Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case-control study

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dc.contributor.authorKhandaker, G.
dc.contributor.authorRashid, H.
dc.contributor.authorZurynski, Y.
dc.contributor.authorRichmond, P.
dc.contributor.authorButtery, J.
dc.contributor.authorMarshall, H.
dc.contributor.authorGold, M.
dc.contributor.authorWalls, T.
dc.contributor.authorWhitehead, B.
dc.contributor.authorElliott, E.
dc.contributor.authorBooy, R.
dc.date.issued2012
dc.description.abstract<h4>Background</h4>The characteristics of nosocomial influenza in children are not well described.<h4>Aim</h4>To compare the characteristics of nosocomial and community-acquired pandemic influenza A (H1N1) 2009 (pH1N1) in Australian children.<h4>Methods</h4>In a nested case-control study, the clinical and epidemiological features of nosocomial vs community-acquired pH1N1 were compared among hospitalized children aged <15 years in six paediatric hospitals in Australia between 1 June and 30 September 2009.<h4>Findings</h4>Of 506 hospitalized children with pH1N1, 47 (9.3%) were of nosocomial origin. These 47 cases were compared with 141 gender- and age-matched controls. Cases had a significantly higher proportion of underlying medical conditions compared with controls (81% vs 42%, P < 0.001), and were more likely to be exposed to household smokers (36% vs 20%, P = 0.02). Fewer children with nosocomial influenza presented with classical symptoms of influenza, including subjective fever and lethargy. A higher proportion of children with nosocomial influenza received treatment with oseltamivir (77% vs 43%, P < 0.001), and they required a longer stay in hospital following the onset of influenza (mean 8.5 days vs 4.5 days, P = 0.006). Three children (2%) in the community-acquired group died of pH1N1, but there were no deaths in the nosocomial group.<h4>Conclusion</h4>This study shows that children with pre-existing diseases and those who are exposed to household smokers are more susceptible to nosocomial pH1N1. They may have 'occult presentation' of influenza, but their course of illness is not markedly different from that of children with community-acquired influenza.
dc.description.statementofresponsibilityG. Khandaker, H. Rashida, Y. Zurynski, P.C. Richmond, J. Buttery, H. Marshall, M. Gold, T. Walls, B. Whitehead, E. J. Elliott, R. Booy
dc.identifier.citationJournal of Hospital Infection, 2012; 82(2):94-100
dc.identifier.doi10.1016/j.jhin.2012.07.006
dc.identifier.issn0195-6701
dc.identifier.issn1532-2939
dc.identifier.orcidMarshall, H. [0000-0003-2521-5166]
dc.identifier.orcidGold, M. [0000-0003-1312-5331]
dc.identifier.urihttp://hdl.handle.net/2440/73816
dc.language.isoen
dc.publisherW B Saunders Co Ltd
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/402784
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/457084
dc.rights© 2012 The Healthcare Infection Society
dc.source.urihttps://doi.org/10.1016/j.jhin.2012.07.006
dc.subjectAustralia
dc.subjectChildren
dc.subjectCommunity-acquired influenza
dc.subjectNosocomial influenza
dc.subjectPandemic influenza
dc.titleNosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case-control study
dc.typeJournal article
pubs.publication-statusPublished

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