Influenza burden in febrile infants and young children in a pediatric emergency department.
BACKGROUND
In France, epidemiologic data in children in ambulatory settings are scarce. We aimed to measure the burden of influenza in young children.


METHODS
Febrile children younger than 36 months were consecutively recruited in a pediatric emergency department during the 2002 epidemic peak. Virology analysis and follow-up were systematic.


RESULTS
During calendar weeks 3 to 6, 2002, 575 children were recruited; 49% were positive: A/H3N2 in 44% and B in 5%. Prevalence rate was 57% in 12- to 35-month-old children and 39% in infants younger than 12 months. The main clinical pictures were nonrespiratory in one third of them. One of 8 patients had a complication. One of 10 patients was hospitalized, and the estimated specific hospitalization rate for the study period was 237 of 100,000 in the general population among infants younger than 12 months. Forty-two percent of children (n = 110) were prescribed antibiotics and at least 34% of them were inappropriate (n = 89). Median length of disease was 8 days, and 25% of the children had not fully recovered by day 11. Only one child had been previously vaccinated of 65 with chronic conditions. Both epidemic strains were covered by the vaccine.


CONCLUSIONS
Health outcomes showed that influenza disease burden in young French children is similar to that observed in North America. An active vaccination strategy would have strongly reduced the burden of influenza and lowered antibiotic use. Continuous efforts are needed to reach requirements of our influenza vaccination policy.
Ploin
Dominique
D
Département d'Information Médicale des Hospices Civils de Lyon, Lyon, France. dploin@hotmail.fr
Gillet
Yves
Y
Morfin
Florence
F
Fouilhoux
Alain
A
Billaud
Geneviève
G
Liberas
Sylviane
S
Denis
Angélique
A
Thouvenot
Danielle
D
Fritzell
Bernard
B
Lina
Bruno
B
Floret
Daniel
D
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D005334:Fever / Q000209:etiology*; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053122:Influenza A Virus, H3N2 Subtype / Q000302:isolation & purification; D009981:Influenza B virus / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D013997:Time Factors; D014780:Viruses / Q000302:isolation & purification
D000900:Anti-Bacterial Agents