Novel inpatient surveillance in tertiary paediatric hospitals in New South Wales illustrates impact of first-wave pandemic influenza A H1N1 (2009) and informs future health service planning.

To document the impact of pandemic influenza A H1N1 (2009) in New South Wales (NSW) children's hospitals. A novel surveillance system, Paediatric Active Enhanced Disease Surveillance (PAEDS), identified hospitalised children <15 years with laboratory-proven influenza (1 June-30 September 2009) in the three children's hospitals in NSW: Children's Hospital at Westmead (CHW), Sydney Children's Hospital, John Hunter Children's Hospital. Clinical characteristics, management and complications were documented, and at CHW comparison made with 2007 data. The 324 children identified represented 1802 hospital bed-days and 230 PICU bed-days. Most (73.1%) children had H1N1, one had an oseltamivir-resistant isolate. Median age was 2.5 years: 65% were <5 years. Although 80.9% had cough, 8.0% had no respiratory symptoms. Complications occurred in 34.6%, of whom 56% were previously healthy. Only 50% received antivirals. Forty children (12.3%) were admitted to PICU: one child with H1N1 died. At CHW, comparison between 2009 and 2007 showed nearly twice the total number of admissions (226 vs. 122) and PICU admissions (22 vs. 13), but no deaths either year. Vomiting was more frequent in 2009 than 2007 (38.5% vs. 13.1%; P = 0.0001) as were neurological complications (11.4% vs. 2.4%; P = 0.0027) but length of hospital and PICU stay were similar. PAEDS is a valuable surveillance tool that documented the impact of the H1N1 (2009) pandemic in NSW children's hospitals. High numbers of complications, often in previously well children, suggest an important role for early diagnosis, antiviral therapy and influenza vaccination. Observed regional differences identify areas potentially at greater risk in a subsequent wave.

Elliott EJ ，Zurynski YA ，Walls T ，Whitehead B ，Gilmour R ，Booy R ，Members of SWINet ... -  《-》

The burden of influenza in children under 5 years admitted to the Children's Hospital at Westmead in the winter of 2006.

Iskander M ，Kesson A ，Dwyer D ，Rost L ，Pym M ，Wang H ，McCaskill M ，Booy R ... -  《-》

Clinical and epidemiological features of Turkish children with 2009 pandemic influenza A (H1N1) infection: experience from multiple tertiary paediatric centres in Turkey.

Çiftçi E ，Tuygun N ，Özdemir H ，Tezer H ，Şensoy G ，Devrim İ ，Dalgiç N ，Kara A ，Turgut M ，Tapisiz A ，Keser M ，Çelebi S ，Bayram N ，Kocabaş E ，Dinleyici EÇ ，Özen M ，Soysal A ，Kuyucu N ，Tanir G ，Çelikel E ，Belet N ，Evren G ，Aytaç DB ，Cengiz AB ，Canöz PY ，Derinöz O ，İnce E ，Hacimustafaoğlu M ，Anil M ，Özgür Ö ，Kuzdan C ，Özaydin E ，Aşilioğlu N ，Dizdarer C ，Ceyhan M ，Bucak IH ，Kendirli T ，Yakut Hİ ，Fişgin T ，Ünal N ，Altindağ H ，Kilinç AA ，Zöhre SU ，Elhan AH ，Doğru Ü ... -  《-》

2009 pandemic influenza A (H1N1) in critically ill children in Cincinnati, Ohio.

Morgan CI ，Hobson MJ ，Seger B ，Rice MA ，Staat MA ，Wheeler DS ... -  《Pediatric Critical Care Medicine》

Influenza infection in infants aged <6 months during the H1N1-09 pandemic: a hospital-based case series.

To document risk factors, clinical features and outcomes in infants <6 months old admitted with laboratory-confirmed influenza to The Children's Hospital at Westmead during the H1N1-09 pandemic. Prospective, hospital-based case series of infants admitted June-September 2009, identified by the Paediatric Active Enhanced Disease Surveillance system and supplemented by telephone interview post-discharge. Thirty-two infants <6 months old had influenza A: 18 H1N1-09, 11 H3N2 and three unknown subtypes. After discharge, 28 (88%) families were telephoned and provided additional information. Documented risk factors included close contact with young children (46%), living with a smoker (36%), intensive or special care at birth (25%), pre-existing illness (16%) and preterm birth (14%). The number of persons per household was double the state average. Only 14% of mothers were vaccinated against seasonal influenza. Infants commonly presented with cough (69%), coryza (69%), lethargy (38%), fever (31%), dyspnoea (31%) and vomiting (28%). Complications included pneumonia (22%), and bacterial (9%) and viral (6%) co-infection. Five infants (15%) required admission to intensive care, and one was mechanically ventilated. Sixteen (57%) had ongoing respiratory problems, and six (21%) presented to the Emergency Department within 6 months of discharge. These novel data are clinically important. Rates of influenza in infants may be reduced by vaccinating close contacts and minimising exposure to infected contacts and cigarette smoke.

Esterman EE ，Lahra MM ，Zurynski YA ，Booy R ，Elliott EJ ... -  《-》