Children with asthma hospitalized with seasonal or pandemic influenza, 2003-2009.

Abstract

OBJECTIVE:

To describe the characteristics and clinical courses of asthmatic children hospitalized with seasonal or 2009 pandemic H1N1 influenza and compare complications by influenza type.

METHODS:

During the 2003-2009 influenza seasons and the 2009 pandemic, we conducted surveillance of 5.3 million children aged 17 years or younger for hospitalization with laboratory-confirmed influenza and identified those with asthma (defined as those aged 2-17 years with a history of asthma in their medical record or a discharge code for acute asthma exacerbation or status asthmaticus). We collected data from medical records on medical history and clinical course; data on asthma severity and control were not routinely collected.

RESULTS:

During the 2003-2009 influenza seasons, 701 (32%) of 2165 children hospitalized with influenza had asthma; during the 2009 pandemic, 733 (44%) of 1660 children had asthma. The median age of the asthmatic children was 7 years, and 73% had no additional medical conditions. Compared with asthmatic children with seasonal influenza, a higher proportion with 2009 pandemic H1N1 influenza required intensive care (16% vs 22%; P=.01) and were diagnosed with pneumonia (40% vs 46%; P=.04), whereas equal proportions had respiratory failure (5% vs 5%; P=.8) and died (1% vs 1%; P=.4). More asthmatic children with influenza A (seasonal or pandemic) had diagnoses of asthma exacerbations compared with those with influenza B (51% vs 29%; P<.01).

CONCLUSIONS:

The majority of asthmatic children hospitalized with influenza have no additional medical conditions. Complications such as pneumonia and need for intensive care occur in a substantial proportion, highlighting the importance of influenza prevention through vaccination among asthmatic children.

• Authors: Fatimah S Dawood, Laurie Kamimoto, Tiffany A D'Mello, Arthur Reingold, Ken Gershman, James Meek, Kathryn E Arnold, Monica Farley, Patricia Ryan, Ruth Lynfield, Craig Morin, Joan Baumbach, Shelley Zansky, Nancy Bennett, Ann Thomas, William Schaffner, David Kirschke, Lyn Finelli, Emerging Infections Program Network
• Journal: Pediatrics (Pediatrics) Vol. 128 Issue 1 Pg. e27-32 (Jul 2011) ISSN: 1098-4275 [Electronic] United States
• PMID: 21646257 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 by the American Academy of Pediatrics.

Topics

• Adolescent
• Asthma (complications, therapy)
• Child
• Child, Preschool
• Female
• Hospitalization
• Humans
• Influenza, Human (complications, epidemiology, therapy)
• Male
• Pandemics
• Seasons
• Time Factors