Principi Nicola, Esposito Susanna, Marchisio Paola, Gasparini Roberto, Crovari Piero
Peditric Department I, Univeristy of Milan, Milan, Italy.
Pediatr Infect Dis J. 2003 Oct;22(10 Suppl):S207-10. doi: 10.1097/01.inf.0000092188.48726.e4.
Recent studies indicate that influenza can be clinically important in otherwise healthy children. However, the interpretation of many studies is limited because of lack of laboratory confirmation of influenza-like illnesses. Therefore it is difficult to conclude whether the socioeconomic impact of influenza justifies vaccinating all children regardless of age or underlying chronic disorders.
We prospectively collected data from 3771 children younger than 14 years of age presenting to emergency departments or primary care pediatricians with symptoms of respiratory tract infection during the influenza season of 2001 to 2002. Influenza infections were verified by virus culture or polymerase chain reaction. We additionally randomized 303 children age 6 months to 5 years to receive either influenza vaccine (n = 202) or no vaccination (n = 101) before the influenza season. The socioeconomic impact of influenza was assessed for both the participating children and their household contacts.
Influenza was documented in 352 (9.3%) of the 3771 children. Compared with influenza-negative children, children with influenza had longer durations of fever and absenteeism from day care or school (P < 0.0001). Further the numbers of medical visits, missed work or school days and the need for help at home to care for the sick children were higher among the household contacts of influenza-positive children (P < 0.0001). Influenza vaccination reduced significantly the direct and indirect influenza-related costs in healthy children and their unvaccinated family members.
The findings of this study support a wider use of influenza vaccine in healthy children of all ages to reduce the socioeconomic burden of influenza on the community.
近期研究表明,流感对于原本健康的儿童在临床上可能具有重要意义。然而,由于许多研究缺乏对流感样疾病的实验室确诊,其解读受到限制。因此,难以得出流感的社会经济影响是否足以证明无论年龄或潜在慢性疾病如何都应为所有儿童接种疫苗的结论。
我们前瞻性地收集了2001年至2002年流感季节期间到急诊科或初级保健儿科医生处就诊、有呼吸道感染症状的3771名14岁以下儿童的数据。通过病毒培养或聚合酶链反应验证流感感染情况。此外,我们将303名6个月至5岁的儿童随机分组,在流感季节前分别接受流感疫苗接种(n = 202)或不接种疫苗(n = 101)。评估了参与研究的儿童及其家庭接触者流感的社会经济影响。
在3771名儿童中,有352名(9.3%)被证实感染流感。与流感阴性儿童相比,流感阳性儿童发热持续时间更长,日托或学校缺勤时间更长(P < 0.0001)。此外,流感阳性儿童的家庭接触者的就诊次数、误工或缺课天数以及在家中照顾患病儿童所需的帮助需求更高(P < 0.0001)。流感疫苗接种显著降低了健康儿童及其未接种疫苗的家庭成员与流感相关的直接和间接费用。
本研究结果支持在各年龄段健康儿童中更广泛地使用流感疫苗,以减轻流感对社区的社会经济负担。