title: Deaths associated with pandemic (H1N1) 2009 among children, Japan, 2009-2010.
abstract: To clarify the cause of deaths associated with pandemic (H1N1) 2009 among children in Japan, we retrospectively studied 41 patients <20 years of age who had died of pandemic (H1N1) 2009 through March 31, 2010. Data were collected through interviews with attending physicians and chart reviews. Median age of patients was 59 months; one third had a preexisting condition. Cause of death was categorized as unexpected cardiopulmonary arrest for 15 patients, encephalopathy for 15, and respiratory failure for 6. Preexisting respiratory or neurologic disorders were more frequent in patients with respiratory failure and less frequent in patients with unexpected cardiopulmonary arrest. The leading causes of death among children with pandemic (H1N1) 2009 in Japan were encephalopathy and unexpected cardiopulmonary arrest. Deaths associated with respiratory failure were infrequent and occurred primarily among children with preexisting conditions. Vaccine use and public education are necessary for reducing influenza-associated illness and death.
authors.affiliation: Juntendo University Faculty of Medicine, Tokyo, Japan. okumura@juntendo.ac.jp
authors.forename: Akihisa
authors.initials: A
authors.lastname: Okumura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Muguruma
authors.forename: Osamu
authors.initials: O
authors.lastname: Saito
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Fujimoto
authors.forename: Chiaki
authors.initials: C
authors.lastname: Toida
authors.forename: Shuji
authors.initials: S
authors.lastname: Kuga
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Imamura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Naomi
authors.initials: N
authors.lastname: Kondo
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Morishima
mesh_terms: D000293:Adolescent; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000453:epidemiology / Q000401:mortality*; D007564:Japan / Q000453:epidemiology; D008297:Male; D058873:Pandemics
references.citation: Pediatr Crit Care Med. 2010 Mar;11(2):179-84
references.pmid: 20081552
references.citation: N Engl J Med. 2009 Aug 13;361(7):680-9
references.pmid: 19564631
references.citation: Ann Neurol. 2010 Nov;68(5):762-6
references.pmid: 20865762
references.citation: Pediatr Crit Care Med. 2010 Sep;11(5):603-9
references.pmid: 20308929
references.citation: Arch Pediatr Adolesc Med. 2010 Nov;164(11):1023-31
references.pmid: 21041595
references.citation: JAMA. 2009 Nov 4;302(17):1872-9
references.pmid: 19822627
references.citation: Pediatr Emerg Care. 1991 Aug;7(4):226-8
references.pmid: 1758777
references.citation: Lancet. 2010 Nov 27;376(9755):1846-52
references.pmid: 21030071
references.citation: Am J Forensic Med Pathol. 2000 Dec;21(4):375-9
references.pmid: 11111801
references.citation: N Engl J Med. 2010 Jan 7;362(1):45-55
references.pmid: 20032320
references.citation: Can J Cardiol. 2011 Jul-Aug;27(4):514-22
references.pmid: 21652168
references.citation: Pediatr Int. 2000 Apr;42(2):192-6
references.pmid: 10804741
references.citation: Thorax. 2010 Jul;65(7):645-51
references.pmid: 20627925
references.citation: N Engl J Med. 2009 Jun 18;360(25):2605-15
references.pmid: 19423869
references.citation: Virchows Arch. 2011 Mar;458(3):371-6
references.pmid: 21234762
references.citation: MMWR Morb Mortal Wkly Rep. 2009 Jul 24;58(28):773-8
references.pmid: 19629027
references.citation: Pediatrics. 2011 Jan;127(1):e156-63
references.pmid: 21172991
references.citation: Lancet. 2009 Dec 19;374(9707):2072-2079
references.pmid: 19913290
references.citation: PLoS Curr. 2009 Dec 20;1:RRN1139
references.pmid: 20043033
references.citation: Pediatr Infect Dis J. 2011 Feb;30(2):165-7
references.pmid: 20811314
references.citation: Lancet. 2009 Aug 22;374(9690):605-7
references.pmid: 19700000
references.citation: Brain Dev. 1997 Mar;19(2):81-92
references.pmid: 9105653
references.citation: N Engl J Med. 2009 Nov 12;361(20):1925-34
references.pmid: 19815860
references.citation: Clin Infect Dis. 2011 Jan 1;52 Suppl 1:S69-74
references.pmid: 21342902
references.citation: Clin Infect Dis. 2002 Sep 1;35(5):512-7
references.pmid: 12173123
references.citation: JAMA. 2009 Nov 4;302(17):1896-902
references.pmid: 19887665
references.citation: N Engl J Med. 2009 Nov 12;361(20):1935-44
references.pmid: 19815859
references.citation: MMWR Morb Mortal Wkly Rep. 2009 Sep 4;58(34):941-7
references.pmid: 19730406
references.citation: Dev Med Child Neurol. 2008 Sep;50(9):717-9
references.pmid: 18754924
references.citation: Arch Dis Child. 2011 Jan;96(1):96-8
references.pmid: 19906639
references.citation: JAMA. 2009 Nov 4;302(17):1880-7
references.pmid: 19822626
references.citation: BMJ. 2009 Dec 10;339:b5213
references.pmid: 20007665
references.citation: N Engl J Med. 2010 May 6;362(18):1708-19
references.pmid: 20445182
references.citation: Lancet. 2009 Aug 8;374(9688):451-8
references.pmid: 19643469
references.citation: Lancet. 2000 Apr 29;355(9214):1558-9
references.pmid: 10801205