Since its identification in April 2009, human influenza A (H1N1) virus has spread across the world and has important transmission in the community.
Aim This retrospective case series describes the clinical spectrum of 12 children, positive to the H1N1 virus admitted to our hospital during the study period, as well as the epidemiologic characteristics.
Methods The study period was from 16 November 2009 to 30 November 2009. During this period many children examined at the hospital were also tested for pandemic H1N1 virus. Specimens were collected from pharyngeal swabs and sent to the nearest tertiary centre, where it is available a PCR assay. Epidemiologic characteristics included age, gender and preexisting medical condition. Based on the guidelines of the National Center of Disease Control (KEELPNO), children with flu-like symptoms (fever at least 38°C, cough, sore throat or rhinorrhea) are most likely to be infected.
Results In the period from 16 November 2009 to 30 November 2009, a total of 736 children were examined at the emergency ambulatory. Seventy of these children (9.5%) were screened via pharyngeal swab for A (H1N1) virus. A number of 45 children were proven to be positive to the test (64.2%). Twelve of them (26%) were admitted to the clinic due to the severity of the symptoms or the preexisting medical condition.
Patient Demographics Male/female 5/7
Overall median age (years) 5 (0.6–14 years)
Previously healthy 8 (66%)
Preexisting condition 4 (33%)
Asthma 2 (50%)
Prematurity 1 (25%)
Recurrent pneumonias 1 (25%)
Fever was the most common symptom among the admitted children (n=10, 83%), cough (n=9, 75%), rhinorrhea (n=8, 66%) and respiratory distress (n=4, 33%). Other symptoms reported were myalgias, sore throat, vomiting and confusion. Two patients were diagnosed with encephalopathy and they were transferred to the closest paediatric ICU and one with neutropenia. The median length of hospitalisation was 5 days.
Conclusions Infection with the novel A (H1N1) virus can have a various spectrum of symptoms in children. Fever and respiratory problems are the most common presentations; however, encephalopathy and neutropenia were less expected. During this period of time A (H1N1) virus infection should be highly considered as a diagnosis in any child with fever or respiratory illness.
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