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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 3

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

Variable No. patients/no. total (%) Nonsurvivors Survivors‡ Univariable analysis
Multivariable analysis
OR (95% CI) p value OR (95% CI) p value
Male sex 81/148 (55) 15/25 (60) 66/123 (54) 1.3 (0.5–3.5) 0.661 2.5 (0.8–7.4) 0.098
Median age, years (IQR) 4.2 (1.0–8-6) 5.7 (1.6–9.8) 4.1 (1–7.8) NA 0.091 1.1 (1.0–1.2) 0.232
2010–11 season 44/150 (29) 9/25 (36) 35/125 (28) 1.4 (0.5–3.9) 0.4728 1.6 (0.5–5.1) 0.435
Hospital-acquired infection 18/130 (14) 4/22 (18) 14/108 (13) 1.5 (0.3–5.5) 0.507 NA NA
Clinical diagnosis

Pneumonia

103/150 (69) 13/25 (52) 90/125 (72) 0.4 (0.2–1.1) 0.060 NA NA

Secondary pneumonia

30/150 (20) 8/25 (32) 22/125 (18) 2.2 (0.7–6.2) 0.108 NA NA

Encephalopathy

11/150 (7) 1/25 (4) 10/125 (8) 0.5 (0.01–3.7) 0.692 NA NA

ARDS

43/150 (29) 15/25 (60) 28/125 (22) 5.2 (1.9–14.3) <0.001 3.2 (1.1–9.2) 0.029

Sepsis

17/150 (11) 6/25 (24) 11/125 (9) 3.3 (0.9–11.0) 0.040 NA NA

Myocarditis

8/150 (5) 4/25 (16) 4/125 (3) 5.8 (1.0–32.9) 0.027 30.9 (2.6–360.7) 0.006

Febrile seizure

7/150 (5) 0/25 (0) 7/125 (6) 0.0 (0.01–2.7) 0.601 NA NA
Underlying chronic medical condition

Any

108/140 (77) 19/23 (83) 89/117 (76) 1.5 (0.4–6.5) 0.596 NA NA

Neurodevelopmental disorder

78/145 (54) 16/24 (67) 62/121 (51) 1.9 (0.7–5.5) 0.186 NA NA

Respiratory disease

42/135 (31) 8/22 (36) 34/113 (30) 1.3 (0.4–3.8) 0.617 NA NA

Immunodeficiency

16/131 (12) 1/21 (5) 15/110 (14) 0.3 (0.0–2.3) 0.467 NA NA

Cardiac disease

20/137 (15) 4/23 (17) 16/114 (14) 1.3 (0.3–4.6) 0.746 NA NA
Treatment

Oseltamivir

87/139 (63) 15/23 (65) 72/116 (62) 1.1 (0.4–3.4) 0.8185 NA NA

Catecholamine

52/133 (39) 16/23 (70) 36/110 (33) 4.7 (1.6–14.6) 0.002 NA NA

Mechanical ventilation

98/140 (70) 23/24 (96) 75/116 (65) 12.6 (1.9–530.3) 0.001 18.3 (1.3–251.6) 0.030

Vaccination†

5/82 (6) 0/14 (0) 5/68 (7) 0.0 (0.0–3.7) 0.582 NA NA

*Values are no. positive/no. with available information (%), except as indicated. PICUs, pediatric intensive care units; pandemic season, 2009–10; postpandemic season, 2010–11; OR, odds ratio; IQR, interquartile range; NA, not applicable; ARDS, acute respiratory distress syndrome.
†Influenza A(H1N1)pdm09 vaccination of patients >6 mo of age.

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