Source: Annual Congress 2002 - Miscellaneous respiratory infections in children
Disease area: Paediatric lung diseases, Respiratory infections

Abstract

Accurate clinical diagnosis of influenza is considered difficult in pre-school children (<4y) because of complicating factors including the child's inability to describe symptoms, confusion with other infections (e.g. respiratory syncytial virus [RSV]), and a high incidence of non-specific signs/symptoms. Using oseltamivir data, we sought to describe the findings at presentation that characterise influenza infection. Two double-blind, placebo-controlled studies were conducted in children during the Northern and Southern Hemisphere winters of 1998-9. When influenza virus circulated in the community, otherwise healthy (1-12y) or asthmatic children (>=6-12y) were enrolled when presenting [lte]48h after the onset of fever (>=100[degree]F; 37.8[degree]C) with at least one respiratory symptom (cough or coryza). Influenza infection was determined by virus isolation and paired serology, RSV by antigen detection. Pooled analysis showed that 636/1039 (61%) of children had laboratory-confirmed influenza infection (LCII). A positive RSV result excluded <5% of children from the studies. In one study (WV15758), for children <4y, the signs/symptoms with the highest odds ratios for influenza vs non-influenza/non-RSV infected were fever, nasal congestion, fatigue and cough (11.5, 7.1, 2.9, 2.4, respectively). In this study the proportion of subjects with LCII was highest (~75%) at the peak of recruitment. Accurate clinical diagnosis of influenza in children can be characterised by fever and cough or coryza when surveillance indicates the virus is in the community. These diagnostic features, similar to those in adults, facilitate early treatment with an appropriate influenza antiviral agent.

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M. Luz Garcia, K. S. Reisinger, F. G. Hayden, P. Mahoney, R. Dutkowski (Madrid, Spain; Pittsburgh, Charlottesville, Nutley, United States Of America; Welwyn, United Kingdom). Clinical diagnosis of influenza infection in children. Eur Respir J 2002; 20: Suppl. 38, 2091

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