title: The burden of childhood influenza in a tertiary paediatric setting.
abstract: Influenza is usually considered a mild winter-time illness but can be associated with a range of serious complications. We undertook a retrospective medical record review to study the impact of admissions of children with laboratory-confirmed influenza to The Children's Hospital at Westmead, Sydney, during 2007. One hundred and twenty-two children were identified, representing 530 hospital admission days. There was no clearly documented evidence of influenza vaccination for any patient eligible for vaccination. Fever (97.5%) and cough (69.7%) were the most frequent manifestations. Admissions occurred almost entirely between June and September with a peak in July (n=61, 50%). Two-thirds of the children were aged less than 2 years (median 1.5 years). Most (61.5%) had an underlying chronic medical disorder. Lumbar puncture was performed in 28 (23%) children, mostly infants aged less than 3 months (n=18). Antibiotics were commonly prescribed (67.2%), but use of available influenza-specific antiviral agents was uncommon (13.1%). The nosocomial infection rate was 9.8% and the clinical staff vaccination rate was low (less than 30%). Pneumonia was the most common complication (12.3%). No influenza-related deaths occurred. Influenza in young children poses a significant burden to health care services, tertiary admissions representing the tip-of-the-iceberg. Vaccination rates are inappropriately low in both eligible patients and hospital clinical staff. Early 'point of care' testing, use of influenza-specific antiviral agents, and extension of current vaccination schedules to include all children aged six to 23 months could considerably reduce over-investigation, unnecessary use of antibiotics and the health care impact of influenza.
authors.affiliation: The Children's Hospital at Westmead, New South Wales. davidl7@chw.edu.au
authors.forename: David
authors.initials: D
authors.lastname: Lester-Smith
authors.forename: Yvonne A
authors.initials: YA
authors.lastname: Zurynski
authors.forename: Robert
authors.initials: R
authors.lastname: Booy
authors.forename: Marino S
authors.initials: MS
authors.lastname: Festa
authors.forename: Alison M
authors.initials: AM
authors.lastname: Kesson
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Elliott
mesh_terms: D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology*; D012189:Retrospective Studies; D012621:Seasons; D013997:Time Factors