Udompornwattana Songkiat, Srajai Krissada, Suwan Pongsan, Tangsathapornpong Auchara, Wittawatmongkol Orasi, Phongsamart Wanatpreeya, Vanprapar Nirun, Nuntarukchaikul Maneeratn, Taeprasert Pawinee, Sricharoenchai Sirinthip, Tanchaweng Surapong, Phutwattana Pilaipan, Taylor Walter R J, Maleesatharn Alan, Chokephaibulkit Kulkanya
Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Mar;95(3):403-11.
To evaluate the clinical features, risk of prolonged hospitalization, and household infection in Thai children hospitalized with 2009 pandemic influenza A/H1N1 virus (pH1N1).
The authors conducted a retrospective chart review of children hospitalized in four Thai tertiary care hospitals between June 1 and September 30, 2009, with reverse-transcriptase-polymerase-chain-reaction confirmed pH1N1. Household contact data were obtained by telephone.
Pediatric admissions numbered 115, 58 were females (50.4%). Median age was 5.2 (range 0.5 to 15) years. Fifty-one (44.4%) children had underlying diseases, most commonly asthma 17 (14.8%). Median preadmission illness duration was two days (range 1 to 10). Sixty-one (53.0%) children had lymphopenia. Chest X-ray infiltration was detected in 89 (77.4%) children. Oseltamivir was prescribed in 104 (90.4%) children; 47(45.2%) within 48 hours of illness. 70 (60.9%) children received antibiotics. The median hospitalization was three days (range 1 to 94). Independent (multivariate analysis) factors associated with prolonged hospitalization (> or = 7 days) were aged five to nine years (OR 7.4; 95% CI 1.1-48.9, p = 0.037) and having an underlying disease (OR 5.9; 95% CI 1.5-23.3, p = 0.01). Five (4.3%) children required mechanical ventilation; two (1.7%) children died. Household data showed that 63 of 109 (57.8%) patients had contact with a suspected or confirmed pH1N1 case. There were 39 (15.7%) of 249 household contacts who were probable secondary cases: 23 suspected and 16 confirmed pH1N1 of whom 25 (64.1%) were aged < or = 18 years.
Most pH1N1 infected hospitalized children had pneumonia, an uneventful short hospitalization, and a low in hospital mortality. Half of the patients were household acquired. Secondary household cases affected mostly children.
评估2009年甲型H1N1大流行性流感（pH1N1）住院泰国儿童的临床特征、住院时间延长风险及家庭感染情况。
作者对2009年6月1日至9月30日期间在泰国4家三级护理医院住院且经逆转录酶-聚合酶链反应确诊为pH1N1的儿童进行回顾性病历审查。通过电话获取家庭接触者数据。
儿科住院患者115例，女性58例（50.4%）。中位年龄为5.2岁（范围0.5至15岁）。51例（44.4%）儿童有基础疾病，最常见的是哮喘17例（14.8%）。入院前疾病持续时间中位数为2天（范围1至10天）。61例（53.0%）儿童有淋巴细胞减少。89例（77.4%）儿童检测到胸部X线浸润。104例（90.4%）儿童使用了奥司他韦；47例（45.2%）在发病48小时内使用。70例（60.9%）儿童接受了抗生素治疗。中位住院时间为3天（范围1至94天）。与住院时间延长（≥7天）相关的独立（多因素分析）因素为年龄5至9岁（比值比7.4；95%可信区间1.1 - 48.9，p = 0.037）和有基础疾病（比值比5.9；95%可信区间1.5 - 23.3，p = 0.01）。5例（4.3%）儿童需要机械通气；2例（1.7%）儿童死亡。家庭数据显示，109例患者中有63例（57.8%）与疑似或确诊的pH1N1病例有接触。249名家庭接触者中有39例（15.7%）可能为二代病例：23例疑似和16例确诊为pH1N1，其中25例（64.1%）年龄≤18岁。
大多数感染pH1N1的住院儿童患有肺炎，住院时间短且病情平稳，院内死亡率低。半数患者为家庭感染。家庭二代病例主要影响儿童。
