[Influenza virus in pediatrics. A reason for hospitalization].
BACKGROUND
Influenza infection in infants and children has been classically underestimated due to its non-specific symptoms, which sometimes overlap those of other respiratory viruses. Infants under 24 months are a risk group and school-aged children are a major source of influenza infection. The aim of this study was to describe the clinical and epidemiological characteristics of children hospitalized for flu, including co-infections and the differences as compared to other respiratory viruses. The effectiveness of a test for rapid diagnosis of this condition was assessed.


METHODS
Prospective, descriptive study in children < 5 years of age hospitalized from 1 December 2003 to 28 February 2004 with respiratory processes or fever of unknown origin. Polymerase chain reaction (PCR) testing for influenza A (IA) and B, respiratory syncytial virus A (RSV-A) and B, and parainfluenza 1, 2 and 3 was performed in nasopharyngeal aspirate, as well as a test for rapid diagnosis of influenza.


RESULTS
A total of 203 samples were included. PCR was positive for influenza in 11.3% (23/203); IA in 21 cases (20 H3N2, 1 H1N1). Co-infections were frequent (10/23), mainly IA with RSV-A. The rapid diagnostic test had a sensitivity of 45.5%. Median age of patients with flu was 4.87 months (5 days-3.5 years); 69.5% were < 24 months. Gastrointestinal symptoms were associated with fever and respiratory symptoms more often than in other viral infections (P < 0.05). Only 2.9% of patients with a recommendation for flu vaccination had received the vaccination.


CONCLUSIONS
Flu is a major cause of hospitalization in infants and children, particularly those aged < 24 months. Early diagnosis of this condition may avoid unnecessary use of additional tests and antibiotics. Vaccination coverage is low; vaccination between 6 and 24 months seems advisable.
Cruz-Cañete
Marta
M
Unidad de Infectología e Inmunodeficiencias, Departamento de Pediatría, Hospital Materno-Infantil, Centro Hospitalario Carlos Haya, Malaga, España. macruca@gmail.com
Moreno-Pérez
David
D
Jurado-Ortiz
Antonio
A
García-Martín
Francisco Jesús
FJ
López-Siles
Juan
J
Olalla-Martín
Laura
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D042241:Early Diagnosis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D053122:Influenza A Virus, H3N2 Subtype / Q000302:isolation & purification; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D008297:Male; D009305:Nasopharynx / Q000821:virology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology
D007252:Influenza Vaccines; D012367:RNA, Viral