Korean J Pediatr Infect Dis.  2011 Dec;18(2):182-192.

The Influence of Atopic Findings on Severity of Pneumonia in Children with 2009 Pandemic Influenza A (H1N1) Infection

Affiliations
  • 1Department of Pediatrics, Fatima Hospital, Daegu, Korea.
  • 2Im Ju Kang Pediatric Clinic, Daegu, Korea. imjukang@hanmail.net

Abstract

PURPOSE
Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection.
METHODS
A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups.
RESULTS
Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P<0.001), asthma (65% vs 35%, P=0.011), allergic rhinitis (71% vs 40%, P=0.009), and IgE level (P=0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P=0.007).
CONCLUSION
Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.

Keyword

2009 Pandemic influenza A (H1N1); Pneumonia; Atopy; Allergic disease

MeSH Terms

Asthma
Child
Eosinophilia
Humans
Immunoglobulin E
Influenza, Human
Pandemics
Pneumonia
Polymerase Chain Reaction
Retrospective Studies
Rhinitis
Rhinitis, Allergic, Perennial
Risk Factors
RNA-Directed DNA Polymerase
Immunoglobulin E
RNA-Directed DNA Polymerase

Reference

1. Garten RJ, Davis CT, Russell CA, Shu B, Lindstrom S, Balish A, et al. Antigenic and genetic characteristics of swine-origin 2009 A (H1N1) influenza viruses circulating in humans. Science. 2009. 325:197–201.
2. Lee HJ, Min SJ, Choi JH, Kang EK. Clinical characteristics of hospitalized pediatric patients with 2009 novel influenza A infection. Pediatr Allergy Respir Dis. 2010. 20:130–137.
3. 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. 58:521–524.
4. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, 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. 361:680–689.
Article
5. KCDC. Cases of influenza A (H1N1) infections in South Korea. Accessed 12 April 2010. Available at: http://www.cdc.go.kr/kcdchome/jsp/home/information/had/INFOHAD0001Detail.jsp?menuid=100053#appid=kcdchome#content=/contents/information/had/b/9261_view.html.
6. WHO. Global alertand response: current WHO phase of pandemic alert. Accessed September 7, 2009. Available at: www.who.int/csr/disease/avian_influenza/phase/en/index.html.
7. WHO. New influenza A (H1N1) virus: global epidemiological situation, June 2009. Wkly Epidemiol Rec. 2009. 84:249–256.
8. Halasa NB. Update on the 2009 pandemic influenza A H1N1 in children. Curr Opin Pediatr. 2010. 22:83–87.
Article
9. Hanshaoworakul W, Simmerman JM, Narueponjirakul U, Sanasuttipun W, Shinde V, Kaewchana S, et al. Severe human influenza infections in Thailand: oseltamivir treatment and risk factors for fatal outcome. PLoS ONE. 2009. 4:e6051.
Article
10. CDC. Hospitalized patients with novel influenza A (H1N1) virus infection-California, April-May, 2009. MMWR Morb Mortal Wkly Rep. 2009. 58:536–541.
11. Loftus BG, Price JF. Clinical and immunological characteristics of pre-school asthma. Clin Allergy. 1986. 16:251–257.
Article
12. Bousquet J, van Cauwenberge P, Khaltaev N. Aria Workshop Group. World Health Organization (WHO). Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001. 108:S147–S334.
Article
13. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980. 92:44–47.
14. Bautista E, Chotpitayasunondh T, Gao Z, Harper SA, Shaw M, Uyeki TM, et al. Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza WC. Clinical aspects of pandemic 2009 influenza A(H1N1) virus infection. N Engl J Med. 2010. 362:1708–1719.
15. Munster VJ, de Wit E, van den Brand JM, Herfst S, Schrauwen EJ, Bestebroer TM, et al. Pathogenesis and transmission of swine-origin 2009 A (H1N1) influenza virus in ferrets. Science. 2009. 325:481–483.
Article
16. Hasegawa S, Hirano R, Hashimoto K, Haneda Y, Shirabe K, Ichiyama T. Characteristics of atopic children with pandemic H1N1 influenza viral infection: Pandemic H1N1 influenza reveals 'occult' asthma of childhood. Pediatr Allergy Immunol. 2011. 22:e119–e123.
Article
17. Rothberg MB, Haessler SD. Complications of seasonal and pandemic influenza. Crit Care Med. 2010. 38:e91–e97.
Article
18. Kwon MK, Kim MR, Park EY, Lee KH, Yoon HS, Kim KN, et al. Clinical analysis of acute respiratory tract infections by influenza virus in children. J Korean Pediatr Soc. 2002. 45:1519–1527.
19. Agarwal PP, Cinti S, Kazerooni EA. Chest radiographic and CT findings in novel swine-origin influenza A (H1N1) virus (S-OIV) infection. AJR Am J Roentgenol. 2009. 193:1488–1493.
Article
20. Lee EY, McAdam AJ, Chaudry G, Fishman MP, Zurakowski D, Boiselle PM. Swine-origin influenza A (H1N1) viral infection in children: initial chest radiographic findings. Radiology. 2010. 254:934–941.
Article
21. Tanaka N, Matsumoto T, Kuramitsu T, Nakaki H, Ito K, Uchisako H, et al. High resolution CT findings in community-acquired pneumonia. J Comput Assist Tomogr. 1996. 20:600–608.
Article
22. O'Shea D, Cawood TJ, O'Farrelly C, Lynch L. Natural killer cells in obesity: impaired function and increased susceptibility to the effects of cigarette smoke. PLoS One. 2010. 5:e8660.
23. Karlsson EA, Sheridan PA, Beck MA. Diet-induced obesity impairs the T cell memory response to influenza virus infection. J Immunol. 2010. 184:3127–3133.
Article
24. Baik I, Curhan GC, Rimm EB, Bendich A. A Prospective study of age and lifestyle factors in relation to community-acquired pneumonia in US men and women. Arch Intern Med. 2000. 160:3082–3088.
Article
25. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005. 293:1861–1867.
Article
26. Berkovich S, Millian SJ, Snyder RD. The association of viral and mycoplasma infections with recurrence of wheezing in the asthmatic child. Ann Allergy. 1970. 28:43–49.
27. Townley RG, Ryo UY, Kolotkin BM, Kang B. Bronchial sensitivity to methacholine in current and former asthmatic and allergic rhinitis patients and control subjects. J Allergy Clin Immunol. 1975. 56:429–442.
Article
28. Ramsdale EH, Morris MM, Roberts RS, Hargreave FE. Bronchial responsiveness to methacholine in chronic bronchitis: relationship to airflow obstruction and cold air responsiveness. Thorax. 1984. 39:912–918.
Article
29. Boulet LP, Turcotte H, Boutet M, Montminy L, Laviolette M. Influence of natural antigenic exposure on expiratory flows, methacholine responsiveness, and airway inflammation in mild allergic asthma. J Allergy Clin Immunol. 1993. 91:883–893.
Article
30. Chakir J, Laviolette M, Boutet M, Laliberte R, Dube J, Boulet LP. Lower airways remodeling in nonasthmatic subjects with allergic rhinitis. Lab Invest. 1996. 75:735–744.
31. Jensen JR, Sand TT, Jorgensen AS, Thestrup-Pederson K. Modulation of natural killer cell activity in patients with atopic dermatitis. J Invest Dermatol. 1984. 82:30–34.
Article
32. Kawakami Y, Tomimori Y, Yumoto K, Hasegawa S, Ando T, Tagaya Y, et al. Inhibition of NK cell activity by IL-17 allows vaccinia virus to induce severe skin lesions in a mouse model of eczema vaccinatum. J Exp Med. 2009. 206:1219–1225.
Article
33. 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. 361:2507–2517.
Article
34. Cui W, Zhao H, Lu X, Wen Y, Zhou Y, Deng B, et al. Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China. BMC Infect Dis. 2010. 10:145.
Article
35. 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
36. Shlomai A, Nutman A, Kotlovsky T, Schechner V, Carmeli Y, Guzner-Gur H. Predictors of pandemic (H1N1) 2009 virus positivity and adverse outcomes among hospitalized patients with a compatible syndrome. Isr Med Assoc J. 2010. 12:622–627.
37. Sun K, Metzger DW. Inhibition of pulmonary antibacterial defense by interferon-gamma during recovery from influenza infection. Nat Med. 2008. 14:558–564.
Article
38. Refaeli Y, Van Parijs L, Alexander SI, Abbas AK. Interferon gamma is required for activation-induced death of T lymphocytes. J Exp Med. 2002. 196:999–1005.
39. Chun JK, Cha BH, Uh Y, Kim HY, Kim YK, Kwon WC, et al. Association of lymphopenia with the clinical severity in the Korean children admitted to the hospital with pandemic (H1N1) 2009 Infection. Infect Chemother. 2011. 43:36–41.
Article
40. Terai M, Honda T, Yamamoto S, Yoshida M, Tsuchiya N, Moriyama Y, et al. Early induction of interleukin-5 and peripheral eosinophilia in acute pneumonia in Japanese children infected by pandemic 2009 influenza A in the Tokyo area. Microbiol Immunol. 2011. 55:341–346.
Article
41. Takano T, Tajiri H, Kashiwagi Y, Kimura S, Kawashima H. Cytokine and chemokine response in children with the 2009 pandemic influenza A (H1N1) virus infection. Eur J Clin Microbiol Infect Dis. 2011. 30:117–120.
Article
42. Guilbert TW, Morgan WJ, Zeiger RS, Bacharier LB, Boehmer SJ, Krawiec M, et al. Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol. 2004. 114:1282–1287.
Article
43. Bush RK, Prochnau JJ. Alternaria-induced asthma. J Allergy Clin Immunol. 2004. 113:227–234.
Article
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