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35% of children get complications from flulike illness.


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 commonly developed complication was pneumonia (26.1% of the participants), but the overall rate of complications did not vary among those who had influenza, compared with those with a different virus, Dr. Rakesh D. Mistry of the University of Colorado in Aurora, and his colleagues reported online (Pediatrics 2014 Aug. 4 [doi: 10.1542/peds.2014-0505]). The next most common complications were respiratory failure (7.1%) and seizures (5.8%).

The researchers prospectively assessed 241 children aged 0-19 years who presented to a children's hospital emergency department with influenza-like illness--fever plus a cough or sore throat without another cause--from early winter 2008 to late spring 2010.

The study included only children who had moderate to severe symptoms (defined by physicians' decision to do venipuncture and respiratory viral testing) who did not already have severe complications. Severe complications included 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, Dr. Mistry and his coinvestigators said.

Asthma was the most common chronic medical condition among the 53.5% of children who had one. Although children with neurologic or neuromuscular conditions were four times more likely to develop complications, no other high-risk conditions were linked to complications, and 41.2% of children developing complications had no underlying conditions.

Dr. Mistry and his associates wrote that their findings regarding children with underlying conditions "support the need for increased preventive measures in this subgroup of children, including influenza vaccination and early institution of antiviral treatment."

The study was supported in part by the Commonwealth of Pennsylvania Department of Health. The authors reported no disclosures.


Key clinical point: Keep an eye out for severe complications of influenza-like illness, whether or not children have underlying conditions

Major finding: Severe complications from complications of influenza-like illness occurred in 35.3% of children, and those with neurologic or neuromuscular conditions were four times more likely to develop complications.

Data source: The findings are based on a prospective cohort study of 241 children, aged 0-19 years, presenting to an emergency department during respiratory viral seasons during 2008-2010.

Disclosures: The study was supported by the Commonwealth of Pennsylvania Department of Health. The authors reported no disclosures.

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Author:Haelle, Tara
Publication:Family Practice News
Date:Aug 1, 2014
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