Paediatric Department, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Int J Immunopathol Pharmacol. 2011 Jul-Sep;24(3):651-9. doi: 10.1177/039463201102400311.
We investigated clinical characteristics and complications, particularly type 1 diabetes onset, in children hospitalized for 2009 pandemic influenza A (H1N1) virus and compared number of consultations, rate of hospitalization and virus identification in children hospitalized for acute respiratory symptoms (ARS) during the winter season 2009-2010 and 2004-2005. Patients were tested for 2009 H1N1 virus and 14 respiratory viruses on pharyngeal brush/nasal aspirates, using a RT-PCR or nested PCR assays. Consultations and hospitalizations were extracted from operative system GIPSE. The total number of consultations increased by 12%, consultation rate for ARS by 13% and number of hospitalizations by 56% from 2004-2005 to 2009-2010. In 2004-2005, Influenza A virus was identified in only 7 percent of hospitalized children, while in 2009-2010 the 2009 H1N1 virus was identified in 21%. Three children attending the hospital for ARS and 2009 H1N1 infection had ketoacidosis as the onset manifestation of type 1 diabetes. By comparing the number of new diabetes diagnoses among the two winter seasons, we found a higher number of new diagnoses in October 2009-January 2010 than in the same period in 2004-2005 (19 vs 10). Six children (13%), all presenting with pre-existing diseases, were admitted to the pediatric intensive care unit. No children died. The outbreak of this novel virus has increased pediatric consultation rates and hospitalizations compared with previous winters without causing deaths. The children at highest risk for severe infection are those with comorbidities. The 2009 H1N1 virus seems in some way involved in the pathogenesis of type 1 diabetes.
我们研究了住院的儿童中 2009 年大流行的甲型 H1N1 流感病毒的临床特征和并发症，特别是 1 型糖尿病的发病情况，并比较了 2009-2010 年和 2004-2005 年冬季因急性呼吸道症状（ARS）住院的儿童的就诊次数、住院率和病毒鉴定数量。使用 RT-PCR 或嵌套 PCR 检测咽拭子/鼻抽吸物中的 2009 年 H1N1 病毒和 14 种呼吸道病毒。从操作系统 GIPSE 中提取就诊和住院信息。与 2004-2005 年相比，2009-2010 年的就诊次数增加了 12%，ARS 的就诊率增加了 13%，住院人数增加了 56%。2004-2005 年，住院的儿童中仅发现 7%的甲型流感病毒，而 2009-2010 年则发现 21%的 2009 年 H1N1 病毒。有 3 名因 ARS 就诊的儿童和 2009 年 H1N1 感染的儿童出现酮症酸中毒，这是 1 型糖尿病的发病表现。通过比较两个冬季新诊断糖尿病的数量，我们发现 2009 年 10 月至 2010 年 1 月的新诊断数量高于 2004-2005 年同期（19 比 10）。有 6 名儿童（13%），均有合并症，被收入儿科重症监护病房。没有儿童死亡。与以往的冬季相比，这种新型病毒的爆发增加了儿科就诊率和住院率，但没有导致死亡。合并症的儿童感染风险最高。2009 年 H1N1 病毒似乎以某种方式参与了 1 型糖尿病的发病机制。
