Clinical features of severe influenza A (H1N1) virus infection.
OBJECTIVE
To highlight the clinical presentations of influenza A (H1N1) infection, for early diagnosis and recognition by the pediatricians.


METHODS
In this retrospective study, the medical records of inpatients with influenza A (H1N1) infection between November 1, 2009 and May 31, 2011 were reviewed.


RESULTS
Eighty pediatric in-patients with median age 41.9 mo were studied. ARDS (11/80), pneumothorax (8/80), pleural effusion (7/80) and encephalopathy (7/80) were the most frequent complications. Six of 11 ARDS patients died;all of them were under 5 y. The median days of viral shedding was 11.4 d. Slight increase of Il-6, Il-10 and TNF-γ were revealed in some cases.


CONCLUSIONS
During late stage of pandemic wave, the majority of patients were young children. Children with severe Influenza A (H1N1) are prone to develop complications, and die from ARDS. If influenza-like illness is accompanied by neurologic signs, influenza A (H1N1) virus infection should be considered. The viral shedding in children is longer than in adults.
Division of Infection Disease, Zhejiang Key Laboratory for Neonatal Disease, Children's Hospital of Zhejiang University Medical College, Hangzhou, China.
Yinghu
Y
Chen
Shiqiang
S
Shang
Yongmin
Y
Tang
Chenmei
C
Zhang
Meiqin
M
Tong
Yuwen
Y
Dai
D002675:Child, Preschool; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis*; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies