TY - JOUR T1 - Isolation Protocols for Mitigate Influenza in Children AU - Okay, Berker AU - Tatar Atamanalp, Cansu AU - Aydın, Fahrettin AU - Hayrazan, Ozan AU - Özcan, Elif AU - Ahmadian, Nahid AU - Akıntürk, Ardıl AU - Üze Okay, Zeynep AU - Şahin, Kamil AU - Us, Mahmut Caner AU - Akkoç, Gülşen PY - 2025 DA - February Y2 - 2024 DO - 10.26650/jchild.2024.1572413 JF - Çocuk Dergisi PB - Istanbul University WT - DergiPark SN - 1308-8491 SP - 226 EP - 232 VL - 24 IS - 4 LA - en AB - Objective: Influenza, which is characterized by febrile nature and acute respiratory manifestations, poses a significant threat to children with respect to morbidity and mortality. This study aimed to assess influenza infection data among children during periods of enforced isolation and subsequently when these measures were lifted.Methods: This retrospective cross-sectional study categorized patients into two groups: i) influenza direct fluorescent antibody test (DFT) positive patients admitted between June 16, 2021 and June 15, 2022, when isolation measures were in effect (Group 1) and ii) influenza DFT-positive patients admitted between June 16, 2022 and June 15, 2023, when isolation measures were lifted (Group 2).Results: Influenza A was predominant in Group 1, whereas influenza A and B were more evenly distributed in Group 2, demonstrating a statistically significant difference (p<0.001). The incidence of moderate-to-severe disease was significantly higher in Group 2 than in Group 1 (p<0.001). Groups 1 and 2 differed significantly in terms of hospitalization duration and clinical recovery time (5 [1–7] days vs. 7 [3–9] days, **P<0.001 and 3 [1–4] days vs. 5 [4–7] days, p<0.001, respectively). The analysis of monthly infection distribution revealed a peak occurring 3 months earlier in Group 2 than in Group 1. In Group 1, compliance rates to vaccination recommendations by physicians and pediatricians were 33% and 58%, respectively, whereas compliance rates in Group 2 were 31.5% and 43.7%, respectively.Conclusions: Implementing basic measures such as hand hygiene and mask-wearing can mitigate viral outbreaks. Elevating the rate of physician recommended vaccinations can potentially alleviate disease burden and mitigate disease severity. KW - Oseltamivir KW - Influenza KW - Isolation KW - Vaccine KW - SARS-CoV-2 CR - American Academy of Pediatrics. Influenza. In: Red Book: 20212024 Report of the Committee on Infectious Diseases, 32nd ed. Kimberlin, D.W., Barnett, E.D., Lynfield, R., Sawyer, M.H. (Eds), American Academy of Pediatrics, Itasca. 2021. google scholar CR - World Health Organization. Influenza (Seasonal). Available online: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) (accessed on October 10, 2024. google scholar CR - Committee On Infectious Diseases. Recommendations for Prevention and Control of Influenza in Children, 2022-2023. Pediatrics. 2023; 150. doi: 10.1542/peds.2022-059274. google scholar CR - Jefferson T, Jones M, Doshi P, Spencer EA, Onakpoya I, Heneghan CJ. Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ. 2014; 348:g2545. doi: 10.1136/bmj.g2545. google scholar CR - Nelson CA, Meaney-Delman D, Fleck-Derderian S, Cooley KM, Yu PA, Mead PS, et al. Antimicrobial Treatment and Prophylaxis of Plague: Recommendations for Naturally Acquired Infections and Bioterrorism Response. MMWR Recomm Rep. 2021; 70:1. doi: 10.15585/mmwr.rr7003a1. google scholar CR - Peaper, D.R., Landry, M.L. Rapid diagnosis of influenza: state of the art. Clin Lab Med. 2014 Jun;34(2):365-85. doi: 10.1016/j. cll.2014.02.009. google scholar CR - Merckx J, Wali R, Schiller I, Caya C, Gore GC, Chartrand C et al. Diagnostic Accuracy of Novel and Traditional Rapid Tests for Influenza Infection Compared With Reverse Transcriptase Polymerase Chain Reaction: A Systematic Review and Meta-analysis. Ann Intern Med. 2017 Sep 19;167(6):394-409. doi: 10.7326/M17-0848. google scholar CR - Peltola V, Ziegler T, Ruuskanen O. Influenza A and B Virus Infections in Children. Clinical Infectious Diseases. 2023; 36(3):299—305. doi: 10.1086/345909. google scholar CR - Ip DKM, Lau LLH, Chan KH, et al. The Dynamic Relationship Between Clinical Symptomatology and Viral Shedding in Naturally Acquired Seasonal and Pandemic Influenza Virus Infections. Clin Infect Dis. 2016; 15;62(4):431-437. doi: 10.1093/cid/civ909. google scholar CR - Silvennoinen H, Peltola V, Lehtinen P, Vainionpaa R, Heikkinen T. Clinical presentation of influenza in unselected children treated as outpatients. Pediatr Infect Dis J. 2009; 28:372. doi: 10.1097/ INF.0b013e318191eef7. google scholar CR - Danier J, Rivera L, Claeys C, Dbaibo G, Jain VK, Kosalaraksa P et al. Clinical Presentation of Influenza in Children Aged 6-35 Months: Findings from a Randomized Clinical Trial of the Inactivated Quadrivalent Influenza Vaccine. Pediatr Infect Dis J. 2019; 38:866. doi: 10.1097/INF.0000000000002387. google scholar CR - Antoon JW, Hall M, Herndon A, Johnson DP, Brown CM, Browning WL, et al. Prevalence, Risk Factors, and outcomes of influenza-associated neurological complications in children. J Pediatr. 2021; 239:32. doi: 10.1016/j.jpeds.2021.06.075. google scholar CR - Hu JJ, Kao CL, Lee PI, Chen CM, Lee CY, Lu CY, et al. Clinical features of influenza A and B in children and association with myositis. J Microbiol Immunol Infect. 2004; 37:95. google scholar CR - Jules A, Grijalva CG, Zhu Y, Talbot HK, Williams JV, Poehling KA, et al. Influenza-related hospitalization and ED visits in children less than 5 years: 2000-2011. Pediatrics. 2015; 135:e66. doi: 10.1542/ peds.2014-1168. google scholar CR - Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, et al. Changes in Influenza and Other Respiratory Virus Activities During the COVID-19 Pandemic in the United States, 2020-2021. MMWR Morb Mortal Wkly Rep. 2021; 70(29):1013-19. doi: 10.15585/ mmwr.mm7029a1. google scholar CR - Haeder SF. Assessing parental intention to vaccinate for COVID-19, influenza, and RSV in the United States in late 2023. Vaccine. 2023; 41(50):7503-14. doi: 10.1016/j.vaccine.2023.11.004. google scholar CR - Kamidani S, Garg S, Rolfes MA, Campbell AP, Cummings CN, Haston JC, et al. Epidemiology, Clinical Characteristics, and Outcomes of Influenza-Associated Hospitalizations in US Children Over 9 Seasons Following the 2009 H1N1 Pandemic. Clin Infect Dis. 2022; 75:1930. doi: 10.1093/cid/ciac296. google scholar CR - Swets MC, Russell CD, Harrison EM, Docherty AB, Lone N, Girvan M et al. SARS-CoV-2 co-infection with influenza viruses, respiratory syncytial virus, or adenoviruses. Lancet. 2022; 399(10334):1463-1464. doi: 10.1016/S0140-6736(22)00383-X. google scholar CR - B. Cong, S. Deng, X. Wang, Y. Li. The role of respiratory co-infection with influenza or respiratory syncytial virus in the clinical severity of COVID-19: A systematic review and meta-analysis. J Glob Health. 2022; 12:05040. doi: 10.7189/jogh.12.05040. google scholar CR - Centers for Disease Control and Prevention. Influenza (Flu). 2023. Available at <https://www.cdc.gov/flu/index.htm> Accessed October 05, 2024. google scholar CR - Fry AM, Goswami D, Nahar K, Sharmin AT, Rahman M, Gubareva L et al. Efficacy of oseltamivir treatment within 5 days of symptom onset for reducing influenza illness duration and virus shedding in an urban setting in Bangladesh: a randomized placebo-controlled trial. Lancet Infect Dis. 2014; 14:109. doi: 10.1016/ S1473-3099(13)70267-6. google scholar CR - T.C. Sağlık Bakanlığı Halk, Sağlığı Genel Müdürlüğü Bulaşıcı Hastalıklar ve Erken Uyarı Dairesi Başkanlığı. 2021-2022 Haftalık İnfluenza Raporları. Available at <https://grip.saglik. gov.tr/tr/2021-2022-haftal%C4%B1k-i%CC%87nfluenza-raporlar%C4%B1.html> Accessed October 10, 2024. google scholar CR - T.C. Sağlık Bakanlığı Halk, Sağlığı Genel Müdürlüğü Bulaşıcı Hastalıklar ve Erken Uyarı Dairesi Başkanlığı. 2022-2023 Haftalık İnfluenza Raporları. Available at <https://grip.saglik. gov.tr/tr/2022-2023-haftal%C4%B1k-i%CC%87nfluenza-raporlar%C4%B1.html> Accessed October 10, 2024. google scholar UR - https://doi.org/10.26650/jchild.2024.1572413 L1 - https://dergipark.org.tr/en/download/article-file/4310033 ER -