Risk Factors for Complicated Influenza A (H1N1) 2009 Disease in Children

Ann Acad Med Singap. 2013 May;42(5):232-6.

Abstract

Introduction: Singapore had its first case of pandemic influenza A (H1N1) 2009 on 26 May 2009. As of 3 August 2009, 440 children with confirmed H1N1were admitted to KK Women's and Children's Hospital (KKH).

Materials and methods: This is a retrospective case control study of children admitted from 26 May 2009 to 19 July 2009 with H1N1infection. Cases and controls were first differentiated by whether they were complicated or non-complicated in nature, and subsequently analysed with regards to possible independent risk factors.

Results: We analysed 143 admitted children; 48 cases and 95 controls (1: 2 ratio). Significant comorbidity was found in 20.3% (n = 29) of patients with the majority having asthma (n = 18, 12.6 %) followed by obesity (n = 7, 4.9%). Binary logistic regression analysis showed risk factors for complicated disease were comorbidity (adjusted OR 6.0, 95% CI, 2.5 to 14.6, P < 0.0001) and age <2 years (adjusted OR 9.8, 95% CI, 2.4 to 40, P = 0.001). Age less than 5 years was not found to be a risk factor.

Conclusion: In the early stages of an evolving influenza epidemic when oseltamivir stocks are low, oseltamivir treatment for influenza can be streamlined and offered to those at highest risk who are under 2 years old or have significant comorbidity to prevent complicated disease.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Antiviral Agents / therapeutic use
  • Asthma / complications
  • Bronchitis / complications
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Fluid Therapy
  • Gastritis / virology
  • Gastroenteritis / virology
  • Humans
  • Infant
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / complications*
  • Male
  • Obesity / complications
  • Oseltamivir / therapeutic use
  • Pneumonia, Bacterial / complications
  • Retrospective Studies
  • Risk Factors
  • Seizures / complications
  • Singapore

Substances

  • Antiviral Agents
  • Oseltamivir