Hospitalization patterns and outcomes of infants with Influenza A(H1N1) in Kuwait

Abstract

Introduction: Infants represent an important risk group for influenza associated hospitalizations and mortality. This study evaluated the clinical presentations, hospitalization course and outcome of infants hospitalized with the pandemic influenza A H1N1 [Influenza A(H1N1)pdm09] in relation to their previous health status.

Methodology: We conducted a retrospective chart review of hospitalized infants with laboratory-confirmed Influenza A(H1N1)pdm09 infection in two hospitals in Kuwait. Demographic characteristics, pre-existing high-risk medical conditions, clinical presentations, complications and mortality were analyzed. Previously healthy infants’ data were compared with infants with pre-existing high-risk medical conditions for severity of the illness and outcome.

Results: We identified 62 infants comprising 32% of all admissions with Influenza A(H1N1)pdm09.  The median age ± SD was 7 ± 4 months.  Nineteen (31%) had pre-existing high-risk medical conditions. Complications were documented in 53% of previously healthy infants compared to 47% in high-risk infants.  Mean duration of hospitalization was 4.9 days in healthy infants and 6.7 for infants with high-risk medical conditions. Bacterial pneumonia complicated 7% of previously healthy infants compared to 26% with high-risk conditions (P = 0.03). Four infants (6.5%) required admission to the intensive care unit (ICU), of whom three had high risk medical condition.

Conclusion: The majority of hospitalized infants with Influenza A(H1N1)pdm09 were previously healthy. Prolonged hospitalization, ICU admission and mortality were more observed in infants with high-risk medical conditions. According to the latest Advisory Committee on Immunization Practices (ACIP) recommendations, annual influenza vaccination is recommended for any child six months of age and older, particularly those with risk factors.