title: [Clinical features and outcome of 2009 H1N1 influenza in the pediatric setting. Multicenter prospective study in the ED].
abstract: OBJECTIVE
  The clinical manifestations and outcome of infants and children with confirmed 2009 H1N1 influenza in emergency departments is described.
  
  
  METHODS
  We conducted a prospective multicenter case series involving children with symptoms of influenza-like illness in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase chain reaction assay on a nasopharyngeal swab or nasal aspirates and who were admitted to the ED of four university pediatric hospitals. The following data were collected: age, gender, preexisting chronic conditions (PECs) associated with a high risk for influenza-related complications, clinical symptoms, outcome, antiviral treatment, and complications. We recorded length of cough and fever during a phone-call on day 8.
  
  
  RESULTS
  Between 1st October and 31st December 2009, 466 children were included. Their median age was 4 years (range, 1 day to 17 years). The median time to consultation was 24h. Of these 466 infants and children, 55 were aged less than three months and 153 had one or more PECs. Asthma was the most frequent condition. Children at risk and children without risk did not differ for complications (28% vs 31%, P>0.05). Respiratory complications (17%) and decompensations of preexisting disease were the most frequent. Infants aged less than three months did not have more complications than infants without PECs. At-risk infants and children were more frequently hospitalized (P<0.02) and the duration of the pediatric ward stay was longer (P<0.02). This was true only for children aged less than three months. Of the hospitalized children, 17 (9%) were admitted to an ICU. Duration of fever (3.8 days) and duration of cough (6.3 days) did not differ according to whether or not children received oseltamivir.
  
  
  CONCLUSIONS
  Infants younger than three months of age are not a group at risk for influenza-related complications. Oseltamivir did not reduce duration of symptoms in this population.
authors: Service des urgences pédiatriques, université Paris Descartes, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
authors: C
authors: C
authors: Desmoulins
authors: Service de pédiatrie, CASED, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
authors: A-P
authors: AP
authors: Michard-Lenoir
authors: SMUR pédiatrique, CHU de Bordeaux, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors: J
authors: J
authors: Naud
authors: Service d'accueil des urgences pédiatriques, hôpital des enfants, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
authors: I
authors: I
authors: Claudet
authors: Service des urgences pédiatriques, université Paris Descartes, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
authors: V
authors: V
authors: Nouyrigat
authors: Service des urgences pédiatriques, université Paris Descartes, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
authors: G
authors: G
authors: Chéron
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir