title: Influenza A/H1N1 in pediatric oncology patients.
abstract: BACKGROUND
  Our aim was to determine the clinical and epidemiological features of pandemic influenza A/H1N1 in immunocompromised children with solid tumors and hematological malignancies.
  
  
  METHODS
  A prospective study was conducted during the H1N1 pandemic between August 2009 and February 2010 in a pediatric hematology-oncology unit. Demographic and clinical data were obtained from all children with suspected H1N1 infection (high fever with or without respiratory symptoms). Laboratory diagnosis of influenza A/H1N1 was performed by means of polymerase chain reaction analysis of nasopharyngeal wash specimens.
  
  
  RESULTS
  We identified 57 episodes of suspected influenza A/H1N1 infection in 40 children. In all episodes, children were treated with oseltamivir and antibiotics until influenza A/H1N1 results were received. Of all episodes, 13 (22.8%) tested positive for influenza A/H1N1. Two of the H1N1-positive children (15.4%) had been previously immunized against influenza A/H1N1. No differences between H1N1-positive and H1N1-negative children were noted in terms of demographic features, clinical presentation, laboratory findings, and underlying disease.Three polymerase chain reaction-positive (23.0%) children and 1 H1N1-negative (2.3%) child were admitted to the pediatric intensive care unit and were mechanically ventilated (P=0.03). One (7.7%) H1N1-positive patient died versus none of the H1N1-negative patients (P=0.2). The condition of all other children in both the groups improved rapidly during hospitalization.
  
  
  CONCLUSIONS
  Febrile hospitalized pediatric oncology patients, with and without pandemic influenza A/H1N1, had a similar demographic and clinical presentation with a relatively good outcome. This was probably because of early antiviral treatment and possibly because of the relatively low virulence of the virus. Immunization should be encouraged in these patients.
authors.affiliation: *Pediatric Hemato-Oncology Unit †Pediatric Infectious Diseases Unit ‡Viral Clinical Laboratory, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Dotan
authors.forename: Shalom
authors.initials: S
authors.lastname: Ben-Shimol
authors.forename: Yariv
authors.initials: Y
authors.lastname: Fruchtman
authors.forename: Yonat
authors.initials: Y
authors.lastname: Avni-Shemer
authors.forename: Joseph
authors.initials: J
authors.lastname: Kapelushnik
authors.forename: Miri
authors.initials: M
authors.lastname: Ben-Harush
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.forename: Eugene
authors.initials: E
authors.lastname: Leibovitz
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D015278:Intensive Care Units, Pediatric; D008297:Male; D017817:Nasal Lavage Fluid / Q000821:virology; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D053139:Oseltamivir