Andrea Streng1, Christiane Prifert2, Benedikt Weissbrich2, Andreas Sauerbrei3, Ruprecht Schmidt-Ott4, Johannes G Liese1. 1. From the Department of Pediatrics, University Hospital of Würzburg, Würzburg, Germany. 2. Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany. 3. Section Experimental Virology, Institute of Medical Microbiology, Jena University Hospital, Jena, Germany. 4. GSK, Wavre, Belgium.
Abstract
BACKGROUND: Limited data on the influenza burden in pediatric outpatients are available, especially regarding direct comparison of the cocirculating (sub)types A(H1N1)pdm09, A(H3N2) and B. METHODS: Children 1-5 years of age, unvaccinated against influenza and presenting with febrile acute respiratory infections (ARIs), were enrolled in 33 pediatric practices in Germany from 2013 to 2015 (January-May). Influenza was confirmed by multiplex polymerase chain reaction from pharyngeal swabs and (sub)typed. RESULTS: In 805 children with ARI, influenza was the most frequently detected respiratory virus (n = 305; 37.9%). Of 217 influenza patients included, 122 (56.2%) were infected with A(H3N2), 56 (25.8%) with A(H1N1)pdm09 and 39 (18.0%) with B. Median age was 3.7 years [interquartile range (IQR), 2.1-4.8]; 11% had underlying conditions. Median fever duration was 4 days (IQR, 3-5), and the disease duration was 9 days (IQR, 7-12). Most frequent diagnoses were pharyngitis (26%), bronchitis (18%) and acute otitis media (10%). Children received mainly antipyretics (86%) and adrenergic nasal drops/spray (53%); 9% received antibiotics and 3% oseltamivir. Thirty-six percent required at least 1 additional practice visit; 1% was hospitalized. Median absences from childcare were 5 days (IQR, 3-7); parents lost 4 workdays (IQR, 2-6). Symptoms, severity and impact on the family were largely unrelated to (sub)type. However, patients with A(H1N1)pdm09 had fewer underlying conditions (P = 0.017), whereas patients with B more often had pharyngitis (P = 0.022), acute otitis media (P = 0.012) and stenosing laryngotracheitis (P = 0.007). CONCLUSIONS: Influenza was the most frequently detected viral pathogen in outpatient children with febrile, mostly uncomplicated ARI. In this setting, clinical manifestations and severity were similar across the (sub)types prevalent during the postpandemic seasons.
BACKGROUND: Limited data on the influenza burden in pediatric outpatients are available, especially regarding direct comparison of the cocirculating (sub)types A(H1N1)pdm09, A(H3N2) and B. METHODS:Children 1-5 years of age, unvaccinated against influenza and presenting with febrile acute respiratory infections (ARIs), were enrolled in 33 pediatric practices in Germany from 2013 to 2015 (January-May). Influenza was confirmed by multiplex polymerase chain reaction from pharyngeal swabs and (sub)typed. RESULTS: In 805 children with ARI, influenza was the most frequently detected respiratory virus (n = 305; 37.9%). Of 217 influenza patients included, 122 (56.2%) were infected with A(H3N2), 56 (25.8%) with A(H1N1)pdm09 and 39 (18.0%) with B. Median age was 3.7 years [interquartile range (IQR), 2.1-4.8]; 11% had underlying conditions. Median fever duration was 4 days (IQR, 3-5), and the disease duration was 9 days (IQR, 7-12). Most frequent diagnoses were pharyngitis (26%), bronchitis (18%) and acute otitis media (10%). Children received mainly antipyretics (86%) and adrenergic nasal drops/spray (53%); 9% received antibiotics and 3% oseltamivir. Thirty-six percent required at least 1 additional practice visit; 1% was hospitalized. Median absences from childcare were 5 days (IQR, 3-7); parents lost 4 workdays (IQR, 2-6). Symptoms, severity and impact on the family were largely unrelated to (sub)type. However, patients with A(H1N1)pdm09 had fewer underlying conditions (P = 0.017), whereas patients with B more often had pharyngitis (P = 0.022), acute otitis media (P = 0.012) and stenosing laryngotracheitis (P = 0.007). CONCLUSIONS: Influenza was the most frequently detected viral pathogen in outpatientchildren with febrile, mostly uncomplicated ARI. In this setting, clinical manifestations and severity were similar across the (sub)types prevalent during the postpandemic seasons.
Authors: Ghassan Dbaibo; Arshad Amanullah; Carine Claeys; Allen Izu; Varsha K Jain; Pope Kosalaraksa; Luis Rivera; Jyoti Soni; Emad Yanni; Khalequ Zaman; Beatriz Acosta; Miguel Ariza; Maria L Arroba Basanta; Ashish Bavdekar; Alfonso Carmona; Luis Cousin; Jasur Danier; Adolfo Diaz; Javier Diez-Domingo; Ener C Dinleyici; Saul N Faust; Jose Garcia-Sicilia; Grace D Gomez-Go; Maria L A Gonzales; Mustafa Hacimustafaoglu; Stephen M Hughes; Teresa Jackowska; Shashi Kant; Marilla Lucero; Josep Mares Bermudez; Federico Martinón-Torres; May Montellano; Roman Prymula; Thanyawee Puthanakit; Renata Ruzkova; Iwona Sadowska-Krawczenko; Henryk Szymanski; Angels Ulied; Wayne Woo; Anne Schuind; Bruce L Innis Journal: Pediatr Infect Dis J Date: 2020-01 Impact factor: 3.806
Authors: Amber Hsiao; Philip O Buck; Arnold Yee; John Hansen; Edwin M Lewis; Laurie L Aukes; Emad Yanni; Rafik Bekkat-Berkani; Anne Schuind; Nicola P Klein Journal: Hum Vaccin Immunother Date: 2020-02-20 Impact factor: 3.452