Influenza-associated hospitalization in urban Thai children.
BACKGROUND
Studies in North America and Europe have shown that young children are at increased risk of serious complications and hospitalization from influenza infection. In Thailand, however, influenza is commonly considered a mild infection that rarely requires hospitalization. An improved understanding of the burden of serious complications from influenza infection in young children is needed to inform clinical treatment and vaccination guidelines.


METHODS
We conducted a prospective study of children 0-5 years of age with lower respiratory tract infection or influenza-like illness admitted to a pediatric tertiary-care hospital in Bangkok, Thailand during July 2004 to July 2005. All respiratory specimens were tested for influenza using a rapid antigen test and tissue cell culture.


RESULTS
Thirty-nine of 456 (8.6%) hospitalized children had culture-positive influenza. Eighty percent of hospitalized influenza patients had no underlying chronic illnesses. Nineteen (49%) influenza patients required hospital stays of 5 days or more and two patients required mechanical ventilation. Influenza activity demonstrated bimodal seasonal variation with peak activity from August to October and January to April. Cough was present in 38 (97%) cases and fever >38.5 degrees C was significantly associated with influenza.


CONCLUSIONS
Influenza is an important cause of hospitalization in children <5 years of age in Thailand. Children <5 years should be considered as a target group when establishing clinical guidelines for antiviral treatment and influenza vaccination.
Suntarattiwong
Piyarat
P
Department of Pediatrics, Queen Sirikit National Institute of Child Health, Ministry of Public Health, Thailand.
Sian-nork
Chotip
C
Thongtipa
Parada
P
Thawatsupha
Pranee
P
Kitphati
Rungreung
R
Chotpitayasunondh
Tawee
T
D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D009975:Orthomyxoviridae / Q000302:isolation & purification; D015995:Prevalence; D011446:Prospective Studies; D013183:Sputum / Q000821:virology; D013785:Thailand / Q000453:epidemiology; D014505:Urban Population