Seasonal Influenza Remains a Significant Healthcare Burden in Children

Influenza vaccine and antiviral agents are underutilized.

Seasonal influenza remains a major reason why parents seek medical care for their children. Since 2004, the CDC has continued to expand influenza vaccination recommendations to include more healthy children, culminating with a 2008 recommendation for universal vaccination for all children aged 6 months and older. Researchers prospectively examined the burden of influenza in children younger than 5 years in three U.S. counties from 2004 through 2009 (before the 2009 influenza A [H1N1] pandemic). Children with fever, acute respiratory symptoms, or both were enrolled during five influenza seasons (November to April). After enrollment, parents completed questionnaires, nasal swabs were collected, and medical records were reviewed.

After appropriate exclusions, 2970 inpatients, 2698 emergency department (ED) patients, and 2920 clinic patients were enrolled. About half (48%) of hospitalized children were younger than 6 months and 7% had study protocol-confirmed influenza. The annual influenza hospitalization rate for children younger than 5 years was 0.58 per 1000. The burden of influenza in outpatients (ED and clinic combined) was higher (11%) than in inpatients. Overall, only 45% of children were fully vaccinated against influenza. Between 2004 and 2009, the proportion of both partial and fully vaccinated children increased significantly among clinic patients (from about 40%–60% and 20%–40%, respectively), but not among inpatients and ED patients. Antiviral agents were seldom used.

CITATION(S):

Poehling KA et al. The burden of influenza in young children, 2004-2009. Pediatrics 2013 Feb; 131:207.