title: Pandemic A/H1N1(2009) influenza infections in very-low-birth-weight infants--a case series from the German Neonatal Network.
abstract: 6 cases of clinical influenza A/H1N1(2009) infections were reported within the multi-center German Neonatal Network (GNN) during the primary hospital stay in the pandemic season 2009/2010 and 2010/2011. Clinical symptoms varied from transient hyperthermia to apnea and severe respiratory distress. 1 fatal course with systemic inflammatory response after perinatal transmission of A/H1N1(2009) was observed. Oseltamivir treatment in 3/6 infants was without side effects. The reported cases have major implications for the management of VLBW infants: i) fatal courses after perinatal transmission are possible, ii) postnatal A/H1N1(2009) infection may result in life threatening events at a time when the infant is otherwise stable, iii) vaccination should be recommended for parents and medical staff to avoid nosocomial transmission, iv) more data are needed on the benefit and harm of antiviral drugs in preterm infants, v) neonatologists should suspect A/H1N1(2009) infection when unexplained sepsis-like or respiratory symptoms occur in VLBW infants.
authors.affiliation: Department of Pediatrics I, Neonatology, University Hospital Essen, Hufelandstrasse 55, Essen, Germany. anja.stein@uk-essen.de
authors.forename: A
authors.initials: A
authors.lastname: Stein
authors.forename: M
authors.initials: M
authors.lastname: Keller
authors.forename: S
authors.initials: S
authors.lastname: Ross
authors.forename: M
authors.initials: M
authors.lastname: Roggendorf
authors.forename: F
authors.initials: F
authors.lastname: Heitmann
authors.forename: T
authors.initials: T
authors.lastname: Hoehn
authors.forename: W
authors.initials: W
authors.lastname: Göpel
authors.forename: U
authors.initials: U
authors.lastname: Felderhoff-Müser
authors.forename: C
authors.initials: C
authors.lastname: Härtel
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D002423:Cause of Death; D003428:Cross Infection / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000635:transmission; D003937:Diagnosis, Differential; D005260:Female; D005858:Germany; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000635:transmission; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000635:transmission; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D015996:Survival Rate
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir