Background and Aim Influenza A virus infection involved the public Health System worldwide so much that on June 2009 WHO announced the disease from epidemic as pandemic. Our purpose was to investigate the incidence, clinical characteristics, treatment and outcome of H1N1 in children with respiratory tract infection required hospitalization in PICU.
Material and Methods Influenza A in children hospitalized in our unit with respiratory infection during the period April 2009–March 2012 was confirmed by special pharyngeal sample.
Results During this period, 58 out of 322 children were admitted in our Unit with respiratory infection. Seven patients (12%) (4 girls and 3 boys, age 21/2, 41/2, 5, 61/2, 8, 9 and 10 years), all unvaccinated for H1N1, were influenza A infected. Their initial symptoms were:
Fever > 38ο C (5 cases)
Respiratory infection (2 cases of pneumonitis)
Bronchial asthma and pneumomediastinum
Febrile + status epilepticus
Cardiac arrest, multiorgan failure
Five children needed intubation and mechanical ventilation. Five had underlying disease -two had asthma, one had bronchopulmonary dysplasia and heart disease, and two had cerebral palsy.
Oseltamivir was administered immediately and for 5 days in all cases and in one case, with persistent infection, for 15 days.
The outcome was good in 6 cases and only the child with bronchopulmonary dysplasia and heart disease developed multiorgan failure and eventually died.
Conclusion 12% of patients with respiratory infection in our PICU was H1N1 positive. One patient with severe underlying disease died. 71% need mechanical ventilation and the majority of them had co-morbidities.
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