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https://hdl.handle.net/2440/91816
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Type: | Journal article |
Title: | Clinical epidemiology and predictors of outcome in children hospitalised with influenza A(H1N1)pdm09 in 2009: a prospective national study |
Author: | Khandaker, G. Zurynski, Y. Ridley, G. Buttery, J. Marshall, H. Richmond, P. Royle, J. Gold, M. Walls, T. Whitehead, B. McIntyre, P. Wood, N. Booy, R. Elliott, E. |
Citation: | Influenza and Other Respiratory Viruses, 2014; 8(6):636-645 |
Publisher: | John Wiley & Sons |
Issue Date: | 2014 |
ISSN: | 1750-2640 1750-2659 |
Statement of Responsibility: | Gulam Khandaker, Yvonne Zurynski, Greta Ridley, Jim Buttery, Helen Marshall, Peter C. Richmond, Jenny Royle, Michael Gold, Tony Walls, Bruce Whitehead, Peter McIntyre, Nicholas Wood, Robert Booy, Elizabeth J. Elliott |
Abstract: | BACKGROUND: There are few large-scale, prospective studies of influenza A(H1N1)pdm09 in children that identify predictors of adverse outcomes. OBJECTIVES: We aimed to examine clinical epidemiology and predictors for adverse outcomes in children hospitalised with influenza A(H1N1)pdm09 in Australia. METHODS: Active hospital surveillance in six tertiary paediatric referral centres (June-September, 2009). All children aged <15 years admitted with laboratory-confirmed influenza A(H1N1)pdm09 were studied. RESULTS: Of 601 children admitted with laboratory-confirmed influenza, 506 (84·2%) had influenza A(H1N1)pdm09. Half (51·0%) of children with influenza A(H1N1)pdm09 were previously healthy. Hospital stay was longer in children with pre-existing condition (mean 6·9 versus 4·9 days; P = 0·02) as was paediatric intensive care unit (PICU) stay (7·0 versus 2·3 days; P = 0·005). Rapid diagnosis decreased both antibiotic use and length of hospital and PICU stay. Fifty (9·9%) children were admitted to a PICU, 30 (5·9%) required mechanical ventilation and 5 (0·9%) died. Laboratory-proven bacterial co-infection and chronic lung disease were significant independent predictors of PICU admission (OR 6·89, 95% CI 3·15-15·06 and OR 3·58, 95% CI 1·41-9·07, respectively) and requirement for ventilation (OR 5·61, 95% CI 2·2-14·28 and OR 5·18, 95% CI 1·8-14·86, respectively). Chronic neurological disease was a predictor of admission to PICU (OR 2·30, 95% CI 1·14-4·61). CONCLUSIONS: During the 2009 pandemic, influenza was a major cause of hospitalisation in tertiary paediatric hospitals. Co-infection and underlying chronic disease increased risk of PICU admission and/or ventilation. Half the children admitted were previously healthy, supporting a role for universal influenza vaccination in children. |
Keywords: | Children; influenza; influenza A(H1N1)pdm09; outcome; pandemic |
Description: | Article first published online: 26 SEP 2014 |
Rights: | © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd. |
DOI: | 10.1111/irv.12286 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/633028 http://purl.org/au-research/grants/nhmrc/402784 http://purl.org/au-research/grants/nhmrc/457084 http://purl.org/au-research/grants/nhmrc/633032 http://purl.org/au-research/grants/nhmrc/1016272 |
Published version: | http://dx.doi.org/10.1111/irv.12286 |
Appears in Collections: | Aurora harvest 7 Paediatrics publications |
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