TY  - JOUR
T1  - CHildren hospitalized with 2009 novel influenza a(h1n1) in california
AU  - Louie JK, Gavali S, Acosta M, et al
Y1  - 2010/11/01
N1  - 10.1001/archpediatrics.2010.203
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 1023
EP  - 1031
VL  - 164
IS  - 11
N2  - Objective 
    To describe clinical and epidemiologic features of 2009 novel influenza A(H1N1) in children.Design 
    Analysis of data obtained from standardized report forms and medical records.Setting 
    Statewide public health surveillance in California.Participants 
    Three hundred forty-five children who were hospitalized with or died of 2009 novel influenza A(H1N1).Main Exposure 
    Laboratory-confirmed 2009 novel influenza A(H1N1).Main Outcome Measures 
    Hospitalization and death.Results 
    From April 23 to August 11, 2009, 345 cases in children younger than 18 years were reported. The median age was 6 years. The hospitalization rate per 100 000 per 110 days was 3.5 (0.97 per 100 000 person-months), with rates highest in infants younger than 6 months (13.9 per 100 000 or 3.86 per 100 000 person-months). Two-thirds (230; 67%) had comorbidities. More than half (163 of 278; 59%) had pneumonia, 94 (27%) required intensive care, and 9 (3%) died; in 3 fatal cases (33%), children had secondary bacterial infections. More than two-thirds (221 of 319; 69%) received antiviral treatment, 44% (88 of 202) within 48 hours of symptom onset. In multivariate analysis, congenital heart disease (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.9-13.5) and cerebral palsy/developmental delay (OR, 3.5; 95% CI, 1.7-7.4) were associated with increased likelihood of intensive care unit admission and/or death; likelihood was decreased in Hispanic (OR, 0.4; 95% CI, 0.2-0.8) and black (OR, 0.3; 95% CI, 0.1-1.0) children compared with white children.Conclusions 
    More than one-quarter of children hospitalized with 2009 novel influenza A(H1N1) reported to the California Department of Public Health required intensive care and/or died. Regardless of rapid test results, when 2009 novel influenza A(H1N1) is circulating, clinicians should maintain a high suspicion in children with febrile respiratory illness and promptly treat those with underlying risk factors, especially infants.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2010.203
UR  - http://dx.doi.org/10.1001/archpediatrics.2010.203
ER  -