Unchanged Severity of Influenza A(H1N1)pdm09 Infection in Children during First Postpandemic Season - - Emerging Infectious Disease journal - CDC
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Unchanged Severity of Influenza A(H1N1)pdm09 Infection in Children during First Postpandemic Season
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Abstract
We conducted a nationwide hospital-based prospective study in Germany of influenza A(H1N1)pdm09 cases among children <15 112="112" 14="14" 156="156" 17="17" 2009="2009" 2010="2010" 3.2="3.2" 44="44" 5.3="5.3" a="a" accounted="accounted" admitted="admitted" affected.="affected." age="age" although="although" and="and" between="between" care="care" case-patients="case-patients" cases.="cases." challenge="challenge" children.="children." children="children" death="death" deaths="deaths" died="died" difference="difference" during="during" eligible="eligible" especially="especially" factor="factor" findings="findings" for="for" hospital-acquired="hospital-acquired" identified="identified" immunosuppressed="immunosuppressed" immunosuppression="immunosuppression" in="in" infants="infants" infection="infection" infections="infections" influenza="influenza" intensive="intensive" median="median" most="most" myocarditis="myocarditis" need="need" nosocomial="nosocomial" not="not" occurred="occurred" of="of" our="our" p="0.473)." pandemic="pandemic" patients:="patients:" patients="patients" pediatric="pediatric" postpandemic="postpandemic" predictive="predictive" prevent="prevent" preventing="preventing" related="related" remained="remained" risk="risk" seasons.="seasons." seasons="seasons" severe="severe" shift="shift" significant="significant" stress="stress" the="the" to="to" transmission="transmission" underlying="underlying" units="units" virus="virus" vs.="vs." was="was" we="we" which="which" year="year" years="years" younger="younger">15>
On August 10, 2010, the general director of the World Health Organization declared the world was no longer in phase 6 of influenza pandemic alert; we were moving into the postpandemic phase (6). Experience from past pandemics suggested that the pandemic virus would gradually take on the behavior of a seasonal influenza virus and circulate for several years. However, in view of the potential for transformation of the virus into a more virulent form (7), as suggested by higher rates of mortality during second pandemic waves in Copenhagen (1918), the United States (1957), and Eurasia (1968–1970) (8,9), the World Health Organization acknowledged the unpredictability of pandemic viruses; recommended continued vigilance; and issued advice on surveillance, vaccination, and prompt clinical management of cases during the postpandemic phase (6).
Little is known about the severity of A(H1N1)pdm09 in children during the first postpandemic season (10). To obtain information on critically ill A(H1N1)pdm09-infected children and to compare risk factors and disease course, outcome, and severity for patients during the pandemic and first postpandemic season, we prospectively and continuously performed a nationwide study in Germany during August 3, 2009–July 29, 2011.
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