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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 2

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

Variable No. patients/no. total (%) Hospital-acquired cases Community-acquired cases‡ Univariable analysis
Multivariable analysis
OR (95% CI) p value OR (95% CI) p value
Male sex 72/134 (54) 10/18 (56) 62/116 (54) 1.1 (0.4–3.4) 1.000 1.4 (0.4–4.5) 0.622
Median age, years (IQR) 4.3 (1.0–9.2) 1.1 (0.3–10.1) 4.8 (1.6–11.9) NA 0.168 1.0 (0.8–1.1) 0.583
2010–11 season 35/136 (26) 8/19 (42) 27/117 (23) 2.4 (0.8–7.4) 0.093 1.5 (0.4–5.7) 0.517
Clinical diagnosis

Pneumonia

96/136 (71) 15/19 (79) 81/117 (69) 1.7 (0.5–7.4) 0.588 NA NA

Secondary pneumonia

27/136 (20) 4/19 (21) 23/117 (20) 1.1 (0.2–3.8) 1.000 NA NA

Encephalopathy

9/136 (7) 0/19 (0) 9/117 (8) 0.0 (0.0–2.5) 0.360 NA NA

ARDS

38/136 (28) 9/19 (47) 29/117 (25) 2.7 (0.9–8.2) 0.054 NA NA

Sepsis

17/136 (13) 5/19 (26) 12/117 (10) 3.1 (0.7–11.4) 0.064 NA NA

Myocarditis

8/136 (6) 0/19 (0) 8/117 (7) 0.0 (0.0–2.9) 0.600 NA NA

Febrile seizure

6/136 (4) 0/19 (0) 6/117 (5) 0.0 (0.0–3.9) 0.595 NA NA
Underlying chronic medical conditions

Any

101/129 (78) 19/19 (100) 82/110 (75) NA (1.7–NA) 0.013 NA NA

Neurodevelopmental disorders

75/133 (56) 13/19 (68) 62/114 (54) 1.8 (0.6–6.2) 0.321 NA NA

Respiratory disease

17/126 (14) 3/18 (17) 14/108 (13) 1.3 (0.2–5.7) 0.710 NA NA

Immunodeficiency

15/121 (12) 5/17 (29) 10/104 (10) 3.9 (0.9–15.2) 0.037 5.9 (1.5–23.9) 0.013

Cardiac disease

17/126 (14) 3/18 (17) 14/108 (13) 1.3 (0.2–5.7) 0.710 NA NA
Treatment

Oseltamivir

80/128 (63) 13/18 (72) 67/110 (61) 1.7 (0.5–6.4) 0.4378 NA NA

Catecholamine

47/124 (38) 11/16 (69) 36/108 (33) 4.4 (1.3–17.2) 0.011 NA NA

Mechanical ventilation

85/129 (66) 17/18 (94) 68/111 (61) 10.8 (1.6–459.4) 0.006 8.9 (1.1–74.7) 0.043

Vaccination†

5/80 (6) 0/10 (0) 5/70 (7) 0.0 (0.0–5.5) 1.000 NA NA
Outcome

All deaths

28/136 (21) 5/19 (26) 23/117 (20) 1.5 (0.4–4.9) 0.543 NA NA

Death in PICU

22/130 (17) 4/18 (22) 18/112 (16) 1.5 (0.3–5.5) 0.507 NA NA

*Values are no. positive/no. with available information (%), except as indicated. Pandemic season, 2009–10; postpandemic season, 2010–11; OR, odds ratio; IQR, interquartile range; NA, not applicable; 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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