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Severe influenza in children: incidence and risk factors
Nicola Principi1, Susanna Esposito1
1a Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation , Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.
Insights
Identifying severe influenza risk factors in children is crucial for effective prevention. Young children and school-aged patients, especially those with immature immune systems, face higher hospitalization and mortality risks.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Epidemiology
Background:
- Severe influenza cases require targeted prevention strategies, particularly in pediatric populations.
- Understanding factors predisposing children to severe influenza is essential for public health interventions.
Purpose of the Study:
- To identify risk factors associated with severe influenza outcomes in children.
- To inform the development of optimal prevention and control measures for vulnerable pediatric populations.
Main Methods:
- Analysis of epidemiological data on pediatric influenza hospitalizations, intensive care unit admissions, and mortality.
- Review of immunological factors contributing to severe influenza in children.
Main Results:
- The highest rates of severe influenza (hospitalization, ICU admission, death) occur in children under two years and school-aged children.
- Immature immune system responses to influenza viruses may explain higher hospitalization rates in younger children.
- Chronic conditions increase the risk of severe influenza, but severe outcomes can also affect healthy children.
Conclusions:
- Pediatric influenza severity is influenced by age-related immune system maturity and underlying health conditions.
- Further research is needed to elucidate specific immune mechanisms and risk factors in pediatric influenza.
- Targeted interventions are necessary for high-risk pediatric groups to mitigate severe influenza outcomes.
Introduction:
The identification of factors that can predispose to the development of severe influenza is essential to enable the implementation of optimal prevention and control measures for vulnerable populations.
Areas Covered:
Unfortunately, data in the pediatric age group remain difficult to interpret. However, epidemiological data seem to suggest that the most severe influenza cases, those who are hospitalized, those who are admitted to the intensive care unit, and those who died, occur in children in the first 2 years of life and in school age patients. Expert commentary: Immaturity of the immune system, and in particular of the mechanisms that usually recognize influenza viruses and activate cytokine and chemokine responses to reduce viral replication, might explain the high hospitalization rate observed in the youngest patients. Some underlying chronic conditions favour the development of the severe cases, sometime leading to death, although both admission to the intensive care unit and death can occur in otherwise healthy subjects.
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