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Pediatría (Asunción)
On-line version ISSN 1683-9803
Abstract
CABELLO, Ma. Agueda et al. The 2009 H1N1 Influenza A Pandemic: Clinical and Epidemiological Characteristics of Pediatric Cases in Paraguay. Pediatr. (Asunción) [online]. 2011, vol.38, n.1, pp.40-44. ISSN 1683-9803.
ABSTRACT Introduction: In April 2009 the first cases were reported of a new influenza subtype, H1N1 Influenza A, which showed different clinical behavior in different age groups. Objective: To describe the clinical and epidemiological characteristics of pediatric cases (ages 0 to 18 years) reported to the general directorate for health surveillance (DGVS) during the pandemic of 2009. Methodology: The study was observational and descriptive with analytical components, and included all suspected cases of infection by H1N1 influenza A in patients under age 19 reported to the DGVS between April 28, 2009 and January 30, 2010. Reporting centers included both public and private facilities. To collect data we used a clinical-epidemiological form that included: age, sex, place of origin, signs and symptoms, comorbidities, vaccination history, laboratory results for influenza A H1N1, and clinical outcome. Results: The DGVS received 3233 reports of suspected cases of influenza A H1N1, of which 50.6% were in male patients. Incidence was highest in the age 15 to 18 group (43.9%), followed by the age 1 to 4 group (31.7%). Most cases came from the Central Department (38.4%), followed by Asuncion(23%) and Alto Parana 10.2%). Fully 90% of cases were reported between June and August. Signs and symptoms most frequently found were cough (90%), fever (77%) and sore throat (61%). At least one risk factor for complications was present in 4.7% of cases, with the most common being asthma (n=91), pregnancy (n=26), and cardiovascular disease (n=19). Of those that presented any comorbidity risk factor, 6.6% died. The mortality rate was 1.6% and was significantly higher in children under age 1 year (5.6%, p<0.001). In 476 cases (14.7%) infection by H1N1 influenza A was confirmed. Conclusion: The clinical features observed were similar to those reported internationally. The need for hospitalization and mortality were significantly higher in children under age 1 year.
Keywords : Influenza A H1N1; clinical features; epidemiology; pediatrics.