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Volume 18, Number 11—November 2012

Research

Unchanged Severity of Influenza A(H1N1)pdm09 Infection in Children during First Postpandemic Season

Mathias AltmannComments to Author , Lena Fiebig, Silke Buda, Rüdiger von Kries, Manuel Dehnert, and Walter Haas
Author affiliations: Robert Koch Institute, Berlin, Germany (M. Altmann, L. Fiebig, S. Buda, M. Dehnert, W. Haas); and Ludwig-Maximilians-Universität, München, Germany (R. von Kries)

Main Article

Table 1

Comparison of severe cases of influenza A(H1N1)pdm09 virus infection in children during the pandemic and the first postpandemic seasons, Germany, 2009–2011*

Variable No. patients/no. total (%) Influenza season
p value
2009–10 2010–11
Male sex 81/154 (53) 65/111 (59) 16/43 (37) 0.020
Median age, y (IQR) 4.2 (1.2–9.2) 5.3 (1.7–10.1) 3.2 (0.5–6.5) 0.007
Hospital-acquired infection
19/136 (14)
11/101 (11)
8/35 (23)
0.093

Clinical diagnosis

Pneumonia

108/156 (69) 79/112 (71) 29/44 (66) 0.569

Secondary pneumonia

30/156 (19) 22/112 (20) 8/44 (18) 1.000

Encephalopathy

11/156 (7) 7/112 (6) 4/44 (9) 0.506

ARDS

43/156 (28) 29/112 (26) 14/44 (32) 0.551

Sepsis

18/156 (12) 9/112 (8) 9/44 (21) 0.048

Myocarditis

8/156 (5) 4/112 (4) 4/44 (9) 0.223

Febrile seizure

7/156 (5) 3/112 (3) 4/44 (9) 0.099
Underlying chronic medical conditions

Any

114/146 (78) 82/107 (77) 32/39 (82) 0.652

Neurodevelopmental disorders

84/151 (56) 61/110 (56) 23/41 (56) 1.000

Respiratory disease

44/141 (31) 35/104 (34) 9/37 (24) 0.409

Immunodeficiency

17/137 (12) 15/97 (16) 2/40 (5) 0.152

Cardiac disease

20/143 (14) 12/102 (12) 8/41 (20) 0.286
Treatment

Oseltamivir

90/145 (62) 65/105 (62) 25/40 (63) 1.000

Catecholamine

52/138 (38) 35/101 (35) 17/37 (46) 0.240

Mechanical ventilation

98/145 (68) 68/107 (64) 30/38 (79) 0.107

Vaccination†

5/88 (6) 5/67 (8) 0/21 (0) 0.332
Outcome

All death

31/156 (20) 22/112 (20) 9/44 (21) 1.000

Death in PICU

25/150 (17) 16/106 (15) 9/44 (21) 0.473

*Values are no. positive/no. with available information (%), except as indicated. Pandemic season, 2009–10; postpandemic season, 2010–11; IQR, interquartile range; ARDS, acute respiratory distress syndrome; PICU, pediatric intensive care unit.
†Influenza A(H1N1)pdm09 vaccination of patients >6 mo of age.

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