Influenza A community-acquired pneumonia in East London infants and young children.
BACKGROUND
Community-acquired pneumonia (CAP) is common in young children, but there are few data in Europe on influenza A virus as a cause of childhood CAP. The aim of this study was to determine the relative contributions of different etiologic agents to CAP in children.


METHODS
This was a 6-month prospective study of pediatric accident and emergency and general practice consultations with a diagnosis of CAP. Nasopharyngeal aspirates for viral immunofluorescence and PCR studies and blood cultures for bacterial studies were taken from 51 children with symptoms, signs and chest radiographic features that satisfied a diagnosis of pneumonia.


RESULTS
An etiologic agent was isolated from 25 patients (49%). A viral cause was identified in 22 patients (43%), and influenza A virus and respiratory syncytial virus (RSV) were detected in 16 and 18% of all cases, respectively. Only four patients (8%) had a positive bacterial blood culture; three had Streptococcus pneumoniae and one had Neisseria meningitidis W135. Mycoplasma pneumoniae was detected in 2 children, and mixed infections were detected in 5 (10%). The use of viral PCR increased the detection rate of influenza A virus by 100%.


CONCLUSIONS
Influenza A virus caused more than one-third of all viral CAP cases, a rate comparable with that of RSV CAP. Viral PCR doubled the diagnostic yield of influenza A virus. The clinical burden of influenza A CAP was comparable with that of RSV CAP, as measured by the duration of fever, hospital stay and total duration of illness.
Laundy
Matthew
M
Department of Child Health, Barts and the London Hospital NHS, Queen Mary School of Medicine and Dentistry, University of London, London, UK. r.booy@qmul.ac.uk
Ajayi-Obe
Ekundayo
E
Hawrami
Khidir
K
Aitken
Celia
C
Breuer
Judith
J
Booy
Robert
R
D017677:Age Distribution; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000302:isolation & purification*; D008297:Male; D011024:Pneumonia, Viral / Q000453:epidemiology* / Q000821:virology*; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population