From the Department of Pediatrics, Turku University Hospital and University of Turku.
Department of Clinical Microbiology, Turku University Hospital.
Pediatr Infect Dis J. 2020 Jun;39(6):489-493. doi: 10.1097/INF.0000000000002610.
Influenza A viruses are conventionally thought to cause more severe illnesses than B viruses, but few studies with long observation periods have compared the clinical severity of A and B infections in hospitalized children.
We analyzed the clinical presentation, outcomes and management of all children <16 years of age admitted to Turku University Hospital, Finland, with virologically confirmed influenza A or B infection during the 14-year period of 1 July 2004 to 30 June 2018. All comparisons between influenza A and B were performed both within predefined age groups (0-2, 3-9 and 10-15 years) and in all age groups combined.
Among 391 children hospitalized with influenza A or B infection, influenza A was diagnosed in 279 (71.4%) and influenza B in 112 (28.6%) children. Overall, there were no significant differences in any clinical features or outcomes, management, treatment at intensive care unit or length of stay between children with influenza A and B, whether analyzed by age group or among all children. As indicators of the most severe clinical presentations, blood cultures were obtained from 101 (36.2%) children with influenza A and 39 (34.8%) with influenza B (P = 0.80), and lumbar puncture was performed to 16 (5.7%) children with influenza A and 11 (9.8%) children with influenza B (P = 0.15).
The clinical severity of influenza A and B infections is similar in children. For optimal protection against severe influenza illnesses, the use of quadrivalent vaccines containing both lineages of B viruses seems warranted in children.
传统上认为甲型流感病毒比乙型流感病毒引起更严重的疾病，但很少有研究进行长期观察来比较住院儿童中甲型和乙型感染的临床严重程度。
我们分析了在 2004 年 7 月 1 日至 2018 年 6 月 30 日期间，在芬兰图尔库大学医院住院的所有经病毒学确诊的甲型或乙型流感感染的<16 岁儿童的临床表现、结局和治疗情况。在预设年龄组（0-2 岁、3-9 岁和 10-15 岁）内以及所有年龄组内均对甲型和乙型流感进行了比较。
在 391 例因甲型或乙型流感感染住院的儿童中，诊断为甲型流感的有 279 例（71.4%），乙型流感的有 112 例（28.6%）。总体而言，无论按年龄组分析还是在所有儿童中分析，无论是在任何临床特征或结局、治疗管理、入住重症监护病房或住院时间方面，甲型流感和乙型流感患儿之间均无显著差异。作为最严重临床表现的指标，101 例（36.2%）甲型流感患儿和 39 例（34.8%）乙型流感患儿进行了血培养（P=0.80），16 例（5.7%）甲型流感患儿和 11 例（9.8%）乙型流感患儿进行了腰椎穿刺（P=0.15）。
在儿童中，甲型和乙型流感感染的临床严重程度相似。为了针对严重流感疾病提供最佳保护，儿童使用包含两种乙型流感病毒谱系的四价疫苗似乎是合理的。
