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Swiss Med Wkly. 2015 Jul 28;145:w14171. doi: 10.4414/smw.2015.14171. eCollection 2015.

Clinical characteristics and outcomes in children hospitalised with pandemic influenza A/H1N1/09 virus infection – a nationwide survey by the Pediatric Infectious Diseases Group of Switzerland.

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Department of Paediatrics, University Hospitals of Geneva and Medical School of Geneva, Switzerland.
University Children's Hospital Bern, Switzerland.
University Children's Hospital (UKBB) Basel, Switzerland.
Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Switzerland.
Pediatric Infectious Diseases Group Switzerland (PIGS, Influenza study group members are: Andrea Lehmann (Children's Hospital Aarau), Ulrich Heininger and Gurli Bär (University Children's Hospital Basel), Andrea Duppenthaler and Sara Ber.



To describe all patients admitted to children's hospitals in Switzerland with a diagnosis of influenza A/H1N1/09 virus infection during the 2009 influenza pandemic, and to analyse their characteristics, predictors of complications, and outcome.


All patients ≤18-years-old hospitalised in eleven children's hospitals in Switzerland between June 2009 and January 2010 with a positive influenza A/H1N1/09 reverse transcriptase polymerase chain reaction (RT-PCR) from a nasopharyngeal specimen were included.


There were 326 PCR-confirmed patients of whom 189 (58%) were younger than 5 years of age, and 126 (38.7%) had one or more pre-existing medical condition. Fever (median 39.1 °C) was the most common sign (85.6% of all patients), while feeding problems (p = 0.003) and febrile seizures (p = 0.016) were significantly more frequent in children under 5 years. In 142 (43.6%) patients there was clinical suspicion of a concomitant bacterial infection, which was confirmed in 36 patients (11%). However, severe bacterial infection was observed in 4% of patients. One third (n = 108, 33.1%) of the patients were treated with oseltamivir, 64 (59.3%, or 20% overall) within 48 hours of onset of symptoms. Almost half of the patients (45.1%) received antibiotics for a median of 7 days. Twenty patients (6.1%) required intensive care, mostly for complicated pneumonia (50%) without an underlying medical condition. The median duration of hospitalisation was 2 days (range 0-39) for 304 patients. Two children (<15 months of age with underlying disease) died.


Although pandemic influenza A/H1N1/09 virus infection in children is mostly mild, it can be severe, regardless of past history or underlying disease.

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