Mahut Bruno, Refabert Luc, Marchac Valentine, Iniguez Jean-Luc, Aubertin Guillaume, Tamalet Aline, Lebras Marie-Noëlle, Troadec Corinne, Chatellier Gilles, Delclaux Christophe
Cabinet La Berma, Antony, France.
J Asthma. 2011 Apr;48(3):224-7. doi: 10.3109/02770903.2011.555032. Epub 2011 Feb 21.
Asthma seems to be the more prevalent underlying condition in patients hospitalized for H1N1-related flu.
A prospective survey was conducted during the early phase of H1N1 pandemic in France in asthmatic children before vaccination to assess whether severe exacerbations in childhood asthma are associated with influenza-like illness (ILI, the definition of H1N1-related flu in a pandemic). Eight pediatricians in primary care distributed in three localities (Paris, south suburb, and west suburb) conducted the survey (4 weeks/locality from week 36 to 47). At each visit, the pediatrician filled a questionnaire entering the information regarding asthma treatment, severe exacerbation (at least 3 days' use of systemic corticosteroids), and ILI (temperature ≥37.8°C, cough, and/or sore throat, in the absence of a known cause other than influenza) during the past 3 weeks.
The survey included 1155 asthmatic children (mean age [SD]: 7.5 years [4.1]); almost all visits were scheduled (99%). A severe exacerbation was recorded in 121 children [10.5%; 95% confidence interval (CI): 8.7-12.2%], which was concomitant with ILI in 20 children (16.5%; 95% CI: 9.9-23.2%), whereas 1034 children did not exhibit any exacerbation. In these latter children, 40 ILI were observed (3.9%; 95% CI: 2.7-5.0%), which constituted a significantly lesser percentage as compared with children with both exacerbation and ILI (p < .0001). This result remained significant in each locality. Overall, 60/1155 (5.2%; 95% CI: 3.9-6.5%) asthmatic children had an ILI.
Our survey shows that severe exacerbation and ILI are strongly associated during the H1N1 pandemic in asthmatic children.
在因甲型H1N1流感相关疾病住院的患者中，哮喘似乎是更为普遍的基础疾病。
在法国甲型H1N1流感大流行早期，对哮喘儿童进行了一项前瞻性调查，调查在疫苗接种前进行，以评估儿童哮喘的严重加重是否与流感样疾病（ILI，大流行中甲型H1N1流感相关疾病的定义）有关。分布在三个地区（巴黎、南郊和西郊）的八名初级保健儿科医生开展了此项调查（从第36周至47周，每个地区为期4周）。每次就诊时，儿科医生填写一份问卷，记录过去3周内有关哮喘治疗、严重加重（至少3天使用全身糖皮质激素）和ILI（体温≥37.8°C、咳嗽和/或咽痛，且无除流感外的已知病因）的信息。
该调查纳入了1155名哮喘儿童（平均年龄[标准差]：7.5岁[4.1]）；几乎所有就诊都是按计划进行的（99%）。121名儿童记录有严重加重[10.5%；95%置信区间（CI）：8.7 - 12.2%]，其中20名儿童（16.5%；95% CI：9.9 - 23.2%）同时伴有ILI，而1034名儿童未出现任何加重情况。在后者这些儿童中，观察到40例ILI（3.9%；95% CI：2.7 - 5.0%），与既出现加重又伴有ILI的儿童相比，这一比例显著更低（p < .0001）。这一结果在每个地区均保持显著。总体而言，1155名哮喘儿童中有60名（5.2%；95% CI：3.9 - 6.5%）患有ILI。
我们的调查表明，在甲型H1N1流感大流行期间，哮喘儿童的严重加重与ILI密切相关。
