title: Clinical characteristics and factors associated with severe acute respiratory infection and influenza among children in Jingzhou, China.
abstract: Influenza is an important cause of respiratory illness in children, but data are limited on hospitalized children with laboratory-confirmed influenza in China.
  
  
  
  We conducted active surveillance for severe acute respiratory infection (SARI; fever and at least one sign or symptom of acute respiratory illness) among hospitalized pediatric patients in Jingzhou, Hubei Province, from April 2010 to April 2012. Data were collected from enrolled SARI patients on demographics, underlying health conditions, clinical course of illness, and outcomes. Nasal swabs were collected and tested for influenza viruses by reverse transcription polymerase chain reaction. We described the clinical and epidemiological characteristics of children with influenza and analyzed the association between potential risk factors and SARI patients with influenza.
  
  
  
  During the study period, 15 354 children aged <15 years with signs and symptoms of SARI were enrolled at hospital admission. severe acute respiratory infection patients aged 5-15 years with confirmed influenza (H3N2) infection were more likely than children without influenza to have radiographic diagnosis of pneumonia (11/31, 36% vs 15/105, 14%. P<.05). Only 16% (1116/7145) of enrolled patients had received seasonal trivalent influenza vaccination within 12 months of hospital admission. Non-vaccinated influenza cases were more likely than vaccinated influenza cases to have pneumonia (31/133, 23% vs 37/256, 15%, P<.05). severe acute respiratory infection cases aged 5-15 years diagnosed with influenza were also more likely to have a household member who smoked cigarettes compared with SARI cases without a smoking household member (54/208, 26% vs 158/960, 16%, P<.05).
  
  
  
  Influenza A (H3N2) virus infection was an important contributor to pneumonia requiring hospitalization. Our results highlight the importance of surveillance in identifying factors for influenza hospitalization, monitoring adherence to influenza prevention and treatment strategies, and evaluating the disease burden among hospitalized pediatric SARI patients. Influenza vaccination promotion should target children.
authors.affiliation: China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Huai
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Guan
authors.affiliation: Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Shali
authors.initials: S
authors.lastname: Liu
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.affiliation: Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.affiliation: China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Klena
authors.affiliation: Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Jigui
authors.initials: J
authors.lastname: Huang
authors.affiliation: Jingzhou Center for Disease Control and Prevention, Jingzhou, China.
authors.forename: Maoyi
authors.initials: M
authors.lastname: Chen
authors.affiliation: Jingzhou First People's Hospital, Jingzhou, China.
authors.forename: Youxing
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Jingzhou Second People's Hospital, Jingzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yang
authors.affiliation: Jingzhou Maternal and Children's Hospital, Jingzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Luo
authors.affiliation: Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Xixiang
authors.initials: X
authors.lastname: Huo
authors.affiliation: Jingzhou Central Hospital, Jingzhou, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.
authors.forename: Yuzhi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Xuesen
authors.initials: X
authors.lastname: Xing
authors.affiliation: Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Luzhao
authors.initials: L
authors.lastname: Feng
authors.affiliation: China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.|Vaccine Clinical Research Branch Vaccine Research Program, Division of AIDS, NIAID/NIH, Bethesda, MD, USA.
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Hu
authors.affiliation: Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
authors.affiliation: Hubei Provincial Centre for Disease Control and Prevention, Wuhan, China.
authors.forename: Faxian
authors.initials: F
authors.lastname: Zhan
authors.affiliation: China-US Collaborative Program on Emerging and Re-Emerging Infection Disease, Center for Global Health, Centers for Disease Control and Prevention, Beijing, China.|Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D053122:Influenza A Virus, H3N2 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D008297:Male; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology / Q000821:virology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012621:Seasons; D014611:Vaccination
keywords: children; influenza; risk factors; severe acute respiratory infection