Abstract

Influenza produces annual epidemics that affect 5–15% of the world population. Complications and hospitalizations are more frequent in childhood. This study describes and analyses the epidemiological and clinical characteristics of children hospitalized due to confirmed influenza in influenza surveillance sentinel hospitals in Catalonia. Retrospective descriptive study conducted in six influenza seasons (2010–2011 to 2015–2016) in persons aged 0–17 years diagnosed with laboratory-confirmed influenza requiring hospitalization. 291 cases were notified to the health authorities: 79.4% were due to the influenza A virus and 20.6% to the B virus. The most common subtype was H1N1 with 57.6% of cases: 52.6% were male, 56.7% were aged <2 years, and 24.4% were aged <1 year. 62.2% of cases had pneumonia, 26.8% acute respiratory distress syndrome and 11.7% bacterial pneumonia. 5.8% of cases were vaccinated and 21.3% required intensive care unit admission, of whom 54.8% were aged <2 years. There were 3 deaths, all with influenza A infection. Influenza A cases were younger than influenza B cases (OR 3.22; 95% CI: 1.73–6.00). Conclusion: Children aged <2 years are especially vulnerable to the A H1N1 virus, including those without pre-existing chronic disease. These results are relevant for the planning of vaccination programs to improve maternal and child health.

Highlights

  • Influenza, an acute viral infectious disease that primarily affects the upper respiratory tract, is caused by the influenza virus, which belongs to the Orthomyxoviridae family

  • A hospitalized case of severe influenza was defined as a case of laboratory-confirmed influenza virus infection that required hospitalization due to pneumonia, acute respiratory distress syndrome, septic shock, multiorgan failure or any other serious condition, including intensive care unit (ICU) admission or death or who developed these criteria during hospitalization for another reason

  • During the six seasonal influenza seasons between 2010–2011 and 2015–2016, 291 confirmed cases of influenza requiring hospitalization were reported to the General Subdirectorate of Surveillance and Response to Public Health Emergencies, with ages ranging from 0 to 17 years

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Summary

Introduction

An acute viral infectious disease that primarily affects the upper respiratory tract, is caused by the influenza virus, which belongs to the Orthomyxoviridae family. A surveillance program of influenza and other acute respiratory infections (PIDIRAC) was initiated in Catalonia in the 1999–2000 season, based on a network of sentinel primary care physicians (general practitioners and paediatricians) who report influenza-like activity detected in their reference population daily. Various studies have analysed the distribution of influenza in the general population, vaccine effectiveness and hygienic preventive measures in our setting, but the characteristics and distribution of severe disease in children are not known[10,11,12,13].

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