The hospital-based incidence of influenza infection in children with type C symptoms: an observational study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20253301Keywords:
Pediatric influenza, RT-PCR, Respiratory illness, VaccinationAbstract
Background: Influenza, a contagious respiratory illness, poses a significant threat to children, especially those with severe symptoms (Category C). This study aimed to investigate the hospital-based incidence, clinical profile, and outcomes of influenza in pediatric patients.
Methods: This prospective cross-sectional study was conducted from June 2019 to August 2021, enrolling 220 children (6 months to 18 years) with category C influenza-like symptoms. Influenza was diagnosed via reverse transcription polymerase chain reaction (RT-PCR) using nasopharyngeal and oropharyngeal swabs. Clinical data, laboratory findings, and treatment outcomes were analyzed.
Results: Influenza was detected in 47 (21.63%) patients, with peak incidence in October 2019 and February 2020. No cases were recorded in 2021. No significant differences were observed between influenza-positive and-negative groups in demographics or clinical symptoms. ICU admission was higher in the influenza-positive group (14.9% vs. 1.7%). Mortality was significantly higher in influenza-positive patients (12.8% vs. 1.2%). Vaccination rates were low (2.3%).
Conclusions: Influenza poses a considerable health burden in children with severe respiratory symptoms, with increased mortality in positive cases. The marked decline in influenza cases during the COVID-19 pandemic highlights the effectiveness of public health measures. Clinicians should consider influenza in the differential diagnosis of children with severe respiratory illness, particularly during winter. Low vaccination rates emphasize the need for improved vaccination strategies.
Metrics
References
Moghadami MA. Narrative Review of Influenza: A Seasonal and Pandemic Disease. Iran J Med Sci. 2017;42(1):2-13.
Ekşi A, Öztürk GK, Çiçek C, Gülen F, Demir E. Comparison of Clinical Presentations and Disease Severity of Children Hospitalized with Influenza A and B. Turk Arch Pediatr. 2024;59(4):397-403. DOI: https://doi.org/10.5152/TurkArchPediatr.2024.23286
Jiang C, Yao X, Zhao Y, Wu J, Huang P, Pan C, et al. Comparative review of respiratory diseases caused by coronaviruses and influenza A viruses during epidemic season. Microbes Infect. 2020;22(6-7):236-44. DOI: https://doi.org/10.1016/j.micinf.2020.05.005
Mostafa A, Abdelwhab EM, Mettenleiter TC, Pleschka S. Zoonotic Potential of Influenza A Viruses: A Comprehensive Overview. Viruses. 2018;10:497. DOI: https://doi.org/10.3390/v10090497
Bouvier NM, Palese P. The biology of influenza viruses. Vaccine. 2008;26(4):D49-53. DOI: https://doi.org/10.1016/j.vaccine.2008.07.039
Al Majhdi FN. A report on the association of influenza B virus with respiratory tract infection of hospitalized children in Saudi Arabia. Saudi J Biological Sci. 2009;16:109-11. DOI: https://doi.org/10.1016/j.sjbs.2009.10.008
Rath S. H3N2: A Perspective on Re-emergence of Influenza Pandemic. N Emirates Med J. 2024;5. DOI: https://doi.org/10.2174/0102506882291440240101075435
Yu WCL, Chan RWY, Wang J, Travanty EA, Nicholls JM, Peiris JSM, et al. Viral Replication and Innate Host Responses in Primary Human Alveolar Epithelial Cells and Alveolar Macrophages Infected with Influenza H5N1 and H1N1 Viruses. J Virol. 2011;85(14):6844-55. DOI: https://doi.org/10.1128/JVI.02200-10
Ministry of Health; Family Welfare Seasonal Influenza. Guidelines on categorization of Seasonal Influenza cases during screening for home isolation, testing, treatment and hospitalization. Available at: https://ncdc.mohfw.gov.in/wp-content/uploads/2024/ 02/72513234671561442053-1.pdf. Accessed on 25 June 2025.
Sriram P, Kumar M, Renitha R, Mondal N, Bhat VB. Clinical profile of swine flu in children at Puducherry. Indian J Pediatr. 2010;77(10):1093-5. DOI: https://doi.org/10.1007/s12098-010-0198-7
Mahajan V, Jain S. Clinical Spectrum of Category ‘C’ Swine Flu in Indian Children. Indian Pediatr. 2011;48(12):989. DOI: https://doi.org/10.1007/s13312-011-0145-3
Okada T, Morozumi M, Matsubara K, Komiyama O, Ubukata K, Takahashi T, et al. Characteristic findings of pediatric inpatients with pandemic (H1N1) 2009 virus infection among severe and non-severe illnesses. J Infect Chemother. 2011;17(2):238-45. DOI: https://doi.org/10.1007/s10156-010-0115-z
Leung CH, Tseng HK, Wang WS, Chiang HT, Wu AY, Liu CP. Clinical characteristics of children and adults hospitalized for influenza virus infection. J Microbiol Immunol Infect. 2014;47(6):518-25. DOI: https://doi.org/10.1016/j.jmii.2013.06.002
Rothberg MB, Haessler SD, Brown RB. Complications of Viral Influenza. Am J Med. 2008;121(4):258-64. DOI: https://doi.org/10.1016/j.amjmed.2007.10.040
Lee N, Hurt AC. Neuraminidase inhibitor resistance in influenza: a clinical perspective. Curr Opinion Infect Dis. 2018;31(6):520-6. DOI: https://doi.org/10.1097/QCO.0000000000000498
Lynch JP, Walsh EE. Influenza: evolving strategies in treatment and prevention. Semin Respir Crit Care Med. 2007;28(2):144-58. DOI: https://doi.org/10.1055/s-2007-976487
Szucs T. The socio-economic burden of influenza. J Antimicrobial Chemotherapy. 1999;44(2):11-5. DOI: https://doi.org/10.1093/jac/44.suppl_2.11
Pandemic (H1N1) 2010-update 83. Geneva: World Health Organization. Available at: http://www.who.int/csr/don/20100115/en/index.html. Accessed on 25 June 2025.
Mishra AC, Chadha MS, Choudhary ML, Potdar VA. Pandemic influenza (H1N1) 2009 is associated with severe disease in India. PloS one. 2010;5(5):e10540. DOI: https://doi.org/10.1371/journal.pone.0010540
Munoz FM. Seasonal Influenza in Children Clinical Features and Diagnosis. Upto Date. 2021. Available at: https://www.uptodate.com/contents/seasonal-influenza-in-children-clinical-features-and-diagnosis. Accessed on 25 June 2025.
Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, et al. Decreased influenza activity during the COVID-19 pandemic-United States, Australia, Chile, and South Africa, 2020. Am J Transplant. 2020;20(12):3681-5. DOI: https://doi.org/10.1111/ajt.16381
Soo RJJ, Chiew CJ, Ma S, Pung R, Lee V. Decreased Influenza Incidence under COVID-19 Control Measures, Singapore. Emerg Infect Dis. 2020;26(8):1933-5. DOI: https://doi.org/10.3201/eid2608.201229
Bin Saleh K, Badreldin HA, Alqahtani T, Alsuhebany N, Alowais SA, Sulaiman KA, et al. Assessing the influence of COVID-19 on influenza prevalence: A multicenter time series study. J Infect Public Health. 2023;16(12):1989-93. DOI: https://doi.org/10.1016/j.jiph.2023.09.018
Sarvepalli SS, Cruz ABV, Chopra T, Salimnia H, Chandrasekar P. Striking absence of “usual suspects” during the winter of the coronavirus disease 2019 (COVID-19) pandemic 2020-2021. Infect Control Hosp Epidemiol. 2021;42(12):1516-7. DOI: https://doi.org/10.1017/ice.2021.303
Nicholson KG. Clinical features of influenza. Semin Respir Infect. 1992;7:26-37.
Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, et al. Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med. 2009;361(20):1935-44. DOI: https://doi.org/10.1056/NEJMoa0906695
Libster R, Bugna J, Coviello S, Hijano DR, Dunaiewsky M, Reynoso N, et al. Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. N Engl J Med. 2010;362(1):45-55. DOI: https://doi.org/10.1056/NEJMoa0907673
Munoz FM. The impact of influenza in children. Semin Pediatr Infect Dis. 2002;13(2):72-8. DOI: https://doi.org/10.1053/spid.2002.122992
Downloads
Published
How to Cite
Issue
Section
