Pediatr Infect Vaccine.  2016 Aug;23(2):87-93. 10.14776/piv.2016.23.2.87.

Influenza A Outbreak in a Neonatal Intensive Care Unit During the 2011-2012 Influenza Season in Korea

Affiliations
  • 1Department of Pediatrics, Kosin University College of Medicine, Busan, Korea. pondhong@gmail.com

Abstract

PURPOSE
An outbreak of influenza virus is uncommon in neonatal intensive care unit (NICU). The clinical presentation of influenza virus infection in neonates is diverse. This study was aimed to report an outbreak of influenza A in a NICU and to investigate the clinical characteristics of influenza virus infection in neonates especially preterm infants during the 2011-2012 influenza season in Korea.
METHODS
We reviewed the medical records of 29 patients who were evaluated by respiratory virus multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) at NICU of Kosin University Gospel Hospital during the 2011-2012 seasonal influenza outbreak in Korea.
RESULTS
Eleven patients (37.9%) were influenza A virus RT-PCR positive during the survey periods. They were all preterm infants and three of them had no symptoms. Eight patients had symptoms and it was fever (18%, 2/11), respiratory difficulty (72.7%, 8/11) without symptoms of upper respiratory infection, and gastrointestinal symptoms (27.3%, 3/11). The median duration of symptom was 5 days. There were differences of duration of admission at the test of respiratory RT-PCR, Clinical Risk Index for Babies (CRIB) score, use of mechanical ventilation, and use of dexamethasone before infection between influenza A virus RT-PCR positive and negative group. All 11 patients with influenza A were discharged without any complications.
CONCLUSIONS
The symptoms of influenza A virus infection in the preterm infants is nonspecific. Influenza A virus should be considered as a possible cause of infection in NICU during the influenza season in the community.

Keyword

Influenza A virus; Intensive Care Units; Neonatal; Outbreak

MeSH Terms

Dexamethasone
Fever
Humans
Infant, Newborn
Infant, Premature
Influenza A virus
Influenza, Human*
Intensive Care Units
Intensive Care, Neonatal*
Korea*
Medical Records
Orthomyxoviridae
Respiration, Artificial
Seasons*
Dexamethasone

Reference

1. Tsagris V, Nika A, Kyriakou D, Kapetanakis I, Harahousou E, Stripeli F, et al. Influenza A/H1N1/2009 outbreak in a neonatal intensive care unit. J Hosp Infect. 2012; 81:36–40.
Article
2. Puck JM, Glezen WP, Frank AL, Six HR. Protection of infants from infection with influenza A virus by transplacentally acquired antibody. J Infect Dis. 1980; 142:844–849.
Article
3. Cunney RJ, Bialachowski A, Thornley D, Smaill FM, Pennie RA. An outbreak of influenza A in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2000; 21:449–454.
Article
4. Milupi M, Madeo M, Brooke N, Ahmad SJ. Neonatal influenza A/H1N1/2009 outbreak in a UK district general hospital. J Hosp Infect. 2012; 81:131–133.
Article
5. Munoz FM, Campbell JR, Atmar RL, Garcia-Prats J, Baxter BD, Johnson LE, et al. Influenza A virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J. 1999; 18:811–815.
Article
6. Sagrera X, Ginovart G, Raspall F, Rabella N, Sala P, Sierra M, et al. Outbreaks of influenza A virus infection in neonatal intensive care units. Pediatr Infect Dis J. 2002; 21:196–200.
Article
7. The International Neonatal Network. The CRIB (clinical risk index for babies) score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. Lancet. 1993; 342:193–198.
8. Vij NK, Stryker CC, Esper FP, Jacobs MR, Gonzalez BE. Influenza A/H1N1/09-10 infections in a NICU during the 2009–2010 H1N1 pandemic. Pediatrics. 2011; 128:e1297–e1301.
Article
9. Choi JW, Cho HJ, Kim HM, Hahn S. Clinical and laboratory findings of the 2012 winter seasonal influenza A and B outbreak at a single institution. Korean J Pediatr Infect Dis. 2014; 21:1–8.
Article
10. Barak S, Kushnir A, Chulski E, Miron D. Influenza A/H1N1 virus in very low-birth-weight premature infant: case report. Am J Perinatol. 2010; 27:513–515.
Article
11. Glezen WP, Taber LH, Frank AL, Gruber WC, Piedra PA. Influenza virus infections in infants. Pediatr Infect Dis J. 1997; 16:1065–1068.
Article
12. Kidszun A, Hansmann A, Winter J, Grondahl B, Knuf M, Weise K, et al. Detection of respiratory viral infections in neonates treated for suspicion of nosocomial bacterial sepsis: a feasibility study. Pediatr Infect Dis J. 2014; 33:102–104.
Article
13. Bennett NJ, Tabarani CM, Bartholoma NM, Wang D, Huang D, Riddell SW, et al. Unrecognized viral respiratory tract infections in premature infants during their birth hospitalization: a prospective surveillance study in two neonatal intensive care units. J Pediatr. 2012; 161:814–818.
Article
Full Text Links
  • PIV
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr