Severe pandemic H1N1 and seasonal influenza in children and young adults with sickle cell disease

Author:

Strouse John J.12,Reller Megan E.3,Bundy David G.4,Amoako Martha1,Cancio Maria5,Han Rachel N.1,Valsamakis Alexandra3,Casella James F.1

Affiliation:

1. Division of Pediatric Hematology, Department of Pediatrics,

2. Division of Hematology, Department of Internal Medicine,

3. Division of Medical Microbiology, Department of Pathology,

4. Division of Quality and Safety, Department of Pediatrics, and

5. Department of Pediatrics, Johns Hopkins University, Baltimore, MD

Abstract

Abstract Influenza causes excess morbidity in sickle cell disease (SCD). H1N1 pandemic influenza has been severe in children. To compare H1N1 with seasonal influenza in SCD (patients younger than 22), we reviewed medical records (1993-2009). We identified 123 cases of laboratory-confirmed influenza (94 seasonal, 29 H1N1). Those with seasonal influenza were younger (median 4.4 vs 8.7 years old, P = .006) and had less asthma (24% vs 56%, P = .002). Those with H1N1 influenza more often had acute chest syndrome (ACS; 34% vs 13%, P = .01) and required intensive care (17% vs 3%, P = .02), including mechanical ventilation (10% vs 0%, P = .02). In multivariate analysis, older age (odds ratio [OR] 1.1 per year, P = .04) and H1N1 influenza (OR 3.0, P = .04) were associated with ACS, and older age (OR 1.1 per year, P = .02) and prior ACS (OR 3.3 per episode in last year, P < .006) with intensive care. Influenza, especially H1N1, causes critical illness in SCD and should be prevented.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference19 articles.

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