Clinical profile and outcome of swine flu in Indian children.

OBJECTIVE

To describe the clinical characteristics and outcome of Indian children infected with 2009 H1N1 influenza virus.

STUDY

DESIGN

Retrospective chart review.

SETTING

Outpatient department and hospitalized patients in a tertiary care hospital.

METHODS

Clinical details of 85 children (positive for the 2009 H1N1 virus infection tested by real time reverse transcriptas epolymerasechain reaction assay) were analyzed from medical charts.

RESULTS

Of the 85 (55 boys) children positive for 2009 H1N1 virus infection, 64.7%were between 5 years to 16 years, and 35.3%were below 5 years age. The mean age of these children was 7.5±3.5 yr. Contact history was positive only in 22 (26%) cases. High grade fever was the most common symptom, followed by cough and rhinorrhea. Twenty-nine (34%) patients had an underlying co-morbid condition. Of the 34 patients who underwent chest radiography during evaluation, 18 children (52.9%) had findings consistent with lower respiratory tract infection. Antiviral therapy was initiated in 76 patients. Hospitalization was required in 30 (35.3%) children. Risk factors for hospitalization included underlying co-morbid condition, respiratory distress, vomiting, wheezing, diarrhea, hypotension and infiltrates/consolidation on chest radiograph. Mean length of hospitalization was 131±76 hours, irrespective of underlying disease. Three children developed Acute Respiratory Distress Syndrome and died.

CONCLUSIONS

Clinical features and routine laboratory investigations in children with swine origin influenza were non-specific. Children with co-morbid condition, respiratory distress, vomiting, wheezing, diarrhea, hypotension and infiltrates/consolidation on chest radiograph were at higher risk of hospitalization.