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2009 H1N1 influenza A in children: a descriptive clinical study
Maha Mahmoud Hamdi Khalil Mansour1, Khalid Mohamed Abdullah Al Hadidib
1Pediatric Department, Cairo University, Cairo, Egypt, Clinical Pathology Department, Ain Shams University, Cairo, Egypt. fractaledge3@yahoo.com
Insights
The 2009 pandemic influenza A H1N1 virus caused severe illness in children, with those under 5 years old at higher risk. Early diagnosis using clinical signs and lymphopenia aided prompt antiviral treatment, preventing fatalities.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Epidemiology
Background:
- The 2009 H1N1 influenza virus posed a significant threat, particularly to young children and individuals with pre-existing medical conditions.
- Influenza-related complications were more prevalent in specific high-risk pediatric age groups.
Purpose of the Study:
- To detail the clinical presentation of H1N1 cases in pediatric patients at Jeddah Clinic Hospital-Al Kandarah (JCH-K).
- To identify high-risk age groups for severe H1N1 influenza complications.
- To evaluate diagnostic criteria for early antiviral intervention.
Main Methods:
- A prospective study was conducted at JCH-K from October 2009 to January 2010.
- Pediatric patients (up to 15 years) with influenza-like illnesses were clinically assessed and tested via reverse transcriptase polymerase chain reaction (RT-PCR).
- Confirmed H1N1 cases were analyzed for clinical symptoms, demographic data, and outcomes.
Main Results:
- Eighty-nine laboratory-confirmed H1N1 cases were reported, with 38.2% of patients younger than 5 years.
- Fever was universal; pneumonia occurred in 31.5% of cases. Asthmatic children represented 15.7%.
- Lymphopenia (58.4%) and leucopenia (35.9%) were common. Hospitalization was required for 73%, with 5.6% needing intensive care.
Conclusions:
- Despite a generally mild presentation, severe H1N1 influenza occurred in children.
- Clinical presentation and lymphopenia served as crucial early diagnostic markers for initiating antiviral therapy, especially with delayed PCR results.
- No deaths were associated with the 2009 pandemic influenza A H1N1 in this cohort.
Background And Objective:
The 2009 H1N1 was a new influenza virus causing illness in people. Especially those younger than 5 years of age and those who have high-risk medical conditions are at increased risk for influenza-related complications. In the present study, we describe the clinical presentation of the H1N1 cases attending Jeddah Clinic Hospital-Al Kandarah (JCH-K) in the time period from October 2009 to January 2010, and identified the high-risk age groups.
Design And Setting:
Prospective study at JCH-K from October 2009 through January 2010.
Patients And Methods:
All pediatric patients (up to 15 years old) presenting with influenza-like illnesses in the clinics during the specified period were clinically examined and tested using reverse transcriptase polymerase chain reaction. Only confirmed H1N1 cases were included in the study.
Results:
Over a 4-month period, 89 cases of laboratory-confirmed H1N1 were reported in JCH-K. Thirty-four patients (38.2%) were younger than 5 years of age. Forty-six (51.6%) cases were males. Thirty-three cases were Saudis (37.1%). The most commonly reported symptom was fever, which was noted in all cases. Twenty-eight cases (31.5%) had pneumonia. Fourteen cases (15.7%) were known asthmatics. Fifty-two (58.4%) cases were lymphopenic and 32 (35.9%) cases were leucopenic. Sixty-five (73%) patients were hospitalized, and five of them were treated in the intensive care unit.
Conclusions:
Even though the majority of cases of the 2009 pandemic influenza A H1N1 were mild, a severe disease does occur in children. In view of delayed PCR results, clinical presentation and lymphopenia were used as diagnostic criteria to start antiviral treatment as early as possible. No deaths were attributed to the 2009 pandemic.
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Acute pharyngitis can be categorized based on its underlying cause: