Divisions of Infectious Diseases, Paediatric Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada.
Acad Pediatr. 2011 Jan-Feb;11(1):66-74. doi: 10.1016/j.acap.2010.12.010.
The pandemic influenza H1N1 2009 (pH1N1) virus is expected to remain a prominent circulating strain in the current and subsequent influenza seasons. The objective of this study was to compare the clinical course of infection with laboratory-confirmed pH1N1 and seasonal influenza A and B in a cohort of previously healthy children managed in the outpatient setting without antiviral therapy.
Previously healthy children 17 years of age or younger were prospectively enrolled during the first wave of the 2009 pandemic (May-July 2009) and the 2 preceding influenza seasons from a single primary care physician office and a tertiary children's hospital emergency department. Inclusion criteria were: age ≤17 years; laboratory-confirmed influenza; and not receiving antiviral agents. Follow-up telephone interviews were conducted approximately 2 days and 14 days after presentation to assess symptom duration.
A total of 251 patients (101 with pH1N1, 90 with seasonal influenza A, 60 with seasonal influenza B) were included. Presenting symptoms and duration of symptoms associated with pH1N1 were similar to those with seasonal influenza. Median fever duration in pH1N1 was 3 days and had resolved within 8 days in 95% of patients. Among patients with pH1N1, abnormalities on chest auscultation (10 of 101), the hospitalization rate (2 of 101), the proportion of children receiving intravenous fluid therapy (1 of 101) or supplemental oxygen (1 of 101) were not significantly different from patients with seasonal influenza.
In most children without underlying risk factors for severe influenza, pH1N1 virus causes an uncomplicated respiratory tract illness, no more severe than seasonal influenza.
预计 2009 年大流行性流感 H1N1（pH1N1）病毒将继续成为当前和随后流感季节的主要流行株。本研究的目的是比较在门诊环境中未接受抗病毒治疗的既往健康儿童中，经实验室确认的 pH1N1 和季节性流感 A 和 B 的感染临床过程。
在 2009 年大流行的第一波（2009 年 5 月至 7 月）和前两个流感季节，从一家初级保健医生办公室和一家三级儿童医院急诊科前瞻性招募了 17 岁或以下的既往健康儿童。纳入标准为：年龄≤17 岁；实验室确认的流感；未接受抗病毒药物治疗。在就诊后大约 2 天和 14 天进行随访电话访谈，以评估症状持续时间。
共纳入 251 例患者（101 例 pH1N1、90 例季节性流感 A、60 例季节性流感 B）。pH1N1 与季节性流感相关的首发症状和症状持续时间相似。pH1N1 的中位发热持续时间为 3 天，95%的患者在 8 天内消退。在 pH1N1 患者中，胸部听诊异常（101 例中有 10 例）、住院率（101 例中有 2 例）、接受静脉补液治疗（101 例中有 1 例）或补充氧气（101 例中有 1 例）的患儿比例与季节性流感患者无显著差异。
在大多数无严重流感相关危险因素的儿童中，pH1N1 病毒引起的呼吸道疾病并不比季节性流感严重。
