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Viral Epidemiology and Severity of Respiratory Infections in Infants in 2009: A Prospective Study

tetano

Editor, Senior Moderator
Pediatric Infectious Disease Journal:
POST ACCEPTANCE, 18 April 2012
doi: 10.1097/INF.0b013e3182566005
Original Studies: PDF Only



Background: Viral respiratory infections are common in infants and can be severe. The new pandemic influenza virus H1N1v2009 was feared to cause particularly severe outcomes.

Objective: This study aimed at evaluating the impact of H1N1v2009 on the viral epidemiology, the clinical presentation and the severity of respiratory infections in infants.

Patients and Methods: This prospective epidemiologic study included all infants less than 2 years of age, both inpatients and outpatients, presenting with respiratory symptoms, from November 2009 through April 2010, at the pediatric emergency department of the University Hospital of Caen, France. A nasal swab was taken for viral detection and analyzed by immunofluorescence and, if negative, polymerase chain reaction (PCR). Severe respiratory infection was defined by a score of respiratory severity.

Results: 1,021 infectious episodes with a respiratory sample met inclusion criteria. 834 samples (81.7%) were positive. The viruses with the highest incidence were the respiratory syncytial virus (RSV) (34.2%), the rhinoviruses (23.9%), the coronaviruses (9.3%) and H1N1v2009 (7.7%). Of all infections, 28.6% were severe, and more frequent in infants with risk factors. H1N1v2009 infections had a low risk of severe respiratory disease (OR = 0.15) and hospitalization (OR = 0.40) compared to the other viruses. RSV infections had a high risk of respiratory severity (OR = 7.85) and were responsible for 71.4% of admissions to the intensive care unit.

Conclusion: Despite the modest impact of H1N1v2009 observed in this study, further surveillance is needed to detect virological factors that may increased its severity.

http://journals.lww.com/pidj/Abstra...miology_and_Severity_of_Respiratory.98743.asp
 
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