Abstract
BackgroundInfluenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden) in children in Western Europe via a systematic literature review.MethodsWe conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011) and extracted data on influenza burden in children (defined as aged ≤ 18 years) from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness).ResultsChildren with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%), medical visits (1.7-2.8 visits per case), antibiotic prescriptions (7%-55%), and antipyretic or other medications for symptomatic relief (76%-99%); young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median) length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children.ConclusionsInfluenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in European countries.
Highlights
Influenza illness in children causes significant clinical and economic burden
Dynamic transmission modelling and several communitybased studies have demonstrated that paediatric influenza vaccination, in addition to direct benefit to the vaccinated children, can indirectly protect other members of the community [15,18-23]
The current literature review provides a comprehensive summary of the available influenza burden data in children from selected Western European countries
Summary
Influenza illness in children causes significant clinical and economic burden. Some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. It is often forgotten that children have the highest influenza attack rates, with annual incidence rates of up to 30% [3]. This translates into significant illness and health care resource use, related to outpatient consultations and hospitalisations [4-8]. Dynamic transmission modelling (a tool that can compute the effect of infectious disease transmission) and several communitybased studies have demonstrated that paediatric influenza vaccination, in addition to direct benefit to the vaccinated children, can indirectly protect other members of the community [15,18-23]
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