Improvement is needed in preventing severe disease and nosocomial transmission in children beyond pandemic situations. We conducted a nationwide hospital-based prospective study in Germany of influenza A(H1N1)pdm09 cases among children <15 years of age admitted to pediatric intensive care units and related deaths during the 2009–10 pandemic and the 2010–11 postpandemic influenza seasons. We identified 156 eligible patients: 112 in 2009–10 and 44 in 2010–11. Although a shift to younger patients occurred in 2010–11 (median age 3.2 vs. 5.3 years), infants <1 year of age remained the most affected. Underlying immunosuppression was a risk factor for hospital-acquired infections (p = 0.013), which accounted for 14% of cases. Myocarditis was predictive of death (p = 0.006). Of the 156 case-patients, 17% died; the difference between seasons was not significant (p = 0.473). Our findings stress the challenge of preventing severe postpandemic influenza infection in children and the need to prevent nosocomial transmission of influenza virus, especially in immunosuppressed children.
【저자키워드】 viruses, Influenza, children, Critically ill, Nosocomial transmission, Hospital-acquired infection, Influenza A(H1N1)pdm09 virus, postpandemic,