Differences in Clinical Manifestations and Treatment Responses in Influenza Type A and B in a Single Hospital during 2013 to 2015

Sang Min Lee; Sang Kyu Park; Ji Hyun Kim; Jung Ha Lee; So Young Na; Do Hyun Kim; Eun Kyeong Kang; Sung Min Cho; Hee Sub Kim

doi:10.14776/piv.2017.24.1.16

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Lee, Park, Kim, Lee, Na, Kim, Kang, Cho, and Kim: Differences in Clinical Manifestations and Treatment Responses in Influenza Type A and B in a Single Hospital during 2013 to 2015

Original Article

Pediatric Infection & Vaccine 2017; 24(1): 16-22.

Published online: 18 April 2017

DOI: https://doi.org/10.14776/piv.2017.24.1.16

Differences in Clinical Manifestations and Treatment Responses in Influenza Type A and B in a Single Hospital during 2013 to 2015

Sang Min Lee, Sang Kyu Park, Ji Hyun Kim, Jung Ha Lee, So Young Na, Do Hyun Kim, Eun Kyeong Kang, Sung Min Cho, Hee Sub Kim

Department of Pediatrics, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, the Republic of Korea.

Corresponding author (silbear@hanmail.net)

Received 30 July 2016 Revised 27 September 2016 Accepted 12 October 2016

Abstract

Purpose

We suspect there is a difference in the clinical manifestations and treatment response to antiviral drugs for influenza A and B. This study was conducted to investigate this difference.

Methods

We collected information on pediatric patients, infected with the influenza virus, admitted to Dongguk University Ilsan Hospital from October 2013 to May 2015. We investigated the clinical manifestations of influenza and differences in treatment response to oseltamivir treatment for the two types of influenza.

Results

A total of 138 patients were included. The mean age was 3.5±4.0 years. When comparing the diseases associated with influenza A and B, croup (19.2% vs. 1.7%, P =0.001) was more common with influenza A infection. Myositis (0% vs. 6.7%, P =0.021) and gastroenteritis (29.5% vs. 46.7%, P =0.038) were more common with influenza B infection. When comparing the total fever duration from the start of oseltamivir administration, patients treated with oseltamivir within 2 days of fever had the shortest duration. Among the patients treated with oseltamivir, the duration of fever, after the start of oseltamivir treatment, for was shorter for influenza A infection than for influenza B infection (16.0±19.1 hours vs. 28.9±27.9 hours, P =0.006).

Conclusions

There appear to be differences in the accompanying diseases and antiviral medication responses between the two types of influenza. It is important to administer oseltamivir within 2 days of fever.

Keywords: Influenza, human, Oseltamivir, Child

Figures and Tables

Fig. 1

Comparison of mean total fever duration by the initiation time of oseltamivir. Patients treated with oseltamivir within 2 days after fever had the shortest duration (2.8±1.1 days).

Fig. 2

Comparison of fever duration of after initiation of oseltamivir between influenza A and B. The fever duration after initiation of oseltamivir for influenza A infection was shorter than that for influenza B infection (16.0±19.1 hours vs. 28.9±27.9 hours). Although the initiation time of oseltamivir was significantly different between influenza A and B (2.8±1.9 days vs. 3.6±2.3 days, P=0.033), the difference of fever duration after the initiation of oseltamivir was affected by type of influenza (multiple linear regression analysis, P=0.006).

Table 1

Comparison of Clinical Symptoms and Associated Disease in Influenza

Values are presented as number (%).

^*Lower respiratory infection includes pneumonia, bronchiolitis, bronchitis.

Table 2

Comparison of Unvaccinated Group and Vaccinated Group in Influenza

Values are presented as mean±standard deviation.

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