Clinical analysis of 19 deaths from severe influenza among children in Shenzhen

Abstract

Objective To explore the characteristics and causes of death of severe influenza cases, in order to attract the attention of pediatricians. Methods The data of 19 cases with influenza-associated deaths admitted to Shenzhen Children′s Hospital from September 2009 to November 2018 were retrospectively analyzed. Results There were 11 males and 8 females, aged from 4 months to 12 years old, of whom 5 cases were over 5 years old.Five deaths occurred during the 2009 influenza A (H1N1) pandemic, followed by 1 case in 2014, 6 cases in 2016, 3 cases in 2017 and 4 cases in 2018.Four of the 19 deaths were due to underlying diseases.The time from onset to death was 0.5-36.0 days, and the most common clinical manifestations were high fever, convulsions, coma and dyspnea.Among them, 11 cases died of influenza-associated encephalopathy, 4 cases died of severe pneumonia, acute respiratory distress syndrome(ARDS) and respiratory failure, 3 cases died of sepsis caused by secondary streptococcus pneumoniae infection, and 1 case died of secondary fungal pyothorax and fungal meningitis. Conclusions Children under 5 years of age, even if they were previously healthy, may still be at high risk of dying from influenza. Neurological complications were high and the leading causes of death were influenza-associated encephalopathy, severe pneumonia, ARDS and secondary severe bacterial infection. Key words: Child; Influenza A (H1N1); Death