Michael A Smit1, Hai-Lin Wang, Edward Kim, Noel Barragan, Grace M Aldrovandi, Alvin Nelson El Amin, Laurene Mascola, Pia S Pannaraj. 1. From the *Division of Infectious Diseases, Hasbro Children's Hospital, Providence, Rhode Island; †Alpert Medical School of Brown University, Providence, Rhode Island; ‡Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA; §Los Angeles County Department of Public Health, and ¶Keck School of Medicine, University of Southern California, Los Angeles, California.
Abstract
BACKGROUND: Obesity emerged as a novel risk factor for severe disease during the 2009 H1N1 influenza pandemic. Murine studies indicate that obesity is associated with ineffective response to influenza vaccine, but few human studies exist. We aimed to determine if influenza vaccine is protective against laboratory-confirmed influenza in obese children. METHODS: Body mass index, vaccination status, and laboratory-confirmed influenza data were analyzed from a previously conducted prospective study in which active surveillance for influenza-like illness was conducted in 8 elementary schools in Los Angeles County during the 2010-2011 influenza season. Polymerase-chain reaction (PCR) was performed on combined nose/throat swabs collected from children with influenza-like illness at presentation to the school nurse or during absenteeism. RESULTS: Of 4260 children with height/weight data, 1191 (28.0%) were obese (body mass index ≥95th percentile). Respiratory specimens were obtained from 858 (20.1%) children. Unvaccinated obese compared with vaccinated obese children acquired 3 times more PCR-confirmed influenza (62 vs. 17 per 1000 children, P = 0.003) and missed more school days (4.6 vs. 3.2 per 100 school days, P < 0.001) during influenza season. Obese children with PCR-confirmed influenza were more likely to present with cough (86.2 vs. 72.4%, P = 0.030) and missed more school per episode (2.4 vs.1.9 days, P = 0.023) compared with nonobese children. Among vaccinated children, rates of PCR-confirmed influenza were similar in obese and nonobese children (17 vs. 20 per 1000 children, P = 0.77). CONCLUSIONS: Obese children with PCR-confirmed influenza suffered from more cough and missed more school days than their nonobese peers. Influenza vaccination protected obese children against PCR-proven influenza illness.
BACKGROUND:Obesity emerged as a novel risk factor for severe disease during the 2009 H1N1influenza pandemic. Murine studies indicate that obesity is associated with ineffective response to influenza vaccine, but few human studies exist. We aimed to determine if influenza vaccine is protective against laboratory-confirmed influenza in obesechildren. METHODS: Body mass index, vaccination status, and laboratory-confirmed influenza data were analyzed from a previously conducted prospective study in which active surveillance for influenza-like illness was conducted in 8 elementary schools in Los Angeles County during the 2010-2011 influenza season. Polymerase-chain reaction (PCR) was performed on combined nose/throat swabs collected from children with influenza-like illness at presentation to the school nurse or during absenteeism. RESULTS: Of 4260 children with height/weight data, 1191 (28.0%) were obese (body mass index ≥95th percentile). Respiratory specimens were obtained from 858 (20.1%) children. Unvaccinated obese compared with vaccinated obesechildren acquired 3 times more PCR-confirmed influenza (62 vs. 17 per 1000 children, P = 0.003) and missed more school days (4.6 vs. 3.2 per 100 school days, P < 0.001) during influenza season. Obesechildren with PCR-confirmed influenza were more likely to present with cough (86.2 vs. 72.4%, P = 0.030) and missed more school per episode (2.4 vs.1.9 days, P = 0.023) compared with nonobese children. Among vaccinated children, rates of PCR-confirmed influenza were similar in obese and nonobese children (17 vs. 20 per 1000 children, P = 0.77). CONCLUSIONS:Obesechildren with PCR-confirmed influenza suffered from more cough and missed more school days than their nonobese peers. Influenza vaccination protected obesechildren against PCR-proven influenza illness.
Authors: Alon Eliakim; Christina Schwindt; Christina Swindt; Frank Zaldivar; Paolo Casali; Dan M Cooper Journal: Autoimmunity Date: 2006-03 Impact factor: 2.815
Authors: R J Kuczmarski; C L Ogden; L M Grummer-Strawn; K M Flegal; S S Guo; R Wei; Z Mei; L R Curtin; A F Roche; C L Johnson Journal: Adv Data Date: 2000-06-08
Authors: Robert B Belshe; Kathryn M Edwards; Timo Vesikari; Steven V Black; Robert E Walker; Micki Hultquist; George Kemble; Edward M Connor Journal: N Engl J Med Date: 2007-02-15 Impact factor: 91.245
Authors: Douglas M Fleming; Pietro Crovari; Ulrich Wahn; Timo Klemola; Yechiel Schlesinger; Alexangros Langussis; Knut Øymar; Maria Luz Garcia; Alain Krygier; Herculano Costa; Ulrich Heininger; Jean-Louis Pregaldien; Sheau-Mei Cheng; Jonathan Skinner; Ahmad Razmpour; Melanie Saville; William C Gruber; Bruce Forrest Journal: Pediatr Infect Dis J Date: 2006-10 Impact factor: 2.129
Authors: Shai Ashkenazi; Andre Vertruyen; Javier Arístegui; Susanna Esposito; David Douglas McKeith; Timo Klemola; Jiri Biolek; Joachim Kühr; Tadeusz Bujnowski; Daniel Desgrandchamps; Sheau-Mei Cheng; Jonathan Skinner; William C Gruber; Bruce D Forrest Journal: Pediatr Infect Dis J Date: 2006-10 Impact factor: 2.129
Authors: Alexia G Smith; Patricia A Sheridan; Raymond J Tseng; John F Sheridan; Melinda A Beck Journal: Immunology Date: 2008-08-27 Impact factor: 7.397
Authors: Kelly Stefano Cole; Judith M Martin; William T Horne; Chyongchiou J Lin; Mary Patricia Nowalk; John F Alcorn; Richard K Zimmerman Journal: Vaccine Date: 2017-11-11 Impact factor: 3.641
Authors: S D Neidich; W D Green; J Rebeles; E A Karlsson; S Schultz-Cherry; T L Noah; S Chakladar; M G Hudgens; S S Weir; M A Beck Journal: Int J Obes (Lond) Date: 2017-06-06 Impact factor: 5.095