Influenza Virus Infection in Infants Less than Three Months of Age
Bender , Jeffrey M. MD; Ampofo, Krow MD; Gesteland, Per MD, MSc; Sheng, Xiaoming PhD; Korgenski, Kent MS; Raines, Bill; Daly, Judy A. PhD; Valentine , Karen MS;
Bender , Jeffrey M. MD; Ampofo, Krow MD; Gesteland, Per MD, MSc; Sheng, Xiaoming PhD; Korgenski, Kent MS; Raines, Bill; Daly, Judy A. PhD; Valentine , Karen MS;
Srivastava, Rajendu MD, FRCP(C), MPH; Pavia, Andrew T. MD; Byington, Carrie L. MD
Abstract
Objective: We evaluated the presentation, outcomes, and the risk of serious bacterial infection (SBI) in infants < 3 months old with influenza virus infection. Patients and Methods: We identified demographic, hospitalization, and microbiologic data from computerized medical records for all infants and children < 24 months of age, with laboratory confirmed influenza infection cared for at a tertiary care children's hospital during 4 winter seasons (20042008). We compared those < 3 months of age with older groups. Results: We identified 833 children < 24 months of age with laboratory-confirmed influenza. Of those , 218 were < 3 months old. Influenza accounted for 3.6% of all evaluationsof febrile infants and 12% of febrile infant encounters during winter. Infants < 3 months of age were less likely to have a high risk chronic medical condition , but were more likely to be hospitalized than children 3 to < 24 months old (P < 0.005). Infants < 3 months with influenza had fewer prolonged hospital stays than those 3 to < 6 months old [P = 0.056; OR: 0 .5 (0.24 1.0 )] and 6 to < 12 months old [P = 0.011; OR: 0.43 (0.240 .83)]. Five (2 .3%) infants < 3 months old had SBI.
Objective: We evaluated the presentation, outcomes, and the risk of serious bacterial infection (SBI) in infants < 3 months old with influenza virus infection. Patients and Methods: We identified demographic, hospitalization, and microbiologic data from computerized medical records for all infants and children < 24 months of age, with laboratory confirmed influenza infection cared for at a tertiary care children's hospital during 4 winter seasons (20042008). We compared those < 3 months of age with older groups. Results: We identified 833 children < 24 months of age with laboratory-confirmed influenza. Of those , 218 were < 3 months old. Influenza accounted for 3.6% of all evaluationsof febrile infants and 12% of febrile infant encounters during winter. Infants < 3 months of age were less likely to have a high risk chronic medical condition , but were more likely to be hospitalized than children 3 to < 24 months old (P < 0.005). Infants < 3 months with influenza had fewer prolonged hospital stays than those 3 to < 6 months old [P = 0.056; OR: 0 .5 (0.24 1.0 )] and 6 to < 12 months old [P = 0.011; OR: 0.43 (0.240 .83)]. Five (2 .3%) infants < 3 months old had SBI.
Conclusions: Infants< 3 months of age with influenza virus infection often present with fever alone. Although they are more likely to be hospitalized than those 3 to < 24 months old, hospital stays are short and outcomes generally good. Infants with influenza virus infectionhave a low risk of concomitant SBI. Introduction
Febrile infants younger than 3 months are often evaluated for serious bacterial infection (SBI). Approximately 8 .5% to 9 .5% of these infants have a SBI, with the remaining fevers presumably caused by viral illness.[1,2] Many studies have demonstrated that febrile infants with the clinical diagnosis of a specific viral illness such as bronchiolitis or a laboratory confirmed diagnosis of enterovirus or respiratory syncytial virus (RSV), are at lower risk for SBI than those with otherwise undifferentiated fever.[211] There are few data on the risk of SBI and outcomes of young infants with laboratory-confirmed influenza.
Influenza is a common viral cause of fever in young children during the winter.[12 ,13 ] Unlike other respiratory viruses, influenza frequently presents with high fever [14 ] that can be difficult to differentiate from SBI. In infants younger than 3 months, this often results in an evaluation for SBI and hospitalization.
Influenza vaccination is recommended for infants and children 6 months and older. Recent studies have demonstrated significant morbidity and mortality associated with influenza infection in infants younger than 6 months who are too young to be immunized. [15 17] Likewise, influenza infection in infants 6 months and younger may lead to high hospitalization rates and associated hospital costs.[17 19 ]
The objective of this study was to describe the outcomes, including rates of concomitant SBI, of a large cohort of infants younger than 3 months of age with laboratory confirmed influenza . We compare the outcomes of this group of infants with the outcomes among infants and children 3 to < 24 months old. DOWNLOAD COMPLETE PDF HERE
Febrile infants younger than 3 months are often evaluated for serious bacterial infection (SBI). Approximately 8 .5% to 9 .5% of these infants have a SBI, with the remaining fevers presumably caused by viral illness.[1,2] Many studies have demonstrated that febrile infants with the clinical diagnosis of a specific viral illness such as bronchiolitis or a laboratory confirmed diagnosis of enterovirus or respiratory syncytial virus (RSV), are at lower risk for SBI than those with otherwise undifferentiated fever.[211] There are few data on the risk of SBI and outcomes of young infants with laboratory-confirmed influenza.
Influenza is a common viral cause of fever in young children during the winter.[12 ,13 ] Unlike other respiratory viruses, influenza frequently presents with high fever [14 ] that can be difficult to differentiate from SBI. In infants younger than 3 months, this often results in an evaluation for SBI and hospitalization.
Influenza vaccination is recommended for infants and children 6 months and older. Recent studies have demonstrated significant morbidity and mortality associated with influenza infection in infants younger than 6 months who are too young to be immunized. [15 17] Likewise, influenza infection in infants 6 months and younger may lead to high hospitalization rates and associated hospital costs.[17 19 ]
The objective of this study was to describe the outcomes, including rates of concomitant SBI, of a large cohort of infants younger than 3 months of age with laboratory confirmed influenza . We compare the outcomes of this group of infants with the outcomes among infants and children 3 to < 24 months old. DOWNLOAD COMPLETE PDF HERE
Yes, great information here! My opinion is that the older people and adults with low immunity are also exposed to influenza infection. So vaccination is recommended for everybody.
i agree. thanks for comment.