title: Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1): an experience from a tertiary care center in north India.
abstract: OBJECTIVE
  To describe our experience in children hospitalized with the pandemic Influenza A (H1N1) from Northern India.
  
  
  METHODS
  The retrospective case study was conducted at the Pediatric ward and Pediatric Intensive Care Unit (PICU) dedicated to the children (aged 18 years or younger) with influenza-like illness (ILI) with positive laboratory test results for pandemic H1N1 by reverse-transcriptase polymerase-chain-reaction assay.
  
  
  RESULTS
  Between August 2009 and January 2010, a total of 100 children were hospitalized with suspected 2009 H1N1 influenza with Category "C" as described by the Government of India. Twenty five patients were positive for H1N1 and 9 for seasonal influenza A. The most common presentation (H1N1 positive) was with fever (100%), cough (100%), coryza (52%), respiratory distress (88%), vomiting (28%) and diarrhea (16%). One child presented with hypernatremic dehydration and seizures (Serum sodium 174 meq/l). Of the H1N1 positive hospitalized children, 7 (28%) had respiratory failure and required PICU admission, 4 (16%) required mechanical ventilation, and 3 (12%) died. The major radiological findings were bilateral pulmonary infiltrates and consolidation. All patients were treated with oral Oseltamivir suspension or capsule as per appropriate weigh band and supportive care as required. Two deaths were caused by refractory hypoxemia and one by refractory shock.
  
  
  CONCLUSIONS
  The exact incidence of Pandemic 2009 H1N1 influenza on morbidity and mortality is difficult to calculate since only Category "C" patients were screened.
authors.affiliation: Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi 110001, India. ankitparakh102@rediffmail.com
authors.forename: Ankit
authors.initials: A
authors.lastname: Parakh
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.forename: Virendra
authors.initials: V
authors.lastname: Kumar
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Dutta
authors.forename: Shashi
authors.initials: S
authors.lastname: Khare
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D053139:Oseltamivir
references.citation: J Infect Dis. 2010 Mar;201(5):746-50
references.pmid: 20102270
references.citation: Pediatr Crit Care Med. 2010 Mar;11(2):179-84
references.pmid: 20081552
references.citation: Pediatr Infect Dis J. 2010 Jul;29(7):591-4
references.pmid: 20589976
references.citation: Pediatr Crit Care Med. 2010 Sep;11(5):603-9
references.pmid: 20308929
references.citation: Vaccine. 2010 Apr 19;28(18):3180-4
references.pmid: 20189488
references.citation: J Clin Microbiol. 2010 Jun;48(6):2298-300
references.pmid: 20392922
references.citation: Eur J Pediatr. 2010 Sep;169(9):1159-61
references.pmid: 20213303
references.citation: N Engl J Med. 2010 Jan 7;362(1):45-55
references.pmid: 20032320
references.citation: Ann Trop Paediatr. 2010;30(1):51-5
references.pmid: 20196934
references.citation: Zhonghua Er Ke Za Zhi. 2009 Dec;47(12):935-8
references.pmid: 20193148
references.citation: Arch Dis Child. 2011 Jan;96(1):96-8
references.pmid: 19906639