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Hospitalization patterns and outcomes of infants with Influenza A(H1N1) in Kuwait
Entesar H Husain1, Ahmad Alkhabaz, Hanan Y Al-Qattan
1Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait. ehusain@hsc.edu.kw
Insights
Previously healthy infants were the majority hospitalized with Influenza A(H1N1)pdm09. High-risk infants experienced longer hospital stays and more ICU admissions, underscoring the importance of vaccination.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Infants are a high-risk group for influenza-related hospitalizations and mortality.
- Pandemic influenza A(H1N1)pdm09 posed a significant threat to infant health.
Purpose of the Study:
- To evaluate clinical presentations, hospitalization, and outcomes of infants hospitalized with Influenza A(H1N1)pdm09.
- To compare outcomes between previously healthy infants and those with pre-existing high-risk conditions.
Main Methods:
- Retrospective chart review of hospitalized infants with confirmed Influenza A(H1N1)pdm09 in Kuwait.
- Analysis of demographic data, medical conditions, clinical presentations, complications, and mortality.
- Comparative analysis of illness severity and outcomes based on prior health status.
Main Results:
- 62 infants hospitalized with Influenza A(H1N1)pdm09; 31% had pre-existing high-risk conditions.
- Previously healthy infants: 53% complications, 4.9-day hospitalization. High-risk infants: 47% complications, 6.7-day hospitalization.
- Bacterial pneumonia occurred in 7% of healthy vs. 26% of high-risk infants; 6.5% overall ICU admission, predominantly in high-risk infants.
Conclusions:
- Previously healthy infants constituted the majority of hospitalizations for Influenza A(H1N1)pdm09.
- Infants with high-risk medical conditions faced prolonged hospitalization, increased ICU admissions, and higher mortality.
- Annual influenza vaccination is crucial for all infants ≥6 months, especially those with risk factors, per ACIP recommendations.
Introduction:
Infants represent an important risk group for influenza associated hospitalizations and mortality. This study evaluated the clinical presentations, hospitalization course and outcome of infants hospitalized with the pandemic influenza A H1N1 [Influenza A(H1N1)pdm09] in relation to their previous health status.
Methodology:
We conducted a retrospective chart review of hospitalized infants with laboratory-confirmed Influenza A(H1N1)pdm09 infection in two hospitals in Kuwait. Demographic characteristics, pre-existing high-risk medical conditions, clinical presentations, complications and mortality were analyzed. Previously healthy infants' data were compared with infants with pre-existing high-risk medical conditions for severity of the illness and outcome.
Results:
We identified 62 infants comprising 32% of all admissions with Influenza A(H1N1)pdm09. The median age ± SD was 7 ± 4 months. Nineteen (31%) had pre-existing high-risk medical conditions. Complications were documented in 53% of previously healthy infants compared to 47% in high-risk infants. Mean duration of hospitalization was 4.9 days in healthy infants and 6.7 for infants with high-risk medical conditions. Bacterial pneumonia complicated 7% of previously healthy infants compared to 26% with high-risk conditions (P = 0.03). Four infants (6.5%) required admission to the intensive care unit (ICU), of whom three had high risk medical condition.
Conclusion:
The majority of hospitalized infants with Influenza A(H1N1)pdm09 were previously healthy. Prolonged hospitalization, ICU admission and mortality were more observed in infants with high-risk medical conditions. According to the latest Advisory Committee on Immunization Practices (ACIP) recommendations, annual influenza vaccination is recommended for any child six months of age and older, particularly those with risk factors.
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