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Pandemic (H1N1) 2009 influenza in pediatric hematology/oncology units in Lebanon
Peter Noun1, Roula Farah, Elie Bechara
1Department of Pediatrics, Geitaoui Lebanese Hospital, Beirut, Lebanon. petern@inco.com.lb
Insights
Pediatric H1N1 influenza in immunocompromised children in the Middle East can be severe. Rapid diagnosis and treatment of pandemic 2009 influenza are crucial for better outcomes in these vulnerable patients.
Area of Science:
- Pediatric Hematology/Oncology
- Infectious Diseases
- Virology
Background:
- Limited data exist on pandemic (H1N1) 2009 influenza in immunocompromised pediatric patients in the Middle East.
- This study focuses on the clinical characteristics of children with hematological malignancies and H1N1 influenza in Lebanon.
Purpose of the Study:
- To describe the clinical features of pediatric patients with hematological malignancies infected with pandemic (H1N1) 2009 influenza.
- To evaluate the outcomes of H1N1 influenza infection in this specific patient population.
Main Methods:
- Retrospective data collection from three pediatric hematology/oncology units in Lebanon.
- Confirmed cases of pandemic (H1N1) 2009 influenza were identified through rapid immunofluorescence assay or real-time polymerase chain reaction.
- Patients included were immunocompromised children diagnosed between October 2009 and March 2010.
Main Results:
- Fourteen immunocompromised children (8 male, 6 female; median age 4.5 years) were diagnosed with H1N1 influenza.
- All patients were hospitalized and received oseltamivir treatment.
- Twelve patients responded well to treatment; however, two with severe respiratory distress died despite intensive care.
Conclusions:
- Prompt diagnosis and treatment of pandemic 2009 influenza in immunocompromised children can lead to favorable outcomes.
- Severe underlying conditions, such as high-risk leukemia and significant immunosuppression, increase the risk of mortality in these patients.
Background:
The impact of pandemic (H1N1) 2009 influenza on immunocompromised patients in western countries has been described, but reports from pediatric patients in the Middle East or Arab countries are deficient. In this study, we describe the clinical characteristics of children with hematological malignancies and laboratory-proven H1N1 influenza.
Patients And Methods:
Patients were recruited from 3 pediatric hematology/oncology units in Lebanon. A confirmed case of pandemic (H1N1) 2009 influenza is a clinically suspected case with positive H1N1 test by either a rapid immunofluorescence test or by real-time polymerase chain reaction. Data were collected retrospectively from the medical charts.
Results:
From October 2009 to March 2010, 14 immunocompromised children were infected with H1N1 influenza. Eight were male and 6 were female. The median age of patients was 4.5 years (range, 1 to 14). All children were hospitalized and treated with oseltamivir. Twelve children responded to treatment; the other 2 patients with severe respiratory distress were transferred to intensive care unit and resuscitated but died after 7 and 12 days.
Conclusions:
Immunocompromised children infected with pandemic 2009 influenza may respond very well when the diagnosis and treatment are rapid. However, on the basis of our experience, if the underlying disease is more severe (immunodeficiency with significant immunosuppressive treatment and induction of high-risk leukemia), the odds of mortality are likely greater.
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