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High-throughput Detection Method for Influenza Virus
Published on: February 4, 2012
Multistate surveillance for laboratory-confirmed, influenza-associated hospitalizations in children: 2003-2004
Stephanie J Schrag1, David K Shay, Ken Gershman
1National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. SSchrag@cdc.gov
Insights
Influenza caused significant hospitalizations in children during 2003-2004, especially in infants under 6 months. Continued surveillance is vital for effective influenza prevention strategies in pediatric populations.
Area of Science:
- Pediatric Infectious Diseases
- Public Health Surveillance
- Epidemiology
Background:
- Rapid influenza diagnostics enable laboratory confirmation of infections.
- This study details laboratory-confirmed, influenza-associated hospitalizations in a large US pediatric population.
Purpose of the Study:
- To describe the epidemiology of influenza-associated hospitalizations in children.
- To evaluate clinical characteristics and predictors of severe outcomes.
- To determine age-specific and geographic incidence rates.
Main Methods:
- Population-based surveillance for influenza-associated hospitalizations from October 2003 to March 2004.
- Covered 4.2 million children across 54 counties in 9 states.
- Analyzed clinical data, intensive care unit admission predictors, and incidence rates.
Main Results:
- 1,308 case-patients identified; 80% were under 5 years, 27% under 6 months.
- Bacterial coinfections were linked to intensive care admission (aOR 16.9).
- Overall hospitalization incidence was 36 per 100,000 children.
Conclusions:
- Influenza was a significant cause of pediatric hospitalization in 2003-2004.
- Infants under 6 months, a group ineligible for vaccination, were disproportionately affected.
- Ongoing surveillance is recommended to guide influenza prevention efforts.
Background:
Increasing use of rapid influenza diagnostics facilitates laboratory confirmation of influenza infections. We describe laboratory-confirmed, influenza-associated hospitalizations in a population representing almost 6% of children in the United States.
Methods:
We conducted population-based surveillance for influenza-associated hospitalizations between October 1, 2003, and March 31, 2004, in 54 counties in 9 states (4.2 million children) participating in the Emerging Infections Program Network. Clinical characteristics, predictors of intensive care unit admission and geographic and age-specific incidence were evaluated.
Results:
Surveillance identified 1,308 case-patients; 80% were <5 years and 27% were <6 months of age. Half of the patients and 4 of 5 pediatric deaths did not have a medical indication for influenza vaccination and were outside the 6- to 23-month age group. Twenty-eight percent of case-patients had radiographic evidence of a pulmonary infiltrate, 11% were admitted to intensive care and 3% received mechanical ventilation. The median length of hospital stay was 2 days. Community-acquired invasive bacterial coinfections (1% of patients) were associated with intensive care admission (adjusted odds ratio, 16.9; 95% confidence interval, 5.0-56.8). Thirty-five percent of patients >or=6 months old had received at least one influenza vaccine dose that season. The overall incidence of influenza-associated hospitalizations was 36 per 100,000 children (range per state, 10 per 100,000 to 86 per 100,000).
Conclusions:
Influenza was an important cause of hospitalizations in children during 2003-2004. Hospitalizations were particularly common among children <6 months of age, a group for whom influenza vaccine is not licensed. Continued surveillance for laboratory-confirmed influenza could inform prevention strategies.
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