title: Clinical manifestations and socio-economic impact of influenza among healthy children in the community.
abstract: OBJECTIVE
  To evaluate the total burden of influenza among healthy children in the community in order to analyse the cost of influenza in paediatric age.
  
  
  METHODS
  This prospective study involved a total community population of 21,986 children, 6988 of whom experienced an influenza-like illness (ILI) between 1 November 2008 and 30 April 2009. An electronic chart was completed, a nasopharyngeal swab was obtained, and information was recorded concerning the clinical outcomes and household impact of the ILI episodes. Influenza A and B viruses were detected in all the swabs by means of polymerase chain reaction, and costs of the disease were calculated.
  
  
  RESULTS
  Influenza viruses were detected in 2143 cases (30.7%), an incidence of 96.4 per 1000 children. Influenza A and B viruses were found in respectively 1751 (81.7%) and 392 cases (18.3%). The mean cost of influenza was no less than €130, 32% higher than the cost of influenza-negative ILIs (p < 0.001). The influenza A cases were significantly more expensive than the influenza B cases (p < 0.001), and influenza in children aged <2 and 2-5 years was significantly more expensive than in children aged >5 years (p < 0.05). The differences were mainly related to the indirect costs of the parents' lost working days.
  
  
  CONCLUSIONS
  The findings of this study confirm that influenza among healthy children is important because of its frequency and its indirect consequences on the households of infected children, and support the use of influenza vaccination in healthy children aged between 6 months and 5 years.
authors.affiliation: Department of Maternal and Paediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Luigi
authors.initials: L
authors.lastname: Cantarutti
authors.forename: Claudio Giuseppe
authors.initials: CG
authors.lastname: Molteni
authors.forename: Cristina
authors.initials: C
authors.lastname: Daleno
authors.forename: Alessia
authors.initials: A
authors.lastname: Scala
authors.forename: Claudia
authors.initials: C
authors.lastname: Tagliabue
authors.forename: Claudio
authors.initials: C
authors.lastname: Pelucchi
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000191:economics / Q000453:epidemiology / Q000473:pathology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000302:isolation & purification; D009981:Influenza B virus / Q000302:isolation & purification; D007251:Influenza, Human / Q000191:economics* / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D009305:Nasopharynx / Q000821:virology; D015995:Prevalence; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction