One in three (35.3%) children developed complications with influenzalike illnesses, and children with neurologic or neuromuscular conditions were at highest risk for complications, according to a recent study.
The most common pediatric complication was pneumonia, seen in 26.1% of the study patients. Dr. Rakesh D. Mistry of the University of Colorado in Aurora, and his colleagues reported in the journal Pediatrics that the complication rate did not vary between influenza and other respiratory viruses. Seizures was another complication that was common, at 5.8%. Interestingly, children with neurological or neuromuscular conditions were also four times more likely to develop complications in general.
The researchers prospectively assessed 241 children aged 0-19 years who presented to a children’s hospital emergency department with influenzalike illness – fever plus a cough or sore throat without another cause – from early winter 2008 to late spring 2010. The study included only children with moderate to severe symptoms (defined by physicians’ decision to do venipuncture and respiratory viral testing) who did not already have severe complications (including seizures, encephalopathy, pneumonia, bacteremia, bacterial tracheitis, respiratory failure, myocarditis, or death.
Overall, 24.9% of the children had influenza, 28.2% had no virus detected, 14.5% had rhinovirus, 11.6% had respiratory syncytial virus, and the remainder had human metapneumovirus, adenovirus, or parainfluenza viruses. Among children with influenza, the risk of developing pneumonia was 7.6 times higher with the H1N1 strain than with other strains.
Asthma was the most common chronic medical condition in the study population but of note, 53.5% of patients in the study were identified as having a chronic underlying disease state. With the finding that children with neurological and neuromuscular disorders also are at higher risk for respiratory viral complications, the authors emphasized that children with chronic health problems need an increased focus by health care providers to provide yearly influenza vaccinations and early institution of antiviral treatment (Pediatrics 2014 Aug. 4 [doi:10.1542/peds.2014-0505]).
The Pennsylvania Department of Health supported the study in part. The authors reported no disclosures.