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Published on: April 14, 2011
[Influenza virus infections in infants aged less than two years old]
C Calvo Rey1, M L García García, I Casas Flecha
1Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, Spain. ccalvo@mi.madritel.es
Insights
Influenza is a significant cause of respiratory illness in infants, often leading to hospitalization. This study highlights its clinical features and differentiates it from Respiratory Syncytial Virus (RSV) infections in young children.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Public Health
Context:
- Influenza is a common cause of infant respiratory illness, frequently underestimated due to non-specific symptoms.
- Hospitalized infants with respiratory tract infections represent a significant burden of disease.
Purpose:
- To describe confirmed influenza infections in infants under 2 years old.
- To compare influenza infections with Respiratory Syncytial Virus (RSV) infections in the same pediatric population.
Summary:
- A prospective study analyzed 100 hospitalized infants with influenza, identifying it as the cause for 4.1% of admissions for fever or respiratory tract infection.
- Influenza A was the predominant subtype (83%). Common diagnoses included bronchiolitis (38%), recurrent wheezing (25%), and pneumonia (9%).
- Influenza presented with more frequent fever and radiologic infiltrates compared to RSV, while bronchiolitis was more common in RSV cases. Infants under 6 months showed milder symptoms.
Impact:
- Influenza is a major cause of respiratory disease in hospitalized infants, contributing to bronchiolitis and recurrent wheezing.
- Understanding influenza's clinical presentation and differentiating it from RSV is crucial for accurate diagnosis and management in infants.
- The findings underscore the importance of considering influenza in the differential diagnosis of respiratory infections in young children.
Introduction:
Influenza is a major cause of respiratory tract illness in infants. The clinical characteristics of these infections are non-specific and the burden of influenza is frequently underestimated in very young children. The objective of this study was to describe confirmed influenza infections in infants < 2 years attended in a level II public hospital. A second-rate aim was to compare influenza infections in hospitalized infants with respiratory syncytial virus (VRS) infection in the same population.
Patients And Methods:
We performed a descriptive, prospective study between 1991 and 2003 in infants younger than 24 months of age, who were admitted to the Severo Ochoa Hospital (Leganés. Madrid) with fever or respiratory tract infection. Virological diagnosis was made with direct immunofluorescent assay and/or reverse transcription-polymerase chain reaction on specimens obtained from nasopharyngeal washings. The patients' clinical characteristics were recorded. Patients with influenza infection were compared with a similar group of infants with RSV infection.
Results:
We analyzed hospitalized 100 infants with influenza infection. Influenza caused 4.1% of the admissions in infants with fever or respiratory tract infection. Influenza A was isolated in 83%, influenza B in 12% and influenza C in 5% of the patients. The mean age of hospitalized infants was 8.3 +/- 5.9 months and the most frequent clinical diagnoses were bronchiolitis in 38%, recurrent wheezing in 25%, upper respiratory tract infection in 19% and pneumonia in 9%. Fever > 38 degrees C was present in 83% of the patients. Radiologic infiltrate was found in 65% of the children. Oxygen saturation less then 95% was present in 44%. In children under 6 months of age fever was less frequent (p = 0.049) and upper respiratory tract infection was more frequent (p = 0.01). Patients with influenza virus infection were older (p = 0.002), more frequently presented fever (p < 0.0001) and radiologic infiltrate (p < 0.001) than infants with RSV infection. Bronchiolitis was more frequent in the RSV group (p = 0.006).
Conclusions:
Influenza infection is a major cause of respiratory tract disease in hospitalized infants. It is an etiologic cause of bronchiolitis, recurrent wheezing, and fever and radiologic consolidations are frequent. Clinical presentation is milder in children under 6 month of age. The characteristics of influenza infection differ substantially from those of RSV infection.
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