title: Novel influenza a (H1N1) infection in a Pediatric Hematology Oncology Clinic during the 2009-2010 pandemia.
abstract: Pandemic influenza A infection (2009 H1N1) was associated with a worldwide outbreak of febrile respiratory infection. Although usually it results in a mild illness, certain patient groups are at increased risk for complications. The authors reviewed their experience in a pediatric hematology-oncology unit to determine the outcome of this disease in children with hematological conditions and solid tumors. During the second outbreak (1 November 2009 to 14 January 2010), a total of 187 children from pediatric clinic were tested for H1N1 influenza A by multiplex polymerase chain reaction (PCR), 63 of them were positive. Patients' signs and symptoms were recorded prospectively. Ten (35.7%) (5 children with solid tumors, 4 with leukemia, 1 with hereditary spherocytosis) of 28 tested children with hematological conditions were diagnosed with 2009 H1N1 influenza infection. Fever (100%) and cough (90%) were the most common symptoms. Five were neutropenic (neutrophil count <1000/mm(3)), 4 had severe neutropenia (neutrophil count <500/mm(3)). Systemic antibiotics were given in 5 patients with the diagnosis of febrile neutropenia. Four were inpatients, others were hospitalized after the diagnosis. One patient required mechanical ventilation; however, he had concomitant invasive fungal infection. Eight patients were treated by oseltamivir, all tolerated the drug well. A total of 4 cases from 9 cancer patients had a delay in their planned chemotherapy for 7 to 15 days. Pandemic H1N1 influenza caused mild symptoms in children with cancer and/or hematological conditions but resulted in delay in anticancer therapy and increase in hospitalization and antibiotic usage.
authors.affiliation: Department of Pediatric Hematology-Oncology, Cerrahpaşa Medical Faculty, Istanbul, Turkey. gnozdemir@hotmail.com
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Tiraje
authors.initials: T
authors.lastname: Celkan
authors.forename: Kenan
authors.initials: K
authors.lastname: Midilli
authors.forename: Gökhan
authors.initials: G
authors.lastname: Aygün
authors.forename: Serhat
authors.initials: S
authors.lastname: Sinekbasan
authors.forename: Omer
authors.initials: O
authors.lastname: Kılıç
authors.forename: Hilmi
authors.initials: H
authors.lastname: Apak
authors.forename: Yıldız
authors.initials: Y
authors.lastname: Camcıoğlu
authors.forename: Inci
authors.initials: I
authors.lastname: Yıldız
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D008297:Male; D008495:Medical Oncology; D058873:Pandemics; D010372:Pediatrics; D016896:Treatment Outcome; D014421:Turkey