Continued high incidence of children with severe influenza A(H1N1)pdm09 admitted to paediatric intensive care units in Germany during the first three post-pandemic influenza seasons, 2010/11-2012/13.
Identifieur interne : 000142 ( Main/Exploration ); précédent : 000141; suivant : 000143Continued high incidence of children with severe influenza A(H1N1)pdm09 admitted to paediatric intensive care units in Germany during the first three post-pandemic influenza seasons, 2010/11-2012/13.
Auteurs : Andrea Streng [Allemagne] ; Christiane Prifert [Allemagne] ; Benedikt Weissbrich [Allemagne] ; Johannes G. Liese [Allemagne]Source :
- BMC infectious diseases [ 1471-2334 ] ; 2015.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Allemagne (épidémiologie), Bronchite (thérapie), Bronchite (virologie), Bronchite (épidémiologie), Co-infection (MeSH), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Femelle (MeSH), Grippe humaine (thérapie), Grippe humaine (virologie), Grippe humaine (épidémiologie), Humains (MeSH), Infections de l'appareil respiratoire (thérapie), Infections de l'appareil respiratoire (virologie), Infections de l'appareil respiratoire (épidémiologie), Mâle (MeSH), Nourrisson (MeSH), Oxygénation extracorporelle sur oxygénateur à membrane (MeSH), Pneumopathie bactérienne (thérapie), Pneumopathie bactérienne (épidémiologie), Saisons (MeSH), Sous-type H1N1 du virus de la grippe A (pathogénicité), Unités de soins intensifs pédiatriques (statistiques et données numériques), Vaccination (statistiques et données numériques), Vaccins antigrippaux (MeSH), Épidémies de maladies (MeSH), Études prospectives (MeSH).
- MESH :
- pathogénicité : Sous-type H1N1 du virus de la grippe A.
- statistiques et données numériques : Unités de soins intensifs pédiatriques, Vaccination.
- thérapie : Bronchite, Grippe humaine, Infections de l'appareil respiratoire, Pneumopathie bactérienne.
- virologie : Bronchite, Grippe humaine, Infections de l'appareil respiratoire.
- épidémiologie : Allemagne, Bronchite, Grippe humaine, Infections de l'appareil respiratoire, Pneumopathie bactérienne.
- Adolescent, Co-infection, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Mâle, Nourrisson, Oxygénation extracorporelle sur oxygénateur à membrane, Saisons, Vaccins antigrippaux, Épidémies de maladies, Études prospectives.
English descriptors
- KwdEn :
- Adolescent (MeSH), Bronchitis (epidemiology), Bronchitis (therapy), Bronchitis (virology), Child (MeSH), Child, Preschool (MeSH), Coinfection (MeSH), Disease Outbreaks (MeSH), Extracorporeal Membrane Oxygenation (MeSH), Female (MeSH), Germany (epidemiology), Humans (MeSH), Infant (MeSH), Influenza A Virus, H1N1 Subtype (pathogenicity), Influenza Vaccines (MeSH), Influenza, Human (epidemiology), Influenza, Human (therapy), Influenza, Human (virology), Intensive Care Units, Pediatric (statistics & numerical data), Male (MeSH), Pneumonia, Bacterial (epidemiology), Pneumonia, Bacterial (therapy), Prospective Studies (MeSH), Respiratory Tract Infections (epidemiology), Respiratory Tract Infections (therapy), Respiratory Tract Infections (virology), Seasons (MeSH), Vaccination (statistics & numerical data).
- MESH :
- chemical : Influenza Vaccines.
- epidemiology : Bronchitis, Germany, Influenza, Human, Pneumonia, Bacterial, Respiratory Tract Infections.
- pathogenicity : Influenza A Virus, H1N1 Subtype.
- statistics & numerical data : Intensive Care Units, Pediatric, Vaccination.
- therapy : Bronchitis, Influenza, Human, Pneumonia, Bacterial, Respiratory Tract Infections.
- virology : Bronchitis, Influenza, Human, Respiratory Tract Infections.
- Adolescent, Child, Child, Preschool, Coinfection, Disease Outbreaks, Extracorporeal Membrane Oxygenation, Female, Humans, Infant, Male, Prospective Studies, Seasons.
Abstract
BACKGROUND
Previous influenza surveillance at paediatric intensive care units (PICUs) in Germany indicated increased incidence of PICU admissions for the pandemic influenza subtype A(H1N1)pdm09. We investigated incidence and clinical characteristics of influenza in children admitted to PICUs during the first three post-pandemic influenza seasons, using active screening.
METHODS
We conducted a prospective surveillance study in 24 PICUs in Bavaria (Germany) from October 2010 to September 2013. Influenza cases among children between 1 month and 16 years of age admitted to these PICUs with acute respiratory infection were confirmed by PCR analysis of respiratory secretions.
RESULTS
A total of 24/7/20 influenza-associated PICU admissions were recorded in the post-pandemic seasons 1/2/3; incidence estimates per 100,000 children were 1.72/0.76/1.80, respectively. Of all 51 patients, 80% had influenza A, including 65% with A(H1N1)pdm09. Influenza A(H1N1)pdm09 was almost absent in season 2 (incidence 0.11), but dominated PICU admissions in seasons 1 (incidence 1.35) and 3 (incidence 1.17). Clinical data was available for 47 influenza patients; median age was 4.8 years (IQR 1.6-11.0). The most frequent diagnoses were influenza-associated pneumonia (62%), bronchitis/bronchiolitis (32%), secondary bacterial pneumonia (26 %), and ARDS (21%). Thirty-six patients (77 %) had underlying medical conditions. Median duration of PICU stay was 3 days (IQR 1-11). Forty-seven per cent of patients received mechanical ventilation, and one patient (2%) extracorporeal membrane oxygenation; 19% were treated with oseltamivir. Five children (11%) had pulmonary sequelae. Five children (11%) died; all had underlying chronic conditions and were infected with A(H1N1)pdm09. In season 3, patients with A(H1N1)pdm09 were younger than in season 1 (p = 0.020), were diagnosed more often with bronchitis/bronchiolitis (p = 0.004), and were admitted to a PICU later after the onset of influenza symptoms (p = 0.041).
CONCLUSIONS
Active screening showed a continued high incidence of A(H1N1)pdm09-associated PICU admissions in the post-pandemic seasons 1 and 3, and indicated possible underestimation of incidence in previous German studies. The age shift of severe A(H1N1)pdm09 towards younger children may be explained by increasing immunity in the older paediatric population. The high proportion of patients with underlying chronic conditions indicates the importance of consistent implementation of the current influenza vaccination recommendations for risk groups in Germany.
DOI: 10.1186/s12879-015-1293-1
PubMed: 26678835
PubMed Central: PMC4683816
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Streng_A@ukw.de.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Paediatrics, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Prifert, Christiane" sort="Prifert, Christiane" uniqKey="Prifert C" first="Christiane" last="Prifert">Christiane Prifert</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany. Prifert@vim.uni-wuerzburg.de.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Virology and Immunobiology, University of Würzburg, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Weissbrich, Benedikt" sort="Weissbrich, Benedikt" uniqKey="Weissbrich B" first="Benedikt" last="Weissbrich">Benedikt Weissbrich</name><affiliation wicri:level="3"><nlm:affiliation>Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany. 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Liese_J@ukw.de.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Paediatrics, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author></analytic><series><title level="j">BMC infectious diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Bronchitis (epidemiology)</term><term>Bronchitis (therapy)</term><term>Bronchitis (virology)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Coinfection (MeSH)</term><term>Disease Outbreaks (MeSH)</term><term>Extracorporeal Membrane Oxygenation (MeSH)</term><term>Female (MeSH)</term><term>Germany (epidemiology)</term><term>Humans (MeSH)</term><term>Infant (MeSH)</term><term>Influenza A Virus, H1N1 Subtype (pathogenicity)</term><term>Influenza Vaccines (MeSH)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (therapy)</term><term>Influenza, Human (virology)</term><term>Intensive Care Units, Pediatric (statistics & numerical data)</term><term>Male (MeSH)</term><term>Pneumonia, Bacterial (epidemiology)</term><term>Pneumonia, Bacterial (therapy)</term><term>Prospective Studies (MeSH)</term><term>Respiratory Tract Infections (epidemiology)</term><term>Respiratory Tract Infections (therapy)</term><term>Respiratory Tract Infections (virology)</term><term>Seasons (MeSH)</term><term>Vaccination (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Allemagne (épidémiologie)</term><term>Bronchite (thérapie)</term><term>Bronchite (virologie)</term><term>Bronchite (épidémiologie)</term><term>Co-infection (MeSH)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (thérapie)</term><term>Grippe humaine (virologie)</term><term>Grippe humaine (épidémiologie)</term><term>Humains (MeSH)</term><term>Infections de l'appareil respiratoire (thérapie)</term><term>Infections de l'appareil respiratoire (virologie)</term><term>Infections de l'appareil respiratoire (épidémiologie)</term><term>Mâle (MeSH)</term><term>Nourrisson (MeSH)</term><term>Oxygénation extracorporelle sur oxygénateur à membrane (MeSH)</term><term>Pneumopathie bactérienne (thérapie)</term><term>Pneumopathie bactérienne (épidémiologie)</term><term>Saisons (MeSH)</term><term>Sous-type H1N1 du virus de la grippe A (pathogénicité)</term><term>Unités de soins intensifs pédiatriques (statistiques et données numériques)</term><term>Vaccination (statistiques et données numériques)</term><term>Vaccins antigrippaux (MeSH)</term><term>Épidémies de maladies (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Bronchitis</term><term>Germany</term><term>Influenza, Human</term><term>Pneumonia, Bacterial</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Influenza A Virus, H1N1 Subtype</term></keywords><keywords scheme="MESH" qualifier="pathogénicité" xml:lang="fr"><term>Sous-type H1N1 du virus de la grippe A</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Intensive Care Units, Pediatric</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Unités de soins intensifs pédiatriques</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Bronchitis</term><term>Influenza, Human</term><term>Pneumonia, Bacterial</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Bronchite</term><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term><term>Pneumopathie bactérienne</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Bronchite</term><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Bronchitis</term><term>Influenza, Human</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term><term>Bronchite</term><term>Grippe humaine</term><term>Infections de l'appareil respiratoire</term><term>Pneumopathie bactérienne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Child, Preschool</term><term>Coinfection</term><term>Disease Outbreaks</term><term>Extracorporeal Membrane Oxygenation</term><term>Female</term><term>Humans</term><term>Infant</term><term>Male</term><term>Prospective Studies</term><term>Seasons</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Co-infection</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Nourrisson</term><term>Oxygénation extracorporelle sur oxygénateur à membrane</term><term>Saisons</term><term>Vaccins antigrippaux</term><term>Épidémies de maladies</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Previous influenza surveillance at paediatric intensive care units (PICUs) in Germany indicated increased incidence of PICU admissions for the pandemic influenza subtype A(H1N1)pdm09. We investigated incidence and clinical characteristics of influenza in children admitted to PICUs during the first three post-pandemic influenza seasons, using active screening.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a prospective surveillance study in 24 PICUs in Bavaria (Germany) from October 2010 to September 2013. Influenza cases among children between 1 month and 16 years of age admitted to these PICUs with acute respiratory infection were confirmed by PCR analysis of respiratory secretions.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>A total of 24/7/20 influenza-associated PICU admissions were recorded in the post-pandemic seasons 1/2/3; incidence estimates per 100,000 children were 1.72/0.76/1.80, respectively. Of all 51 patients, 80% had influenza A, including 65% with A(H1N1)pdm09. Influenza A(H1N1)pdm09 was almost absent in season 2 (incidence 0.11), but dominated PICU admissions in seasons 1 (incidence 1.35) and 3 (incidence 1.17). Clinical data was available for 47 influenza patients; median age was 4.8 years (IQR 1.6-11.0). The most frequent diagnoses were influenza-associated pneumonia (62%), bronchitis/bronchiolitis (32%), secondary bacterial pneumonia (26 %), and ARDS (21%). Thirty-six patients (77 %) had underlying medical conditions. Median duration of PICU stay was 3 days (IQR 1-11). Forty-seven per cent of patients received mechanical ventilation, and one patient (2%) extracorporeal membrane oxygenation; 19% were treated with oseltamivir. Five children (11%) had pulmonary sequelae. Five children (11%) died; all had underlying chronic conditions and were infected with A(H1N1)pdm09. In season 3, patients with A(H1N1)pdm09 were younger than in season 1 (p = 0.020), were diagnosed more often with bronchitis/bronchiolitis (p = 0.004), and were admitted to a PICU later after the onset of influenza symptoms (p = 0.041).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Active screening showed a continued high incidence of A(H1N1)pdm09-associated PICU admissions in the post-pandemic seasons 1 and 3, and indicated possible underestimation of incidence in previous German studies. The age shift of severe A(H1N1)pdm09 towards younger children may be explained by increasing immunity in the older paediatric population. The high proportion of patients with underlying chronic conditions indicates the importance of consistent implementation of the current influenza vaccination recommendations for risk groups in Germany.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">26678835</PMID><DateCompleted><Year>2016</Year><Month>06</Month><Day>02</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>02</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>15</Volume><PubDate><Year>2015</Year><Month>Dec</Month><Day>18</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Continued high incidence of children with severe influenza A(H1N1)pdm09 admitted to paediatric intensive care units in Germany during the first three post-pandemic influenza seasons, 2010/11-2012/13.</ArticleTitle><Pagination><MedlinePgn>573</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12879-015-1293-1</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Previous influenza surveillance at paediatric intensive care units (PICUs) in Germany indicated increased incidence of PICU admissions for the pandemic influenza subtype A(H1N1)pdm09. We investigated incidence and clinical characteristics of influenza in children admitted to PICUs during the first three post-pandemic influenza seasons, using active screening.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a prospective surveillance study in 24 PICUs in Bavaria (Germany) from October 2010 to September 2013. Influenza cases among children between 1 month and 16 years of age admitted to these PICUs with acute respiratory infection were confirmed by PCR analysis of respiratory secretions.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 24/7/20 influenza-associated PICU admissions were recorded in the post-pandemic seasons 1/2/3; incidence estimates per 100,000 children were 1.72/0.76/1.80, respectively. Of all 51 patients, 80% had influenza A, including 65% with A(H1N1)pdm09. Influenza A(H1N1)pdm09 was almost absent in season 2 (incidence 0.11), but dominated PICU admissions in seasons 1 (incidence 1.35) and 3 (incidence 1.17). Clinical data was available for 47 influenza patients; median age was 4.8 years (IQR 1.6-11.0). The most frequent diagnoses were influenza-associated pneumonia (62%), bronchitis/bronchiolitis (32%), secondary bacterial pneumonia (26 %), and ARDS (21%). Thirty-six patients (77 %) had underlying medical conditions. Median duration of PICU stay was 3 days (IQR 1-11). Forty-seven per cent of patients received mechanical ventilation, and one patient (2%) extracorporeal membrane oxygenation; 19% were treated with oseltamivir. Five children (11%) had pulmonary sequelae. Five children (11%) died; all had underlying chronic conditions and were infected with A(H1N1)pdm09. In season 3, patients with A(H1N1)pdm09 were younger than in season 1 (p = 0.020), were diagnosed more often with bronchitis/bronchiolitis (p = 0.004), and were admitted to a PICU later after the onset of influenza symptoms (p = 0.041).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Active screening showed a continued high incidence of A(H1N1)pdm09-associated PICU admissions in the post-pandemic seasons 1 and 3, and indicated possible underestimation of incidence in previous German studies. The age shift of severe A(H1N1)pdm09 towards younger children may be explained by increasing immunity in the older paediatric population. The high proportion of patients with underlying chronic conditions indicates the importance of consistent implementation of the current influenza vaccination recommendations for risk groups in Germany.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Streng</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Paediatrics, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany. Streng_A@ukw.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prifert</LastName><ForeName>Christiane</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany. Prifert@vim.uni-wuerzburg.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weissbrich</LastName><ForeName>Benedikt</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany. Weissbrich@vim.uni-wuerzburg.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liese</LastName><ForeName>Johannes G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Department of Paediatrics, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany. 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