Abstract
Background: Influenzavirus (Flu) is associated with high morbidity in children less than 24-mo old, with high rates of hospitalization. Recommendation for annual influenza vaccination has been extended to this age group in the USA.
Objective: We evaluated the proportion of Flu-attributable disease in children younger than 2 years, admitted to a tertiary care hospital for LRTI during the 2004 influenza seasonal outbreak in southeast Brazil.
Methods: All samples submitted for respiratory virus detection were tested for Flu by immunofluorescence and/or RT-PCR. Influenza positive samples were used for viral isolation and identification. Patient records were reviewed for length of hospital stay (LOS), need for oxygen supplementation (OS) and clinical diagnosis.
Results: From March to May 2004, 159 samples were collected and 17 (10.7%) were positive for influenza A. Influenza virus was isolated from 6 samples, all of them A/Korea (H3N2). Of the 17 positive samples, 8 (47%) were obtained in April. Patient records were available for review in 12 cases (7 boys). Of these, 10 (83%) were < 9-mo old and 5 (42%) were 6- to 8-mo old. Bronchiolitis was present in 50%(6/12) and pneumonia in 33% (4/12). LOS ranged from 2 to 10 days and 58% had > 6 days. OS was required by 58% (7/12) of the patients and 71% (5/7) required O2 for 6 or more days. Bronchodilators and antibiotics were the two most frequent treatments used (92% and 42%, respectively).
Conclusions: During this outbreak in a subtropical region of Brazil, influenza associated disease represented 10.7% of all hospitalizations in children less than 24 months of age with LRTI, and the associated morbidity was responsible for prolonged LOS and requirement for OS. The impact of influenza-associated disease on pediatric hospitalization could be reduced by vaccination in this age group.
Financial Support: FAPESP, CNPq and Sanofi -Pasteur
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Cintra, O., Feitosa, M., Silva, K. et al. Impact of Influenza-Attributable Disease on Hospitalizations in Children Younger than 24 Months with Lower Respiratory Tract Infections (LRTI) in Subtropical Brazil: Tl 24. Pediatr Res 60, 637 (2006). https://doi.org/10.1203/00006450-200611000-00031
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DOI: https://doi.org/10.1203/00006450-200611000-00031