Korean J Pediatr Infect Dis.  2012 Aug;19(2):61-70.

2009 Pandemic Influenza A(H1N1) Infections in the Pediatric Cancer Patients and Comparative Analysis with Seasonal Influenza

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Seoul, Korea. yaejeankim@skku.edu
  • 2Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients.
METHODS
A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively.
RESULTS
Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections.
CONCLUSION
The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.

Keyword

2009 pandemic Influenza A(H1N1); A(H1N1)pdm09; Seasonal influenza; Child; Cancer

MeSH Terms

Bronchitis
Child
Cross Infection
Encephalitis
Humans
Influenza, Human
Medical Records
Meningitis
Pandemics
Pericarditis
Pneumonia
Respiratory Tract Infections
Retrospective Studies
Risk Factors
Seasons
Ventilators, Mechanical

Figure

  • Fig. 1 Weekly occurrence of A(H1N1)pdm09 infections in pediatric cancer patients. Most A(H1N1)pdm09 infections developed in 43-46th week 2009.


Reference

1. Centers for Disease Control and Prevention. Swine influenza A (H1N1) infection in two children--Southern California, March-April 2009. MMWR Morb Mortal Wkly Rep. 2009. 58:400–402.
2. WHO. World now at the start of Pandemic influenza. accessed on 27 Nov 2011. Available at http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/.
3. accessed on 27 Dec 2011. Available at http://cdc.gov/h1n1flu/estimates_2009_h1n1.htm.
4. Kim JH, Yoo HS, Lee JS, Lee EG, Park HK, Sung YH, et al. The spread of pandemic H1N1 2009 by age and region and the comparison among monitoring tools. J Korean Med Sci. 2010. 25:1109–1112.
Article
5. Cowling BJ, Chan KH, Fang VJ, Lau LL, So HC, Fung RO, et al. Comparative epidemiology of pandemic and seasonal influenza A in households. N Engl J Med. 2010. 362:2175–2184.
Article
6. Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM, et al. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N Engl J Med. 2010. 362:1708–1719.
7. Lessler J, Reich NG, Cummings DA, Nair HP, Jordan HT, Thompson N. Outbreak of 2009 pandemic influenza A (H1N1) at a New York City school. N Engl J Med. 2009. 361:2628–2636.
Article
8. 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. 361:1935–1944.
Article
9. Chowell G, Bertozzi SM, Colchero MA, Lopez-Gatell H, Alpuche-Aranda C, Hernandez M, et al. Severe respiratory disease concurrent with the circulation of H1N1 influenza. N Engl J Med. 2009. 361:674–679.
Article
10. Rihani R, Hayajneh W, Sultan I, Ghatasheh L, Abdel-Rahman F, Hussein N, et al. Infections with the 2009 H1N 1 influenza virus among hematopoietic SCT recipients: a single center experience. Bone Marrow Transplant. 2011. 46:1430–1436.
Article
11. Espinosa-Aguilar L, Green JS, Forrest GN, Ball ED, Maziarz RT, Strasfeld L, et al. Novel H1N1 influenza in hematopoietic stem cell transplantation recipients: two centers' experiences. Biol Blood Marrow Transplant. 2011. 17:566–573.
Article
12. Redelman-Sidi G, Sepkowitz KA, Huang CK, Park S, Stiles J, Eagan J, et al. 2009 H1N1 influenza infection in cancer patients and hematopoietic stem cell transplant recipients. J Infect. 2010. 60:257–263.
Article
13. Standardization of terminology of the Pandemic A (H1N1) 2009 Virus. accessed on 26 Nov 2011. Availabe at http://who.int/influenza/gisrs_laboratory/terminology_ah1n1pdm09/en/.
14. Korea Centers for Disease Control and Prevention. Influenza sentinel surveillance report. accessed on 26 Nov 2011. Available at http://www.cdc.go.kr/.
15. WHO/CDS/CSR/EPH/2002.12. Prevention of hospital-acquired infection. accessed on 3 Feb 2012. Available at http://www.who.int/csr/resources/publications/drugresist/en/whocdsreph200212.pdf.
16. Kang SJ, Lee JM, Hah JO, Shim YJ, Lee KS, Shin HJ, et al. Novel influenza A (H1N1) 2009 infection in the pediatric patients with hematologic and oncologic diseases in the Yeungnam region. Korean J Pediatr. 2011. 54:117–122.
Article
17. Cost C, Brock E, Adams-Huet B, Siegel JD, Ardura MI. 2009 pandemic influenza A (H1N1) virus infection in pediatric oncology and hematopoietic stem cell transplantation patients. Pediatr Blood Cancer. 2011. 56:127–133.
Article
18. Choi SM, Boudreault AA, Xie H, Englund JA, Corey L, Boeckh M. Differences in clinical outcomes after 2009 influenza A/H1N1 and seasonal influenza among hematopoietic cell transplant recipients. Blood. 2011. 117:5050–5056.
Article
19. Seiter K, Nadelman RB, Liu D, Ahmed T, Montecalvo MA. Novel influenza A (H1N1) in patients with hematologic malignancies. J Clin Oncol. 2010. 28:e27–e29.
Article
20. Nichols WG, Guthrie KA, Corey L, Boeckh M. Influenza infections after hematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis. 2004. 39:1300–1306.
Article
21. Gooskens J, Jonges M, Claas EC, Meijer A, Kroes AC. Prolonged influenza virus infection during lymphocytopenia and frequent detection of drug-resistant viruses. J Infect Dis. 2009. 199:1435–1441.
Article
22. Casper C, Englund J, Boeckh M. How I treat influenza in patients with hematologic malignancies. Blood. 2010. 115:1331–1342.
Article
23. WHO. WHO guidelines for pharmacological management of pandemic (H1N1) 2009 influenza and other influenza viruses. accessed on 3 Feb 2012. Available at http://www.who.int/csr/resources/publications/swineflu/h1n1_use_antivirals_20090820/en.
24. Paganini H, Parra A, Ruvinsky S, Viale D, Baumeister E, Bologna R, et al. Clinical features and outcome of 2009 influenza A (H1N1) virus infections in children with malignant diseases: a case-control study. J Pediatr Hematol Oncol. 2011. 33:e5–e8.
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