A Comparison of the Clinical and Laboratory Characteristics of Influenza A and B Infections in Children

Year 2021, , 180 - 186, 29.05.2021

Hayrettin Temel , Mehmet Gunduz Gokce Koprulu Sumeyye Karaman Merve Celebi Mehmet Dogan Ayse Tosun Mesut Okur

https://doi.org/10.21673/anadoluklin.836285

Abstract

Aim: In this study, we aimed to compare the clinical and laboratory findings of Influenza A and Influenza B infections in children.

Methods: The study included 1826 pediatric patients (aged <16 years) who were di¬agnosed with Influenza A (n=1400) and B (n=426) infections between 1 October 2019 and 30 April 2020. The patients were also divided into age groups: the age groups of 0–2 years, 3–9 years, and 10–16 years. The characteristic clinical and laboratory findings were compared.

Results: Influenza A infection was significantly more common in patients aged <2 years and was significantly less common in patients aged 3–9 years. Body temperature was significantly higher in all age groups with Influenza A infection than in children with Influenza B infection. While leukocy¬tosis and lymphopenia were significantly more common in the Influenza A group, leukopenia and neutropenia were significantly more common in the Influenza B group. While acute otitis media was more common in Influenza A infection, myositis was more common in Influenza B infection. No significant difference was found between the Influenza A and B groups in terms of hospitalization rates. Of all patients, 98.3% were treated with oseltamivir.

Conclusion: Our findings indicate that Influenza A and B infections are, in general, very similar in terms of symptoms. However, Influenza A infection is more common in very young children. It progresses with higher fever and is more frequently associated with pharyngeal hy¬peremia and acute otitis media, while leukopenia, neutropenia, conjunctivitis, nasal discharge, and myositis were found to be more common in Influenza B infection.

Keywords

Influenza A, influenza B, children

Çocuklarda İnfluenza A ve B Enfeksiyonlarının Klinik ve Laboratuvar Özelliklerinin Karşılaştırılması

Abstract

Amaç: Bu çalışmada, çocuklarda İnfluenza A ve İnfluenza B enfeksiyonlarının klinik ve laboratuvar bulgularını karşılaştırmak amaçlanmıştır.

Yöntem: Çalışma 1 Ekim 2019 ile 30 Nisan 2020 tarihleri arasında İnfluenza A (n=1400) ve B (n=426) enfeksiyonu tanısı almış 16 yaş altı 1826 çocuk hasta içerdi. Hastalar aynı zamanda yaş gruplarına ayrıldı: 0–2 (yıl) yaş grubu, 3–9 yaş grubu, ve 10–16 yaş grubu. Karakteristik klinik bulgu¬lar ve laboratuvar bulguları karşılaştırıldı.

Bulgular: İnfluenza A enfeksiyonu <2 yaşındaki hastalarda anlamlı biçimde daha yaygın, 3–9 ya¬şındaki hastalarda anlamlı biçimde daha enderdi. Vücut sıcaklığı İnfluenza A enfeksiyonlu tüm yaş gruplarında İnfluenza B enfeksiyonlu çocuklara göre anlamlı biçimde daha yüksekti. İnfluenza A grubunda lökositoz ve lenfopeni anlamlı biçimde daha yaygınken, İnfluenza B grubunda lökopeni ve nötropeni anlamlı biçimde daha yaygındı. Akut orta kulak iltihabı İnfluenza A enfeksiyonunda daha yaygınken, miyozit İnfluenza B enfeksiyonunda daha yaygındı. Hastaneye yatış oranı açısından ise İnfluenza A ve B grupları arasında anlamlı fark bulunmadı. Tüm hastaların %98,3’ü oseltamivir ile tedavi edildi.

Sonuç: Bulgularımız İnfluenza A ve B enfeksiyonlarının semptomlar açısından genel olarak çok benzer olduğuna işaret etmektedir. Bununla birlikte, İnfluenza A enfeksiyonu çok küçük çocuklarda daha yaygındır. Daha yüksek ateşle ilerler ve farengeal hiperemi ve akut orta kulak ilti¬habı daha sık görülür. Lökopeni, nötropeni, konjonktivit, burun akıntısı ve miyozitin ise İnfluenza B enfeksiyonunda daha yaygın olduğu tespit edilmiştir.

Keywords

Influenza A, influenza B, çocuklar

References

• Krammer F, Smith GJD, Fouchier RAM, Peiris M, Kedzierska K, Doherty PC, et al. Influenza. Nat Rev Dis Primers. 2018;4(1):3
• Kondrich J, Rosenthal M. Influenza in children. Curr Opin Pediatr. 2017;29(3):297–302.
• Rotrosen ET, Neuzil KM. Influenza: a global perspective. Pediatr Clin North Am. 2017;64(4):911–36.
• Daley AJ, Nallusamy R, Isaacs D. Comparison of influ¬enza A and influenza B virus infection in hospitalized children. J Paediatr Child Health. 2000;36(4):332–5.
• Kumar V. Influenza in children. Indian J Pediatr. 2017;84(2):139–43.
• Mattila JM, Vuorinen T, Heikkinen T. Comparative se¬verity of influenza A and B infections in hospitalized children. Pediatr Infect Dis J. 2020;39(6):489–93.
• Dallman PR. In: Rudolph AM (ed.), Pediatrics, 16. ed. New York: Appleton-Century-Crofts; 1977:1178. Long SS, Vodzak J. Laboratory Manifestations of Infec¬tious Diseases, Principles and Practice of Pediatric Infec¬tious Diseases. Amsterdam: Elsevier; 2018:1447–59.
• Machado CM, de Souza ACMF, Romano CM, Freire WDS, Costa AA, Figueiredo WM, et al. Influenza A and B in a cohort of outpatient children and adolescent with influenza like-illness during two consecutive influenza seasons. Braz J Infect Dis. 2020;24(1):73–80.
• Tran D, Vaudry W, Moore D, Bettinger JA, Halperin SA, Scheifele DW, et al. Hospitalization for influenza A ver¬sus B. Pediatrics. 2016;138(3):e20154643.
• Hong KW, Cheong HJ, Song JY, Noh JY, Yang TU, Kim WJ. Clinical manifestations of influenza A and B in chil¬dren and adults at a tertiary hospital in Korea during the 2011–2012 season. Jpn J Infect Dis. 2015;68(1):20–6.
• Mancinelli L, Onori M, Concato C, Sorge R, Chiavelli S, Coltella L, et al. Clinical features of children hospitalized with influenza A and B infections during the 2012–2013 influenza season in Italy. BMC Infect Dis. 2016;16:6.
• Peltola V, Ziegler T, Ruuskanen O. Influenza A and B virus infections in children. Clin Infect Dis. 2003;36(3):299–305.
• Zhong PP, Zhang HL, Chen XF, Liang TF, Lin L, Yang SY, et al. [Lower respiratory tract infection caused by influ¬enza virus A and influenza virus B in Wenzhou, China: a clinical analysis of 366 children]. Zhongguo Dang Dai Er Ke Za Zhi. 2016;18(2):117–22.
• Esposito S, Principi N. Oseltamivir for influenza infec¬tion in children: risks and benefits. Expert Rev Respir Med. 2016;10(1):79–87.
• Szenborn L, Toczek-Kubicka K, Zaryczański J, Marchew¬ka-Kowalik M, Miśkiewicz K, Kuchar E. Benign acute childhood myositis during influenza B outbreak. Adv Exp Med Biol. 2018;1039:29–34.
• Agyeman P, Duppenthaler A, Heininger U, Aebi C. Influenza-associated myositis in children. Infection. 2004;32(4):199–203. 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(2):95–8.