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Impact of type A influenza on children: a retrospective study
Insights
During influenza A epidemics, children experienced increased hospitalizations for pneumonia and bronchitis. High-risk children and boys aged 5-14 faced the greatest risks, highlighting the need for targeted interventions.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Influenza A epidemics pose significant health risks, particularly to children.
- Understanding excess morbidity during epidemics is crucial for public health planning.
- Previous studies have not fully detailed excess hospitalization and ambulatory care contacts in pediatric populations during influenza A outbreaks.
Purpose of the Study:
- To quantify excess morbidity, specifically hospitalization and ambulatory care contacts, among children during influenza A epidemics.
- To identify specific age groups and risk factors associated with increased illness severity.
- To compare pediatric excess hospitalization rates with those of adult populations.
Main Methods:
- Retrospective analysis of hospitalization and ambulatory care data from a large prepaid group practice program.
- Comparison of illness rates during influenza A epidemic years (1968-69, 1972-73) with baseline rates.
- Stratification of data by age group (0-4, 5-14 years) and risk status (high-risk vs. non-high-risk).
Main Results:
- Excess hospitalization rates for influenza-related conditions (pneumonia, bronchitis) ranged from 5 to 29 per 10,000 children.
- High-risk children experienced significantly higher excess hospitalization rates compared to non-high-risk children.
- Boys aged 5-14 showed the greatest relative increase in hospitalization rates; younger children (0-4) had the largest absolute increase.
- Excess ambulatory care contacts were not statistically significant.
- Children (0-14 years) had 3-5 times higher excess hospitalization rates than adults aged 15-64, but lower rates than individuals over 65.
Conclusions:
- Influenza A epidemics result in substantial excess morbidity among children, particularly requiring hospitalization for respiratory conditions.
- Children with high-risk conditions and specific age groups (boys 5-14, younger children) are disproportionately affected.
- Pediatric excess hospitalization rates during epidemics are considerable compared to adults, underscoring the importance of pediatric vaccination and preventive measures.
Abstract:
Excess morbidity was studied during influenza A epidemics (1968-69, 1972-73) among children in a large prepaid group practice program. Excess rates of hospitalization for influenza-related conditions, primarily pneumonia and bronchitis, ranged from 5 per 10,000 (95 per cent confidence limits (CL): 1 to 9) for non-high-risk children to 29 per 10,000 (95 per cent CL: 5 to 53) for children with high-risk conditions. The relative increases in hospitalization rates were greatest for 5-14 year old boys: 278 per cent and 104 per cent increases for high-risk and non-high-risk boys, respectively. The absolute increase was greatest for 0-4 year olds. The excess rate of ambulatory medical care contacts, 2.6 per 100 (95 per cent CL: -1.6 to 6.8 per 100) was not statistically significant. Excess hospitalization rates among 0-14 year olds during epidemics were three to five times larger than those for persons between 15 and 64 years of age but only one-fifth the rate of persons over age 65.