving antiviral agents. Follow-up telephone interviews were conducted approximately 2 days and 14 days after presentation to assess symptom duration.
RESULTS: A total of 251 patients (101 with pH1N1, 90 with seasonal influenza A, 60 with seasonal influenza B) were included. Presenting symptoms and duration of symptoms associated with pH1N1 were similar to those with seasonal influenza. Median fever duration in pH1N1 was 3 days and had resolved within 8 days in 95% of patients. Among patients with pH1N1, abnormalities on chest auscultation (10 of 101), the hospitalization rate (2 of 101), the proportion of children receiving intravenous fluid therapy (1 of 101) or supplemental oxygen (1 of 101) were not significantly different from patients with seasonal influenza.
CONCLUSIONS: In most children without underlying risk factors for severe influenza, pH1N1 virus causes an uncomplicated respiratory tract illness, no more severe than seasonal influenza.
Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
PMID: 21272826 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21272826