Une saison de grippe chez les enfants hospitalisés (hiver 2001/2002)

• Published in: Journal de pédiatrie et de puériculture Vol. 17; no. 6; pp. 331 - 337
• Main Authors: Sanni, E., Mazaud, S., Odievre, M.H., Weill, C., Laurent, C., Olivier, C.
• Format: Journal Article
• Language: French
• Published: Paris Elsevier SAS 01-09-2004; Elsevier
• Subjects: Enfant; Generalites; Hospitalisation; Hospitalization; Influenza vaccines; Influenza virus; Pathologie infectieuse; Psychologie. Psychanalyse. Psychiatrie; Psychopathologie. Psychiatrie; Respiratory syncitial virus; Sciences biologiques et medicales; Sciences medicales; Vaccin contre la grippe; Victimologie; Viroses; Viroses humaines; Viroses respiratoires et orl; Virus de la grippe; Virus respiratoire syncytial; Influenza vaccines; Influenza virus; Virus respiratoire syncytial; Vaccin contre la grippe; Hospitalization; Virus de la grippe; Respiratory syncitial virus; Hospitalisation; Infection; Pédiatrie; Homme; Enfant; Grippe; Hiver; Epidémiologie; Saison; Virose; Nouveau né
• ISSN: 0987-7983; 1777-5981
• DOI: 10.1016/j.jpp.2004.07.001

Pendant l'épidémie de grippe de l'hiver 2001–2002, 472 enfants âgés d'un mois à 15 ans ont été hospitalisés. Parmi eux, 114 (24,2 %) ont eu un prélèvement nasal à la recherche du virus de la grippe. Cinq (51,8 %) prélèvements sont revenus positifs. Le taux d'attaque global de la grippe confirmée au laboratoire était de 12,5 %. Le taux de prélèvement positif le plus élevé était observé dans la tranche d'âge d'un à trois ans. Les enfants de moins de trois ans avaient une pathologie respiratoire incluant les otites moyennes aiguës, les détresses respiratoires, les fièvres élevées, les syndromes méningés et les crises convulsives hyperthermiques. Tous âges confondus, 44,1 % des enfants étaient admis pour des symptômes respiratoires. Les signes extrarespiratoires représentaient plus de la moitié des symptômes. Dix enfants (16,9 %) étaient porteurs d'un facteur de risque. Ils avaient les plus longues durées d'hospitalisation. Aucun d'eux n'était vacciné. Les antibiotiques ont été prescrits chez un tiers des enfants principalement chez les moins de trois ans (42,2 %).
Background. –
Few studies addressed the question about the attack rate and clinical profile of influenza in hospitalized children.
Methods. –
This prospective survey was designed to determine the incidence rate of hospitalizations due to laboratory-confirmed influenza-associated illness and the clinical profile of disease among children tested negative for respiratory syncitial virus (RSV), over the 2002 influenza outbreak, in France.
Results. –
During the influenza outbreak, 472 children âged ≤15 years were hospitalized, of which 114 (24.2%), had nasal swabs collected. Results of testing for influenza virus were positive (culture) in 59 cases (51.8%). The global attack rate of hospitalization for laboratory-confirmed influenza-associated illness was 12.5%. The highest rate of positive results of testing and hospitalization was observed in children âged >1 and ≤3 years (68.9% and 20.5%, respectively). Up to 3 years of âge, symptoms were mainly respiratory, including acute otitis media and respiratory distress, with febrile seizures as the main neurological component. After 3 years of âge, the children presented with very high fever and mainly meningeal syndrome. All âges considered, 44.1% of the children were admitted due to respiratory symptoms, and extra-respiratory symptoms represented more than one half of the manifestations of the disease. Ten (16.9%) children were at risk for hospitalization. The delay from onset of symptoms to hospitalization was ≤48 h for 81.1% of children, and the median duration of hospitalization was 3 days, range 1–10 days. Antibiotic prescriptions were given in 33.9% of children, mainly in subjects âged ≤3 years (42.2%).
Conclusion. –
The influenza burden observed in hospitalized children warrants new strategies for ensuring a better protection.