Epidemiological and Clinical Characteristics of Pandemic Influenza A (H1N1)v Infection Among the Children Admitted to Süleyman Demirel University

Abstract

Aim: We aimed to evaluate the clinical and epidemiological features of the patients that were admitted to Suleyman Demirel University Medical Faculty Pediatric Department, for whom the pre-diagnosis was H1N1v. Material and Methods: Demographic characteristics, clinical findings, laboratory tests results and radiological evaluations of 64 patients who were admitted to Suleyman Demirel University Medical Faculty Pediatric Department with pre-diagnosis of H1N1v were analyzed and evaluated. Findings: Average age of the patients who were admitted and observed with pre-diagnosis of pandemic influenza, was 32,4 months (1–188 months) and 34% (n=22) of the cases were female. Nine of the patients (14%) were confirmed for final diagnosis as H1N1v. Most common complaints during admission were cough (85,9%), fever (68,%) and weakness (57,8%). Five of the patients (55%) that are H1N1v positive had preexisting diseases. Five patients needed intensive care unit during the observation and treatment. Two (22,2%) of them did not survive. Results: Clinical findings of pandemic influenza and seasonal influenza are quite similar. Preexisting diseases increase the rates of morbidity and mortality. Key words: Pandemic Influenza; H1N1v; Vaccine.

Keywords

• Pandemic Influenza; H1N1v; Vaccine.

Süleyman Demirel Üniversitesi’ne Başvuran Çocuklarda Pandemik İnfluenza A(H1N1)v Enfeksiyonunun Epidemiyolojik ve Klinik Özellikleri

Öz

Amaç: Bu çalışmanın amacı Süleyman Demirel Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı polikliniklerinden H1N1 ön tanısı ile yatırılan hastaların klinik ve epidemiyolojik özelliklerinin değerlendirilmesidir. Gereç ve Yöntemler: Süleyman Demirel Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları polikliniklerinden H1N1v ön tanısı ile yatırılan 64 hasta retrospektif olarak değerlendirilmiş, hastaların demografik özellikleri, klinik bulguları, laboratuar ve radyolojik bulguları incelenmiştir. Bulgular: Pandemik influenza ön tanısı ile yatırılarak izlenen hastaların yaş ortalaması 32,4 ay (1–188 ay) ve %34'ü (n=22) kız hastalardı. Hastaların %14'ü (n=9) kesin vaka olarak doğrulandı. En sık şikayet öksürük (%85,9), ateş (%68,8) ve halsizlik (%57,8) olarak saptandı. H1N1v pozitif hastaların %55,5'inde (n=5) nörolojik, metabolik, konjenital kalp hastalığı gibi altta yatan bir hastalık tespit edildi. Sonuç: Pandemik influenzanın klinik bulguları mevsimsel influenza ile oldukça benzerdir. Altta yatan bir hastalığın olması durumunda mortalite ve morbiditesi artmaktadır. Anahtar kelimeler: Pandemik İnfluenza; H1N1v; Aşı.

Anahtar Kelimeler

• Pandemik İnfluenza; H1N1v; Aşı.

References

1. Monto AS. Epidemiology of viral respiratory infections. Am J Med 2002;112:4-12.
2. O‟Brien MA, Uyeki TM, Shay DK,Thompson WW, Kleinman K, McAdam A, et al. Incidence of outpatient visits and hospitalizations related to influenza in infants and young children. Pediatrics 2004;113:585-93.
3. Simonsen L. The global impact of influenza on morbidity and mortality. Vaccine 1999;17:3-10.
4. Kilbourne ED. Influenza pandemics of the 20th century. Emerg Infect Dis 2006;12:9-14.
5. World Health Organisation. Clinical management of human infection with pandemic (H1N1) 2009: Revised guidance. Erişim tarihi: 10.01.2010. Bağlantı adresi: http://www.who.int/csr/resources/publications/swinefl u/clinical_management/en/index.html
6. Wenzel RP, Edmond MB. Preparing for 2009 H1N1 influenza. N Engl J Med 2009;361:1991-3.
7. Libster R, Bugna J, Coviello S,Hijano DR, Dunaiewsky M, Reynoso N, et al. Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. N Engl J Med 2010;362:45-55.
8. Miller MA, Viboud C, Olson DR, Grais RF, Rabaa MA, Simonsen L. Prioritization of influenza pandemic vaccination to minimize years of life lost. J Infect Dis 2008;198:305-11.

9. Chowell G, Bertozzi SM, Colchero MA,Lopez-Gatell H, Alpuche-Aranda C, Hernandez M, et al. Severe respiratory disease concurrent with the circulation of H1N1 influenza. N Engl J Med 2009;361:674-79.
10. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Hernandez M, Quinones-Falconi F, Bautista E, et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009;361:680-88.
11. Jain R, Goldman RD. Novel Influenza A(H1N1): Clinical presentation, diagnosis, and management. Pediatr Emerg Care 2009;25:791-96.
12. www.flunet.com (Erişim tarihi: 06.06.2010) 13. Pandemic (H1N1) 2009 update 74 http://www.who.int/csr/don/2009_11_13/en/index.ht ml
13. Sullivan SJ, Jacobson RM, Dowdle WR, Poland GA. 2009 H1N1 influenza. Mayo Clin Proc 2010;85:64-76.
14. Kanturvardar M, Akcay-Ciblak M, Asar S, Bozkaya E, Yenen OŞ, Badur S. Pandemik A/H1N1 infeksiyonlarının tanısında hızlı test “sorunu”. Klimik Derg 2009;22:79-81.
15. Jefferson T, Jones M, Doshi P, Del Mar CB, Heneghan CJ, Hama R et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults. Cochrane Database Syst Rev 2010;17:21-3.
16. Ross T, Zimmer S, Burke D, Crevar C, Carter D, Stark J, et al. Seroprevalence following the second wave of pandemic 2009 H1N1 influenza. PLoS Curr 10.1371/currents.RRN1148.
17. www.rsm.gov.tr/sbbulhast/mevzuat/avian_influenza/UP P.pdf
18. Bettinger JA, Sauvé LJ, Scheifele DW,Moore D, Vaudry W, Tran D, et al. Pandemic influenza in Canadian children: A summary of hospitalized pediatric cases. Vaccine 2010;28:3180-4.
19. Kondolot M, Öztürk MA. Çocuklarda pandemik influenza (H1N1). Çocuk Enf Derg 2010;4:143-7.
20. Lee EY, McAdam AJ, Chaudry G, Fishman MP, Zurakowski D, Boiselle PM. Swine-origin influenza A (H1N1) viral infection in children: Initial chest radiographic findings. Radiology 2010;254:934-41.
21. Centers for Disease Control and Prevention (CDC). Prevalence of abnormal lipid levels among youths, United States, 1999-2006. MMWR Morb Mortal Wkly Rep 2010;22;59:29-33.
22. Ciblak MA, Albayrak N, Odabas Y,Basak Altas A, Kanturvardar M, Hasoksuz M, et al. Cases of influenza A(H1N1) reported in Turkey, May-July 2009. Euro Surveill 2009;13:14-32.
23. Girard MP, Katz J, Pervikov Y,Palkonyay L, Kieny MP. Report of the 6th meeting on the evaluation of pandemic influenza vaccines in clinical trials World Health Organization, Geneva, Switzerland, 17-18 February 2010. Vaccine 2010; 28: 6811-20.
24. T.C Sağlık Bakanlığı, Grip. http://www.grip.gov.tr/ [Erişim tarihi: 25.06.2010].
25. Dawood FS, Hope KG, Durrheim DN, Givney R, Fry AM, Dalton CB. Estimating the disease burden of pandemic (H1N1) 2009 virus infection in Hunter New England, Northern New South Wales, Australia, 2009. PLos One 2010;25: 5.
26. Çakır D, Çelebi S, Hacımustafaoğlu M, Salı E, Özgür T. Çocuklarda pandemik 2009 influenza A (H1N1) enfeksiyonu. Güncel Ped Derg 2011;9:53-9
27. Hancerli S, Somer A, Salman A, Elshana H, Demirkol D, Kanturvardar M, ve ark. Pandemik influenza; İstanbul‟da bir üniversite hastanesine yatan çocuk vakaların klinik ve epidemiyolojik değerlendirmesi. Çocuk Enf Derg 2010;4:104-9.