title: Neonates investigated for influenza-like illness during the outbreak of pandemic H1N1 2009: trivial infections but major triage implications.
abstract: We report eight cases of neonates (from birth to 25 days) admitted to the neonatal service of a teaching hospital with influenza-like illness during the outbreak of pandemic H1N1 2009, and discuss their management and infection control issues. Empirical antibiotics were often promptly initiated and timely stopped when sepsis was ruled out. Also, there was no pandemic H1N1-09 but influenza A (H3N2, n = 1), parainfluenza (type 3, n = 3) and respiratory syncytial virus (n = 1) have been isolated. The infants recovered spontaneously without any antiviral therapy. There was no outbreak of the respiratory infections in the neonatal service during the admissions. Respiratory viral infections can occur in neonates although the clinical course may be milder and nonspecific. Emergency room and frontline staff must be vigilant of the non-specific clinical features of infections with respiratory viruses in the neonates so that prompt triage and isolation can be implemented to avoid outbreaks in the neonatal service.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, 6/F, Clinical Sciences Building, Shatin, Hong Kong. ehon@cuhk.edu.hk
authors.forename: Kam-lun Ellis
authors.initials: KL
authors.lastname: Hon
authors.forename: Kam Lau
authors.initials: KL
authors.lastname: Cheung
authors.forename: William
authors.initials: W
authors.lastname: Wong
authors.forename: Pak Cheung
authors.initials: PC
authors.lastname: Ng
mesh_terms: D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology* / Q000821:virology; D008297:Male; D009864:Ontario; D058873:Pandemics / Q000517:prevention & control* / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D014218:Triage / Q000379:methods*
references.citation: Infect Control Hosp Epidemiol. 2000 Jul;21(7):449-54
references.pmid: 10926394
references.citation: Pediatr Infect Dis J. 1997 Nov;16(11):1065-8
references.pmid: 9384341
references.citation: Pediatr Pulmonol. 2009 Oct;44(10):1048-9
references.pmid: 19774678
references.citation: Lancet. 2003 May 17;361(9370):1701-3
references.pmid: 12767737
references.citation: J Perinatol. 2006 Dec;26(12):772-6
references.pmid: 17122787
references.citation: Lancet. 2003 Jun 7;361(9373):1984-5
references.pmid: 12801758
references.citation: Pediatr Pulmonol. 2008 Mar;43(3):275-80
references.pmid: 18219695
references.citation: Euro Surveill. 2009 Jul 30;14(30):19287
references.pmid: 19643062
references.citation: Adv Pediatr. 2009;56:47-73
references.pmid: 19968942