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Burden of influenza in children: preliminary data from a pilot survey network on community diseases
Michele Aymard1, Martine Valette, Jacques Luciani
1National Influenza Center, Laboratory of Virology, Lyon, France. aymard@rockefeller.univ-lyon1.fr
Insights
French children with mild respiratory symptoms frequently shed influenza viruses, highlighting their role in transmission. This study tracked influenza prevalence and clinical presentation in young populations over two winters.
Area of Science:
- Pediatric infectious diseases
- Virology
- Epidemiology
Background:
- Influenza burden and clinical presentation are poorly documented in French children.
- Limited data exists on the epidemiology of influenza in pediatric populations in France.
Purpose of the Study:
- To measure the prevalence of acute respiratory infections (ARIs) and influenza in French children.
- To document the clinical presentation of influenza in children.
- To assess the role of children in influenza transmission.
Main Methods:
- Prospective community survey of 0- to 15-year-olds over two winter seasons (2000-2001, 2001-2002).
- Utilized a network of general practitioners and pediatricians (Grippe et Infections Respiratoires Aiguës Pédiatriques - GIRAP).
- Influenza viruses detected via antigen detection and culture; clinical data collected through standardized forms.
Main Results:
- Symptomatic ARI prevalence was 28% (2000-2001) and 27% (2001-2002).
- Influenza A/H1N1 outbreak (5.4%) in 2000-2001, with highest attack rates in 5-15 year olds.
- Subepidemic influenza in 2001-2002 (5.9%): A/H3N2 (60%) in 2-4 year olds, Influenza B (40%) in 4-10 year olds.
Conclusions:
- The GIRAP network detected influenza A or B viruses in 35-60% of samples during peak epidemics.
- Children with mild symptoms frequently excrete influenza viruses.
- Children represent a significant reservoir and source for influenza transmission.
Background:
The burden of influenza and its clinical presentation are both poorly documented in French children.
Methods:
To measure the prevalence of acute respiratory infections over two winters (2000 to 2001 and 2001 to 2002), we performed a prospective community survey of 0- to 15-year-olds (n = 11 500 and 40 000, respectively) through a network [Grippe et Infections Respiratoires Aiguës Pédiatriques (GIRAP)] of general practitioners and pediatricians. Influenza viruses were detected by antigen detection and culture from nasopharyngeal swabs. Data on the clinical presentation of children infected with influenza A/H1N1, A/H3N2 or B viruses were derived from standardized forms.
Results:
The prevalences of symptomatic acute respiratory infections were 28% and 27% for 2000 to 2001 and 2001 to 2002, respectively. In the winter of 2000 to 2001, a mild outbreak of influenza A/H1N1 affected 5.4% of the study population. The attack rates of influenza A/H1N1 were highest in children 5 to 15 years of age. In the winter of 2001 to 2002, influenza activity remained at a subepidemic level (5.9%; A/H3N2, 60%; B, 40%). The incidence of influenza A/H3N2 infections was highest in 2- to 4-year-old children, whereas influenza B strains were most frequently detected in children 4 to 10 years of age.
Conclusions:
Despite subepidemic levels of influenza, the GIRAP network was able to detect influenza A or B viruses in 35 to 60% of the samples during the peak of influenza epidemic. The frequency of influenza virus excretion in children with mild clinical symptoms indicates that children are an important reservoir and source of transmission of this virus.
