title: Clinical and epidemiological characteristics of patients with influenza A (H1N1) 2009 attended to at the emergency room of a children's hospital.
abstract: In June 2009, the first influenza pandemic of the twenty-first century, due to the swine origin influenza A (H1N1) 2009 virus, was declared. This study aimed to describe the epidemiological and clinical features, complications, lethality and risk factors for hospital admission of microbiologically confirmed cases of influenza A (H1N1) 2009 infection seen at the emergency department of a children's hospital. All cases of children with influenza A (H1N1) 2009 viral infection, confirmed microbiologically by real-time reverse transcription polymerase chain reactions and treated in the emergency room between July and December 2009, were prospectively included. Patients were compared according to admission requirement to study variables associated with the risk of hospitalisation. Oseltamivir was the antiviral used for the treatment and its safety was analysed. Four hundred and twelve patients with influenza A (H1N1) 2009 infection were included. The most frequent symptoms were: fever (96%), cough (95%) and coryza (90%). Eighty-five patients (20.6%) were admitted: three to the paediatric intensive care unit and two died. Hospitalised children were younger than those not admitted (median age 5 vs 8 years; p = 0.001). Age under 1 year (OR 6.01; CI 95% 2.77-13.05), pneumonia (OR 7.99; CI 95% 3.50-18.22) and haemoglobinopathy or underlying blood disorders (OR 5.99; CI 95% 1.32-27.30) were statistically significant risk factors for admission. No differences were observed regarding onset of antiviral treatment among admitted and non-admitted patients. Treatment with oseltamivir was well tolerated. In conclusion, the incidence of severe cases and lethality of influenza A (H1N1) 2009 infection were low in our setting, even in a population with risk factors for developing complications.
authors.affiliation: Paediatric Emergency Department, Autonomous University of Barcelona, University Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. 38446elc@comb.cat
authors.forename: Esther
authors.initials: E
authors.lastname: Lera
authors.forename: Núria T
authors.initials: NT
authors.lastname: Wörner
authors.forename: Mónica
authors.initials: M
authors.lastname: Sancosmed
authors.forename: Anna
authors.initials: A
authors.lastname: Fàbregas
authors.forename: Alejandro
authors.initials: A
authors.lastname: Casquero
authors.forename: Susana
authors.initials: S
authors.lastname: Melendo
authors.forename: Mar
authors.initials: M
authors.lastname: Miserachs
authors.forename: Teresa
authors.initials: T
authors.lastname: Tórtola
authors.forename: Astrid
authors.initials: A
authors.lastname: Borrego
authors.forename: Magda
authors.initials: M
authors.lastname: Campins
authors.forename: Fernando
authors.initials: F
authors.lastname: Moraga
authors.forename: Concepció
authors.initials: C
authors.lastname: Figueras
authors.forename: Rocío
authors.initials: R
authors.lastname: Cebrián
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D053139:Oseltamivir / Q000009:adverse effects / Q000627:therapeutic use*; D058873:Pandemics; D010343:Patient Admission; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir