Deniz ÇAKIR, Solmaz ÇELEBİ, Mustafa Turhan HACIMUSTAFAOĞLU, Enes SALI, Taner ÖZGÜR

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Çocuklarda Pandemik 2009 İnfluenza A H1N1 Enfeksiyonu

Gi rifl: Kasım-Aralık 2009 tarihleri arasında influenza benzeri hastalık tanımına uyan vepnömoniyle gelişen, hastaneye yatırılan 68 olgu ile ilgili deneyimlerimizin paylaşılmasıamaçlandı.Gereç ve Yöntem: Kanıtlanmış pandemik 2009 influenza pozitif olgular ile negatifolgular klinik belirti ve bulgular, laboratuvar ve radyolojik görüntüleme sonuçları,hastanede ve yoğun bakımda yatış süreleri, almış oldukları tedaviler vekomplikasyonlar açısından karşılaştırıldı.Bulgular: Her iki grup arasında cinsiyet dağılımı açısından anlamlı bir fark saptanmadı.Pozitif olgularda 5 yaş üstü olgu sayısı aynı yaş grubundaki negatif olgulara göreanlamlı oranda yüksek saptandı p=0,004 . Pozitif olguların %78,8'inin, negatif olguların%68,8'inin altta yatan hastalığı vardı p=0,57 . Pozitif grupta ishal görülme oranı negatifgruptan anlamlı olarak yüksek saptandı p=0,02 . Mevsimsel influenza aşılanmaoranlarının düşüklüğü dikkat çekiciydi. Her iki grup arasında aşılanma oranlarıaçısından anlamlı bir fark saptanmadı p=0,99 .Sonuç: Hastalığın ciddiyeti pozitif ve negatif olgularda benzer seyretmiştir. Her ikigrupta da altta yatan hastalığı olanların oranının yükseldiği dikkat çekmektedir
Anahtar Kelimeler:

Pandemik 2009 influenza A, çocukluk çağı, pnömoni

Pandemic 2009 Influenza A H1N1 Infection in Children

In tro duc ti on: The aim of this study is to share our experience of sixty-eight pediatric hospitalizations associated with influenza-like illness and pneumonia betweenNovember, 2009 and December, 2009.Materials and Methods: Clinical signs and symptoms, laboratory and radiological results,length of stay in hospital and intensive care unit, treatments and complications werecompared in laboratory confirmed pandemic influenza A positive and negative cases.Results: There was no significant difference in gender distribution between the twogroups. The number of positive cases in patients over 5 years of age were significantlyhigher than the same age group in negative patients p=0.004 . There were underlyinghealth conditions in 78.8% of the positive cases and in 68.8% of the negative cases p=0.57 . The incidence of diarrhea in positive group was significantly higher than in thenegative group p=0.02 . Low immunization rates of the seasonal influenza vaccine wereremarkable in each group. There was no significant difference in vaccination ratesbetween the two groups p=0.99 .Conclusions: The severity of the disease remained similar in patients with positive andnegative groups. In both groups, the high ratio of those having an underlying disease wasnoteworthy
Keywords:

Pandemic 2009 influenza A, childhood, pneumonia,

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  • 1. Centers for Disease Control and Prevention (CDC). Outbreak of swine-origin influenza A (H1N1) virus infection-Mexico, March￾April 2009. MMWR Morb Mortal Wkly Rep 2009;58:467-70.
  • 2. World Health Organization (WHO). Pandemic (H1N1) 2009- update 70. Available from http://www.who.int/csr/don/ 2009_10_16/en/index.html (accessed October 20, 2009).
  • 3. World Health Organization (WHO). Preparing for the second wave: lessons from current outbreaks. Available from http://www.who.int/csr/disease/swineflu/notes/h1n1_second _wave_20090828/en/ index.html (accessed October 25, 2009).
  • 4. World Health Organization (WHO). Pandemic (H1N1) 2009- update 69. Available from http://www.who.int/csr/don/ 2009_10_09/en/index.html (accessed October 11, 2009).
  • 5. T.C. Sağlık Bakanlığı. Erişim http://www.grip.gov.tr/images/ stories/sunum/ saglik_personeli_ h1n1 _ sunum_20039.pdf (Erişim Tarihi:25 Haziran 2010).
  • 6. Centers for Disease Control and Prevention (CDC). Hospitalized patients with novel influenza A (H1N1) virus infection￾California, April-May, 2009. MMWR Morb Mortal Wkly Rep 2009;58:536-41.
  • 7. Perez-Padilla R, De La Rosa-Zamboni D, De Leon SP, Hernandez M, Quiñones-Falconi F, Bautista E et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009;361:680-9.
  • 8. Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team, Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ et al. Emergence of a novel swine origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360:2605-15.
  • 9. 2009-2010 Influenza season triage algorithm for children (≤18 years) with influenza-like illness. Available from http://www.cdc.gov/h 1n1flu/clinicians/pdf/childalgorithm2.pdf (accessed October 16,2009).
  • 10. Wardlaw TM, Johansson EW, Hodge M (eds) Pneumonia: the forgotten killer of children. UNICEF/WHO, 2006, p.24-5.
  • 11. Lister P, Reynolds F, Parslow R, Chan A, Cooper M, Plunkett A et al. Swine-origin influenza virus H1N1, seasonal influenza virus, and critical illness in children. Lancet 2009;374:605-7.
  • 12. O'Riordan S, Barton M, Yau Y, Read SE, Allen U, Tran D. Risk factors and outcomes among children admitted to hospital with pandemic H1N1 influenza. CMAJ 2010;182:39-44.
  • 13. Hancock K, Veguilla V, Lu X, Zhong W, Butler EN, Sun H et al. Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N Engl J Med 2009;361:1945-52.
  • 14. Dolin R, Wise TG, Mazur MH, Tuazon CU, Ennis FA. Immunogenicity and reactogenicity of influenza A/New Jersey/76 virus vaccines in normal adults. J Infect Dis 1977;136 Suppl:435-42.
  • 15. Centers for Disease Control and Prevention (CDC). Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. MMWR Morb Mortal Wkly Rep 2009;58:521-4.
  • 16. Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 2009;361: 1935-44.
  • 17. Kelly H, Grant K. Interim analysis of pandemic influenza (H1N1) 2009 in Australia: surveillance trends, age of infection and effectiveness of seasonal vaccination. Euro Surveill 2009;14(31). pii: 19288.
  • 18. Hackett S, Hill L, Patel J, Ratnaraja N, Ifeyinwa A, Farooqi M et al. Clinical characteristics of paediatric H1N1 admissions in Birmingham, UK. Lancet 2009;374:605.
  • 19. Larcombe PJ, Moloney SE, Schmidt PA. Pandemic (H1N1) 2009: a clinical spectrum in the general paediatric population. Arch Dis Child. 2011;96:96-8.
  • 20. Bettinger A, Sauve LJ, Schefeile DW, Moore D, Vaudry W, Tran D et al. Pandemic influenza in Canadian children: A summary of hospitalized pediatric cases. Vaccine 2010;28:3180-4.
  • 21. Libster R, Bugna J, Coviello S, Hijano DR, Dunaiewsky M, Reynoso N et al. Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. N Engl J Med 2010;362:45-55.
  • 22. Turner SJ, Brown LE, Doherty PC, Kelso A. Q&A: What have we found out about the influenza A (H1N1) 2009 pandemic virus? J Biol 2009;8:69.
  • 23. Maines TR, Jayaraman A, Belser JA, Wadford DA, Pappas C, Zeng H et al. Transmission and pathogenesis of swine-origin 2009 A(H1N1) influenza viruses inferrets and mice. Science 2009;325:484-7.
  • 24. Lyon JB, Remigio C, Milligan T, Deline C. Acute necrotizing encephalopathy in a child with H1N1 influenza infection. Pediatr Radiol 2010;40:200-5.
  • 25. Department of Health (DH). Pandemic H1N1 2009 Influenza: Clinical Management Guidelines or Adults and Children. Available from http://www.dh.gov.uk/en/Publicationsandstatistics/ Publications/PublicationsPolicyAndGuidance/DH_107769 (accessed November 19, 2009)
  • 26. Cao B, Li XW, Mao Y, Wang J, Lu HZ, Chen YS et al. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in China. N Engl J Med 2009;361:2507-17.
  • 27. Centers for Disease Control and Prevention (CDC). Surveillance for pediatric deaths associated with 2009 pandemic influenza A (H1N1) virus infection: United States, April–August 2009. MMWR Morb Mortal Wkly Rep 2009;58:941-7.
  • 28. Centers for Disease Control and Prevention (CDC). Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1): United States, May–August 2009. MMWR Morb Mortal Wkly Rep 2009;58:1071-4.
  • 29. Finelli L, Fiore A, Dhara R, Brammer L, Shay DK, Kamimoto L et al. Influenza-associated pediatric mortality in the United States: increase of Staphylococcus aureus coinfection. Pediatrics 2008;122:805-11.
  • 30. Poehling KA, Edwards KM, Weinberg GA, Szilagyi P, Staat MA, Iwane MK et al. The underrecognized burden of influenza in young children. N Engl J Med 2006;355:31-40.
  • 31. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000;342:225-31.
  • 32. WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. Geneva: World Health Organization, August 20, 2009 Available from http://www.who.int/csr/resources/publications/swineflu/ h1n1_use_antivirals_20090820/en/index.html (accessed October 21,2009).
  • 33. Palacios G, Hornig M, Cisterna D, Savji N, Bussetti AV, Kapoor V et al. Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza. PLoS One 2009;4:e8540.
  • 34. Morens DM, Taubenberger, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis 2008;198:962-70.
  • 35. Lee EY, McAdam AJ, Chaudry G, Fishman MP, Zurakowski D, Boiselle PM. Swine-Origin Infl uenza A (H1N1) Viral Infection in Children: Initial Chest Radiographic Findings. Radiology 2010;254:934-41.
  • 36. Denholm JT, Gordon C, Johnson P, Hewagama SS, Stuart RL, Aboltins C et al. Hospitalised adult patients with pandemic (H1N1) 2009 influenza in Melbourne, Australia. Med J Aust 2010;192:84-6.
Güncel Pediatri-Cover
  • Başlangıç: 2003
  • Yayıncı: Erkan Mor
Arşiv
Sayıdaki Diğer Makaleler

Çocuklarda Pandemik 2009 İnfluenza A H1N1 Enfeksiyonu

Deniz ÇAKIR, Solmaz ÇELEBİ, Mustafa Turhan HACIMUSTAFAOĞLU, Enes SALI, Taner ÖZGÜR