Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008.
Identifieur interne : 000283 ( Main/Exploration ); précédent : 000282; suivant : 000284Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008.
Auteurs : Andrea Streng [Allemagne] ; Veit Grote ; Johannes G. LieseSource :
- BMC infectious diseases [ 1471-2334 ] ; 2011.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Allemagne (épidémiologie), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Femelle (MeSH), Grippe humaine (anatomopathologie), Grippe humaine (complications), Humains (MeSH), Incidence (MeSH), Maladie grave (MeSH), Mâle (MeSH), Nourrisson (MeSH), Pneumopathie bactérienne (anatomopathologie), Pneumopathie bactérienne (épidémiologie), Unités de soins intensifs pédiatriques (MeSH).
- MESH :
- anatomopathologie : Grippe humaine, Pneumopathie bactérienne.
- épidémiologie : Allemagne, Grippe humaine, Pneumopathie bactérienne.
- Adolescent, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Incidence, Maladie grave, Mâle, Nourrisson, Unités de soins intensifs pédiatriques.
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Adolescent (MeSH), Child (MeSH), Child, Preschool (MeSH), Critical Illness (MeSH), Female (MeSH), Germany (epidemiology), Humans (MeSH), Incidence (MeSH), Infant (MeSH), Influenza, Human (complications), Influenza, Human (pathology), Intensive Care Units, Pediatric (MeSH), Male (MeSH), Pneumonia, Bacterial (epidemiology), Pneumonia, Bacterial (pathology).
- MESH :
- geographic , epidemiology : Germany.
- complications : Influenza, Human.
- epidemiology : Pneumonia, Bacterial.
- pathology : Influenza, Human, Pneumonia, Bacterial.
- Adolescent, Child, Child, Preschool, Critical Illness, Female, Humans, Incidence, Infant, Intensive Care Units, Pediatric, Male.
Abstract
BACKGROUND
Data on complications in children with seasonal influenza virus infection are limited. We initiated a nation-wide three-year surveillance of children who were admitted to a paediatric intensive care unit (PICU) with severe seasonal influenza.
METHODS
From October 2005 to July 2008, active surveillance was performed using an established reporting system for rare diseases (ESPED) including all paediatric hospitals in Germany. Cases to be reported were hospitalized children < 17 years of age with laboratory-confirmed influenza treated in a PICU or dying in hospital.
RESULTS
Twenty severe influenza-associated cases were reported from 14 PICUs during three pre-pandemic influenza seasons (2005-2008). The median age of the patients (12 males/8 females) was 7.5 years (range 0.1-15 years). None had received vaccination against influenza. In 14 (70%) patients, the infection had been caused by influenza A and in five (25%) by influenza B; in one child (5%) the influenza type was not reported. Patients spent a median of 19 (IQR 12-38) days in the hospital and a median of 11 days (IQR 6-18 days) in the PICU; 10 (50%) needed mechanical ventilation. Most frequent diagnoses were influenza-associated pneumonia (60%), bronchitis/bronchiolitis (30%), encephalitis/encephalopathy (25%), secondary bacterial pneumonia (25%), and ARDS (25%). Eleven (55%) children had chronic underlying medical conditions, including 8 (40%) with chronic pulmonary diseases. Two influenza A- associated deaths were reported: i) an 8-year old boy with pneumococcal encephalopathy following influenza infection died from cerebral edema, ii) a 14-year-old boy with asthma bronchiale, cardiac malformation and Addison's disease died from cardiac and respiratory failure. For nine (45%) patients, possibly permanent sequelae were reported (3 neurological, 3 pulmonary, 3 other sequelae).
CONCLUSIONS
Influenza-associated pneumonia and secondary bacterial infections are relevant complications of seasonal influenza in Germany. The incidence of severe influenza cases in PICUs was relatively low. This may be either due to the weak to moderate seasonal influenza activity during the years 2005 to 2008 or due to under-diagnosis of influenza by physicians. Fifty% of the observed severe cases might have been prevented by following the recommendations for vaccination of risk groups in Germany.
DOI: 10.1186/1471-2334-11-233
PubMed: 21880125
PubMed Central: PMC3175218
Affiliations:
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Streng_A@klinik.uni-wuerzburg.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Paediatric Infectious Diseases and Immunology, University Children's Hospital, Julius-Maximilians-University, 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="Grote, Veit" sort="Grote, Veit" uniqKey="Grote V" first="Veit" last="Grote">Veit Grote</name></author><author><name sortKey="Liese, Johannes G" sort="Liese, Johannes G" uniqKey="Liese J" first="Johannes G" last="Liese">Johannes G. 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Streng_A@klinik.uni-wuerzburg.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Paediatric Infectious Diseases and Immunology, University Children's Hospital, Julius-Maximilians-University, 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="Grote, Veit" sort="Grote, Veit" uniqKey="Grote V" first="Veit" last="Grote">Veit Grote</name></author><author><name sortKey="Liese, Johannes G" sort="Liese, Johannes G" uniqKey="Liese J" first="Johannes G" last="Liese">Johannes G. Liese</name></author></analytic><series><title level="j">BMC infectious diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Critical Illness (MeSH)</term><term>Female (MeSH)</term><term>Germany (epidemiology)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Infant (MeSH)</term><term>Influenza, Human (complications)</term><term>Influenza, Human (pathology)</term><term>Intensive Care Units, Pediatric (MeSH)</term><term>Male (MeSH)</term><term>Pneumonia, Bacterial (epidemiology)</term><term>Pneumonia, Bacterial (pathology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Allemagne (épidémiologie)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (anatomopathologie)</term><term>Grippe humaine (complications)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Maladie grave (MeSH)</term><term>Mâle (MeSH)</term><term>Nourrisson (MeSH)</term><term>Pneumopathie bactérienne (anatomopathologie)</term><term>Pneumopathie bactérienne (épidémiologie)</term><term>Unités de soins intensifs pédiatriques (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Grippe humaine</term><term>Pneumopathie bactérienne</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Pneumonia, Bacterial</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Influenza, Human</term><term>Pneumonia, Bacterial</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term><term>Grippe humaine</term><term>Pneumopathie bactérienne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Child, Preschool</term><term>Critical Illness</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Infant</term><term>Intensive Care Units, Pediatric</term><term>Male</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Maladie grave</term><term>Mâle</term><term>Nourrisson</term><term>Unités de soins intensifs pédiatriques</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Allemagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Data on complications in children with seasonal influenza virus infection are limited. We initiated a nation-wide three-year surveillance of children who were admitted to a paediatric intensive care unit (PICU) with severe seasonal influenza.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>From October 2005 to July 2008, active surveillance was performed using an established reporting system for rare diseases (ESPED) including all paediatric hospitals in Germany. Cases to be reported were hospitalized children < 17 years of age with laboratory-confirmed influenza treated in a PICU or dying in hospital.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Twenty severe influenza-associated cases were reported from 14 PICUs during three pre-pandemic influenza seasons (2005-2008). The median age of the patients (12 males/8 females) was 7.5 years (range 0.1-15 years). None had received vaccination against influenza. In 14 (70%) patients, the infection had been caused by influenza A and in five (25%) by influenza B; in one child (5%) the influenza type was not reported. Patients spent a median of 19 (IQR 12-38) days in the hospital and a median of 11 days (IQR 6-18 days) in the PICU; 10 (50%) needed mechanical ventilation. Most frequent diagnoses were influenza-associated pneumonia (60%), bronchitis/bronchiolitis (30%), encephalitis/encephalopathy (25%), secondary bacterial pneumonia (25%), and ARDS (25%). Eleven (55%) children had chronic underlying medical conditions, including 8 (40%) with chronic pulmonary diseases. Two influenza A- associated deaths were reported: i) an 8-year old boy with pneumococcal encephalopathy following influenza infection died from cerebral edema, ii) a 14-year-old boy with asthma bronchiale, cardiac malformation and Addison's disease died from cardiac and respiratory failure. For nine (45%) patients, possibly permanent sequelae were reported (3 neurological, 3 pulmonary, 3 other sequelae).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Influenza-associated pneumonia and secondary bacterial infections are relevant complications of seasonal influenza in Germany. The incidence of severe influenza cases in PICUs was relatively low. This may be either due to the weak to moderate seasonal influenza activity during the years 2005 to 2008 or due to under-diagnosis of influenza by physicians. Fifty% of the observed severe cases might have been prevented by following the recommendations for vaccination of risk groups in Germany.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21880125</PMID><DateCompleted><Year>2011</Year><Month>12</Month><Day>07</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>11</Volume><PubDate><Year>2011</Year><Month>Aug</Month><Day>31</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008.</ArticleTitle><Pagination><MedlinePgn>233</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2334-11-233</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Data on complications in children with seasonal influenza virus infection are limited. We initiated a nation-wide three-year surveillance of children who were admitted to a paediatric intensive care unit (PICU) with severe seasonal influenza.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">From October 2005 to July 2008, active surveillance was performed using an established reporting system for rare diseases (ESPED) including all paediatric hospitals in Germany. Cases to be reported were hospitalized children < 17 years of age with laboratory-confirmed influenza treated in a PICU or dying in hospital.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Twenty severe influenza-associated cases were reported from 14 PICUs during three pre-pandemic influenza seasons (2005-2008). The median age of the patients (12 males/8 females) was 7.5 years (range 0.1-15 years). None had received vaccination against influenza. In 14 (70%) patients, the infection had been caused by influenza A and in five (25%) by influenza B; in one child (5%) the influenza type was not reported. Patients spent a median of 19 (IQR 12-38) days in the hospital and a median of 11 days (IQR 6-18 days) in the PICU; 10 (50%) needed mechanical ventilation. Most frequent diagnoses were influenza-associated pneumonia (60%), bronchitis/bronchiolitis (30%), encephalitis/encephalopathy (25%), secondary bacterial pneumonia (25%), and ARDS (25%). Eleven (55%) children had chronic underlying medical conditions, including 8 (40%) with chronic pulmonary diseases. Two influenza A- associated deaths were reported: i) an 8-year old boy with pneumococcal encephalopathy following influenza infection died from cerebral edema, ii) a 14-year-old boy with asthma bronchiale, cardiac malformation and Addison's disease died from cardiac and respiratory failure. For nine (45%) patients, possibly permanent sequelae were reported (3 neurological, 3 pulmonary, 3 other sequelae).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Influenza-associated pneumonia and secondary bacterial infections are relevant complications of seasonal influenza in Germany. The incidence of severe influenza cases in PICUs was relatively low. This may be either due to the weak to moderate seasonal influenza activity during the years 2005 to 2008 or due to under-diagnosis of influenza by physicians. Fifty% of the observed severe cases might have been prevented by following the recommendations for vaccination of 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 Paediatric Infectious Diseases and Immunology, University Children's Hospital, Julius-Maximilians-University, Würzburg, Germany. Streng_A@klinik.uni-wuerzburg.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grote</LastName><ForeName>Veit</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Liese</LastName><ForeName>Johannes G</ForeName><Initials>JG</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>08</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Infect Dis</MedlineTA><NlmUniqueID>100968551</NlmUniqueID><ISSNLinking>1471-2334</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" 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G" uniqKey="Liese J" first="Johannes G" last="Liese">Johannes G. Liese</name></noCountry><country name="Allemagne"><region name="Bavière"><name sortKey="Streng, Andrea" sort="Streng, Andrea" uniqKey="Streng A" first="Andrea" last="Streng">Andrea Streng</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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