Childhood severe acute respiratory syndrome in Taiwan and how to differentiate it from childhood influenza infection.
OBJECTIVE
To investigate clinical features and outcomes of children in Taiwan with laboratory-confirmed severe acute respiratory syndrome (SARS) vs those of children with influenza to differentiate the 2 diseases.


METHODS
Patients 20 years or younger with clinical, epidemiological, and laboratory evidence of SARS from March to July 2003 vs children with virus culture-confirmed influenza in a 1:1 age- and sex-matched control group.


METHODS
Rates of symptoms, abnormal laboratory data, and outcomes of recovery, sequelae, or death.


RESULTS
The 15 SARS patients (9 girls and 6 boys) had a median age of 17 years (age range, 4-20 years). Nine patients (60%) were infected through household contact, 4 (27%) nosocomially, 1 (7%) through contact with a neighbor, and 1 (7%) after returning from Hong Kong. All 15 patients had fever, 3 (20%) had chills, and 11 (73%) had cough. Only 1 patient (7%) had sputum production; 1 (7%) had rhinorrhea. At presentation, 5 patients (33%) had leukopenia, 6 (40%) had lymphopenia, and 5 (33%) had monocytopenia. All children recovered without sequelae. Children with SARS had significantly lower incidences of rhinorrhea (odds ratio [OR], 0.01; 95% confidence interval [CI], 0.00-0.09), sputum production (OR, 0.10; 95% CI, 0.02-0.63), and sore throat (OR, 0.17; 95% CI, 0.03-0.85) than children with influenza. Both groups had similar incidences of leukopenia or lymphopenia, but SARS patients had a significantly higher incidence of monocytopenia (33% vs 0%, P = .04).


CONCLUSIONS
Childhood SARS is usually not fatal. The absence of rhinorrhea and presence of monocytopenia in SARS may distinguish it from influenza.
Chang
Luan-Yin
LY
Departments of Pediatric, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei.
Huang
Fu-Yuan
FY
Wu
Yi-Chun
YC
Su
Ih-Jen
IJ
Chiu
Nan-Chang
NC
Chen
Kow-Tong
KT
Wu
Ho-Sheng
HS
Lin
Ting-Hsiang
TH
Peng
Shinn-Forng
SF
Kao
Chuan-Liang
CL
Lee
Chin-Yun
CY
Huang
Li-Min
LM
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology
D000900:Anti-Bacterial Agents