Clinical profile and outcome of swine flu in Indian children

• Published in: Indian pediatrics 2011-05, Vol.48 (5), p.373-378, Article 373
• Main Authors: Das, Rashmi Ranjan, Sami, Abdus, Lodha, Rakesh, Jain, Richa, Broor, S., Kaushik, S., Singh, B. B., Ahmed, M., Seth, Rachna, Kabra, Sushil K.
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Female; Humans; India - epidemiology; Influenza A Virus, H1N1 Subtype; Influenza, Human - epidemiology; Influenza, Human - pathology; Influenza, Human - therapy; Influenza, Human - virology; Male; Maternal and Child Health; Medicine; Medicine & Public Health; Pediatric Surgery; Pediatrics; Research Paper; Retrospective Studies; Risk Factors; Treatment Outcome
• ISSN: 0019-6061; 0974-7559
• DOI: 10.1007/s13312-011-0085-y

Objective To describe the clinical characteristics and outcome of Indian children infected with 2009 H1N1 influenza virus. Study design Retrospective chart review. Setting Outpatient department and hospitalized patients in a tertiary care hospital. Methods Clinical details of 85 children (positive for the 2009 H1N1 virus infection tested by real-time reverse-transcriptase-polymerase-chain-reaction assay) were analyzed from medical charts. Results Of the 85 (55 boys) children positive for 2009 H1N1 virus infection, 64.7% were between 5 years to 16 years, and 35.3% were below 5 years age. The mean age of these children was 7.5±3.5 yr. Contact history was positive only in 22 (26%) cases. High grade fever was the most common symptom, followed by cough and rhinorrhea. Twenty-nine (34%) patients had an underlying co-morbid condition. Of the 34 patients who underwent chest radiography during evaluation, 18 children (52.9%) had findings consistent with lower respiratory tract infection. Antiviral therapy was initiated in 76 patients. Hospitalization was required in 30 (35.3%) children. Risk factors for hospitalization included underlying co-morbid condition, respiratory distress, vomiting, wheezing, diarrhea, hypotension and infiltrates/consolidation on chest radiograph. Mean length of hospitalization was 131±76 hours, irrespective of underlying disease. Three children developed Acute Respiratory Distress Syndrome and died. Conclusions Clinical features and routine laboratory investigations in children with swine origin influenza were non-specific. Children with co-morbid condition, respiratory distress, vomiting, wheezing, diarrhea, hypotension and infiltrates/consolidation on chest radiograph were at higher risk of hospitalization.