Volume 18, Number 11—November 2012
Research
Unchanged Severity of Influenza A(H1N1)pdm09 Infection in Children during First Postpandemic Season
, Lena Fiebig, Silke Buda, Rüdiger von Kries, Manuel Dehnert, and Walter Haas
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..