Burden of Seasonal Influenza Hospitalization in Children, United States, 2003 to 2008
Burden of Seasonal Influenza Hospitalization in Children, United States, 2003 to 2008
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DOI：
10.1016/j.jpeds.2010.05.012
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发表时间：
2010-11-01
影响因子：
5.1
通讯作者：
Finelli, Lyn
中科院分区：
文献类型：
--
作者：
Dawood, Fatimah S.;Fiore, Anthony;Finelli, Lyn
目的评估2003 - 2008年在一个大的、多样化的监测区域内18岁以下儿童季节性流感的住院率。研究设计通过新发感染项目网络，在10个州进行了以人群为基础的实验室确诊流感监测，包括530万儿童。回顾性地确定住院儿童;临床医生做出流感检测决定。从医院记录中收集的数据包括人口统计学，病史和临床过程。结果6个月以下儿童住院率最高（季节性变化，9 ~ 30/万），5 ~ 17岁儿童住院率最低（0.3 ~ 0.8/万）。总体而言，有4015名儿童住院，其中58%仅通过快速诊断测试确定。40%的住院儿童有基础疾病;哮喘（18%），早产（15%的2岁以下儿童）和发育迟缓（7%）是最常见的。严重的结果包括重症监护病房入院（12%），呼吸衰竭（5%），细菌合并感染（2%），死亡（0.5%）。结论流感相关的住院率因季节和年龄而异，可能低估了真实的利率，因为许多住院儿童没有进行流感检测。在不同季节，出现严重后果的儿童比例都很大。量化流感住院和严重结局的发生率对于确定疾病负担至关重要。（J Pediatr 2010;157：808-14）。
Objectives To estimate the rates of hospitalization with seasonal influenza in children aged < 18 years from a large, diverse surveillance area during 2003 to 2008.Study design Through the Emerging Infections Program Network, population-based surveillance for laboratory-confirmed influenza was conducted in 10 states, including 5.3 million children. Hospitalized children were identified retrospectively; clinicians made influenza testing decisions. Data collected from the hospital record included demo-graphics, medical history, and clinical course. Incidence rates were calculated with census data.Results The highest hospitalization rates occurred in children aged < 6 months (seasonal range, 9-30/10 000 children), and the lowest rates occurred in children aged 5 to 17 years (0.3-0.8/10 000). Overall, 4015 children were hospitalized, 58% of whom were identified with rapid diagnostic tests alone. Forty percent of the children who were hospitalized had underlying medical conditions; asthma (18%), prematurity (15% of children aged < 2 years), and developmental delay (7%) were the most common. Severe outcomes included intensive care unit admission (12%), respiratory failure (5%), bacterial coinfection (2%), and death (0.5%).Conclusions Influenza-associated hospitalization rates varied by season and age and likely underestimate true rates because many hospitalized children are not tested for influenza. The proportion of children with severe outcomes was substantial across seasons. Quantifying incidence of influenza hospitalization and severe outcomes is critical to defining disease burden. (J Pediatr 2010;157:808-14).