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Novel Influenza A(H1N1) in a Pediatric Health Care Facility in New York City During the First Wave of the 2009 Pandemic
Yolanda Miroballi, BS;
J. Scott Baird, MD;
Sheemon Zackai, MD;
Jean-Marie Cannon, RN, CIC;
Maria Messina, RN;
Thyyar Ravindranath, MD;
Robert Green, MD, MPH;
Phyllis Della-Latta, PhD, MSc;
Stephen Jenkins, PhD;
Bruce M. Greenwald, MD;
E. Yoko Furuya, MD, MSc;
Philip L. Graham III, MD, MSc;
F. Meridith Sonnett, MD;
Shari Platt, MD;
Patricia DeLaMora, MD;
Lisa Saiman, MD, MPH
Arch Pediatr Adolesc Med. 2010;164(1):24-30.
Objective To describe the burden of care experienced by our pediatric health care facility in New York, New York, from May 3, 2009, to July 31, 2009, during the novel influenza A(H1N1) pandemic that began in spring 2009.
Design Retrospective case series.
Setting Pediatric emergency departments and inpatient facilities of New York–Presbyterian Hospital.
Patients Children presenting to the emergency departments with influenza-like illness (ILI) and children aged 18 years or younger hospitalized with positive laboratory test results for influenza A from May 3, 2009, to July 31, 2009.
Main Outcome Measures Proportion of children with ILI who were hospitalized and proportion of hospitalized children with influenza A with respiratory failure, bacterial superinfection, and mortality.
Results When compared with the same period in 2008, the pediatric emergency departments experienced an excess of 3750 visits (19.9% increase). Overall, 27.7% of visits were for ILI; 2.5% of patients with ILI were hospitalized. Of the 115 hospitalized subjects with confirmed influenza A (median age, 4.3 years), 93 (80.9%) had underlying conditions. Four (3.5%) had identified bacterial superinfection, 1 (0.9%) died, and 35 (30.4%) were admitted to a pediatric intensive care unit; of these 35 patients, 11 had pneumonia and required mechanical ventilation, including high-frequency oscillatory ventilation (n = 3).
Conclusions At our center, 2.5% of children with ILI presenting to the emergency departments during the first wave of the 2009 novel influenza A(H1N1) pandemic were hospitalized. Of the 115 hospitalized children with confirmed influenza A, 9.6% had respiratory failure and 0.9% died. These findings can be compared with the disease severity of subsequent waves of the 2009 novel influenza A(H1N1) pandemic.
Author Affiliations: Departments of Pediatrics (Ms Miroballi and Drs Baird, Ravindranath, Graham, Sonnett, and Saiman), Pathology (Dr Della-Latta), and Medicine (Dr Furuya) and Division of Emergency Medicine (Dr Green), Columbia University College of Physicians and Surgeons, Departments of Pediatrics (Drs Zackai, Greenwald, Platt, and DeLaMora) and Pathology (Dr Jenkins), Weill Cornell Medical College, and Department of Infection Control and Prevention (Mss Cannon and Messina and Drs Furuya, Graham, and Saiman) and Division of Quality and Patient Safety (Drs Green and Graham), New York–Presbyterian Hospital, New York, New York.
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