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Turkish Journal of Medical Sciences

DOI

10.3906/sag-1011-1308

Abstract

To describe the demographic characteristics and clinical features in children with influenza A (H1N1) virus infection and to identify risk factors for severe disease or poor prognosis. Following the first tourist-imported case in Turkey on 16 May 2009, the influenza A (H1N1) virus has spread throughout the country. Materials and methods: Children under 18 years of age who were hospitalized for at least 24 h with an influenza-like illness and who had confirmed influenza A (H1N1) virus infection were included in the study. Demographic factors, clinical signs and symptoms, laboratory results, radiographic findings, treatments, and follow-up periods were noted. Results: During the period of October to December 2009, 126 [63.5% males, median age: 3 years (range: 0.1-9 years)] children with cases of influenza A (H1N1) virus infection were hospitalized. Fever (95.2%), cough (84.1%), rhinorrhea (70%), and dyspnea (63.5%) were the most common presenting symptoms. A total of 46 patients (36.4%) had chronic underlying medical conditions, with asthma being the most common (21.4%). During hospitalization, durations of oxygen requirement and wheezing were longer in patients with chronic respiratory disease. Duration of oxygen requirement and tachypnea decreased if oseltamivir was initiated within 48 h (P = 0.006 and 0.033, respectively). No risk factor was defined for hospitalization longer than 4 days. Conclusion: In our cohort, influenza A (H1N1) virus infection did not appear to cause severe disease. Asthma was a significant risk factor for severe disease. Delayed (>48 h) initiation of antiviral therapy might have contributed to an increase in morbidity, which suggests the importance of timely administration of antiviral treatments.

Keywords

Pandemic H1N1 influenza A, oseltamivir, prognosis, asthma

First Page

433

Last Page

440

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