title: Clinical features and outcome of 2009 influenza A (H1N1) virus infections in children with malignant diseases: a case-control study.
abstract: BACKGROUND
  The impact of the novel 2009 influenza A (H1N1) (2009 H1N1) virus in children with malignant diseases under therapy is not well known.
  
  
  OBJECTIVE
  To analyze the clinical features and outcome in children with anticancer therapy infected with the 2009 H1N1 virus.
  
  
  METHODS
  Descriptive, case-control study. Between May and July 2009, 24 cases of 2009 (H1N1) virus infections in children with malignant diseases were registered and 48 control cases of similar patients infected with common influenza A virus (IA) diagnosed between 2006 and 2008 were selected.
  
  
  RESULTS
  Median age for cases was 72 months and for controls was 83 months (P ≥ 0.05). Children with IA showed neutropenia more frequently (52% vs. 17%), longer period of time with illness before diagnosis (3 d vs. 1.7 d), higher rate of earlier medical consultation (69% vs. 25%), and more antibiotic therapy courses (54% vs. 4%; P ≤ 0.05) than patients with 2009 H1N1 virus. Children infected with this virus presented hypoxemia more frequently (42% vs. 8%) and higher rates of intensive care unit hospitalizations (29% vs. 2%; P ≤ 0.05). Three children with 2009 H1N1 virus and 1 in the control group died.
  
  
  CONCLUSIONS
  Children infected with 2009 H1N1 virus presented more morbidity and mortality than patients infected with seasonal IA virus.
authors.affiliation: Infectious Diseases Department, Hospital de Pediatría Professor Dr Juan P Garrahan, Buenos Aires, Argentina. hpaganini@yahoo.com.ar
authors.forename: Hugo
authors.initials: H
authors.lastname: Paganini
authors.forename: Adriana
authors.initials: A
authors.lastname: Parra
authors.forename: Silvina
authors.initials: S
authors.lastname: Ruvinsky
authors.forename: Diana
authors.initials: D
authors.lastname: Viale
authors.forename: Elsa
authors.initials: E
authors.lastname: Baumeister
authors.forename: Rosa
authors.initials: R
authors.lastname: Bologna
authors.forename: Pedro
authors.initials: P
authors.lastname: Zubizarreta
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000401:mortality / Q000821:virology; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents