Volume 18, Number 11—November 2012
Research
Unchanged Severity of Influenza A(H1N1)pdm09 Infection in Children during First Postpandemic Season
Mathias Altmann
, Lena Fiebig, Silke Buda, Rüdiger von Kries, Manuel Dehnert, and Walter Haas
, Lena Fiebig, Silke Buda, Rüdiger von Kries, Manuel Dehnert, and Walter Haas
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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Page updated: October 16, 2012
Page reviewed: October 16, 2012
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