Clinical Profile and Outcome of Pandemic Influenza A (H1N1) Virus in Child‘s Central Teaching Hospital

Abstract

Abstract:Background: Influenza virus infection (H1N1), although an old disease, gets a great concern in 2009 because of pandemic infection. Objectives: The aim of this study is to describe epidemiological, demographic, clinical and laboratory characteristics and outcome of children infected with 2009 H1N1 influenza virus and attended the Child‘s Central Teaching Hospital in Baghdad. Methods: The study was conducted on 90 patients with influenza-like illness aged 1mon to 16yr during time period from 1st of October till 31st of December 2009. Epidemiological, clinical and laboratory data were reported. For each patient 2 nasal and 2 throat swabs and a single blood sample were collected and sent to Central Health Laboratory for RT-PCR (Real Time Polymerase Chain Reaction).Results: The mean age of these children was 7.5±3.5 yr. The diagnosis of 2009 H1N1 Influenza were confirmed in 60 patients, of which 65% were >6yr old, 35% were <6yr old and no case reported below 1month. Male: female ratio in PCR positive group was 1.2:1, and was 1.3:1 in PCR negative group. Most of children were from urban area in both groups. Contact history was positive only in 3 cases in PCR positive group and 2 cases in PCR negative group. High grade fever was the most common symptom, followed by cough and rhinorrhea. Of the 42/60 patients of PCR positive group who underwent chest radiography during evaluation, 22 (56.3%) patients had findings consistent with lower respiratory tract infection. Antiviral therapy was initiated in 57/60 (95%) patients. Hospitalization was required in 42 (70%) of PCR positive patients. Mean length of hospitalization was 5.5±2.5 days. All PCR negative patients improved while in PCR positive patients only 2 (3.3%) children developed acute respiratory failure and died.Conclusions: Adolescents affected more by H1N1 Influenza followed by school age group. Both sexes equally affected. The H1N1/09 influenza was most common in urban area. Clinical features and routine laboratory investigations in children with swine origin influenza were passed as a simple influenza virus infection like symptoms. Severe co-morbid conditions, respiratory distress, vomiting, wheezing, diarrhea, and infiltrates/consolidation on chest radiograph were most criteria for admission.Key Words: H1N1 infection, PCR positive, PCR negative