A comparison of H1N1 influenza among pediatric inpatients in the pandemic and post pandemic era |
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| Institution: | 1. Department of Pediatrics (Hospital Medicine and Infectious Diseases), University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;2. University of Colorado School of Medicine, Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, CO, USA;3. Department of Pediatrics, University of Maryland School of Medicine, MD, USA;4. Department of Pediatrics (Hospital Medicine), University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;5. Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;6. Department of Pediatrics (Infectious Diseases), University of Colorado School Of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;1. Green Lane Paediatric and Congenital Cardiac Services, Starship Children’s Hospital, Auckland, New Zealand;2. Paediatric Infectious Diseases, Starship Children’s Hospital, Auckland, New Zealand;1. Priority Research Centre Grow Up Well, University of Newcastle, Newcastle, New South Wales, Australia;2. Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia;3. Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia;1. Respiratory Viruses Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain;2. Preventive Medicine and Epidemiology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Vall Hebron Research Institute, Barcelona, Spain;1. Department of Biochemistry, Penang International Dental college, Vinayaka, Mission University, Salem 636 011, TamilNadu, India;2. Chellam Multispeciality Centre, Salem 636007, TamilNadu, India;3. Laboratory of Bioprocess and Engineering, Department of Biochemistry, Periyar University, Salem 636 011, TamilNadu, India;1. WHO Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia;2. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA;3. Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia;4. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, China |
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| Abstract: | BackgroundThe novel influenza A H1N1 (AH1N1]pdm09) strain emerged in 2009, contributing to significant morbidity and mortality. It is not known whether illness associated with A(H1N1) pdm09 in the post-pandemic era exhibits a similar disease profile.ObjectiveThe objectives of this study were to compare the burden of disease of A(H1N1) pdm09 influenza from the 2009 pandemic year to the post-pandemic years (2010–2014), and to explore potential reasons for any differences.Study designWe conducted a retrospective cohort study of inpatients admitted to Children’s Hospital Colorado with a positive respiratory specimen for influenza from May–December, 2009 and December, 2010–April, 2014. Univariate and multivariate analyses were conducted to compare the demographics and clinical characteristics of patients with H1N1 during the two periods.ResultsThere were 388 inpatients with influenza A(H1N1) pdm09 in 2009, and 117 during the post-pandemic years. Ninety-four percent of all H1N1 during the post-pandemic era was observed during the 2013–2014 influenza season. Patients with A(H1N1) pdm09 during the post-pandemic year were less likely to have an underlying medical condition (P < 0.01). Patients admitted to the ICU during the post-pandemic year had a lower median age (5 vs 8 years, P = 0.01) and a lower proportion of patients were intubated, had mental status changes, and ARDS compared with the pandemic years, (P < 0.01 for all), with decreased mortality (P = 0.02).ConclusionPatients with influenza A(H1N1) pdm09 during the post-pandemic years appeared to have less severe disease than patients with A(H1N1) pdm09 during the pandemic year. The reasons for this difference are likely multifactorial. |
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| Keywords: | Influenza Inpatients H1N1 Pandemic Post-pandemic period |
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