The Clinical Characteristics of Influenza B Infection during the 2011-2012 Influenza Season

Min Sun Kim; Hyun Woo Sung; E Young Bae; Seung Beom Han; Dae Chul Jeong; Jin Han Kang

doi:10.14776/kjpid.2013.20.2.89

Journal List > Korean J Pediatr Infect Dis > v.20(2) > 1096054

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Sung, Bae, Han, Jeong, and Kang: The Clinical Characteristics of Influenza B Infection during the 2011-2012 Influenza Season

Original Article

Korean Journal of Pediatric Infectious Diseases 2013; 20(2): 89-97.

Published online: 20 August 2013

DOI: https://doi.org/10.14776/kjpid.2013.20.2.89

The Clinical Characteristics of Influenza B Infection during the 2011-2012 Influenza Season

Min Sun Kim, M.D., Hyun Woo Sung, M.D., E Young Bae, M.D., Seung Beom Han, M.D., Dae Chul Jeong, Ph.D., Jin Han Kang, Ph.D.

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Corresponding author (kjhan@catholic.ac.kr)

Received 4 December 2012 Revised 19 January 2013 Accepted 26 January 2013

Abstract

Purpose

This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection.

Methods

Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients.

Results

A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older (4.7±4.1 years vs. 3.3±2.5 years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups.

Conclusions

No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.

Keywords: Influenza, Influenza B virus, Child

Figures and Tables

Fig. 1

The weekly distribution of influenza infection cases during the 2011-2012 influenza season.

Fig. 2

The number of children according to the age group.

Table 1

Clinical Characteristics of Children with Influenza A and B Infection during the 2011-2012 Influenza Season

Data are median (range) or No. (%) of cases.

Abbreviations: SD, standard deviation; ICU, intensive care unit.

Table 2

Laboratory Characteristics of Children with Influenza A and B Infection during the 2011-2012 Influenza season

Data are median (range) or No. (%) of cases.

^*Neutropenia was defined as an absolute neutrophil count of lower than 1,500/µL.

^†Thrombocytopenia was defined as a platelet count of lower than 150,000/µL.

^‡When 8 children with hemato-oncologic disease were excluded in this analysis, P value was 0.064.

Abbreviations: WBC, white blood cell; AST, aspartate transaminase; ALT, alanine transaminase; LDH, lactate dehydrogenase; CPK, creatine phosphokinase; CRP, C-reactive protein.

References

1. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med. 2000; 342:225–231.

2. Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004; 292:1333–1340.

3. Kang TG, Kim MJ, Kim BG, An HS, Yun HJ, Choi EJ, et al. Comparisons of clinical features among influenza A (H1N1) and seasonal influenza A and B during 2009 to 2010 at a single institution. Pediatr Allergy Respir Dis. 2011; 21:269–276.

4. Kim SH, Park CH, Huh K, Shim GH, Kim HB, You SJ, et al. Comparison of clinical manifestation and laboratory findings between H1N1 and influenza B infection. Pediatr Allergy Respir Dis. 2012; 22:64–70.

5. Ambrose CS, Levin MJ. The rationale for quadrivalent influenza vaccines. Hum vaccin Immunother. 2012; 8:81–88.

6. Jian JW, Lai CT, Kuo CY, Kuo SH, Hsu LC, Chen PJ, et al. Genetic analysis and evaluation of the reassortment of influenza B viruses isolated in Taiwan during the 2004-2005 and 2006-2007 epidemics. Virus Res. 2008; 131:243–249.

7. Rota PA, Wallis TR, Harmon MW, Rota JS, Kendal AP, Nerome K. Cocirculation of two distinct evolutionary lineages of influenza type B virus since 1983. Virology. 1990; 175:59–68.

8. Roy T, Agrawal AS, Mukherjee A, Mishra AC, Chandha MS, Kaur H, et al. Surveillance and molecular characterization of human influenza B viruses during 2006-2010 revealed co-circulation of Yamagata-like and Victoria-like strains in eastern India. Infect Genet Evol. 2011; 11:1595–1601.

9. Korea Centers for Disease Control and Prevention. Korean influenza surveillance report, 2011-2012. Public Health Weekly Report. 2012. 5:873–881. accessed on 1 Dec 2012. Available at http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU0004-MNU0036-MNU0037.

10. Daley AJ, Nallusamy R, Isaacs D. Comparison of influenza A and influenza B virus infection in hospitalized children. J Paediatr Child Health. 2000; 36:332–335.

11. Hite LK, Glezen WP, Demmler GJ, Munoz FM. Medically attended pediatric influenza during the resurgence of the Victoria lineage of influenza B virus. Int J Infect Dis. 2007; 11:40–47.

12. Peltola V, Ziegler T, Ruuskanen O. Influenza A and B virus infections in children. Clin Infect Dis. 2003; 36:299–305.

13. Belshe RB, Coelingh K, Ambrose CS, Woo JC, Wu X. Efficacy of live attenuated influenza vaccine in children against influenza B viruses by lineage and antigenic similarity. Vaccine. 2010; 28:2149–2156.

14. Frey S, Vesikari T, Szymczakiewicz-Multanowska A, Lattanzi M, Izu A, Groth N, et al. Clinical efficacy of cell culture-derived and egg-derived inactivated subunit influenza vaccines in healthy adults. Clin Infect Dis. 2010; 51:997–1004.

15. Jackson LA, Gaglani MJ, Keyserling HL, Balser J, Bouveret N, Fries L, et al. Safety, efficacy, and immunogenicity of an inactivated influenza vaccine in healthy adults: a randomized, placebo-controlled trial over two influenza seasons. BMC Infect Dis. 2010; 10:71.

16. Janjua NZ, Skowronski DM, De Serres G, Dickinson J, Crowcroft NS, Taloy M, et al. Estimates of influenza vaccine effectiveness for 2007-2008 from Canada's sentinel surveillance system: cross-protection against major and minor variants. J Infect Dis. 2012; 205:1858–1868.

17. Monto AS, Ohmit SE, Petrie JG, Johnson E, Truscon R, Teich E, et al. Comparative efficacy of inactivated and live attenuated influenza vaccines. N Engl J Med. 2009; 361:1260–1267.

18. Vesikari T, Fleming DM, Aristegui JF, Vertruyen A, Ashkenazi S, Rappaport R, et al. Safety, efficacy, and effectiveness of cold-adapted influenza vaccine-trivalent against community-acquired, culture-confirmed influenza in young children attending day care. Pediatrics. 2006; 118:2298–2312.

19. Lim J, Eom CS, Kim KH, Kim S, Cho B. Coverage of influenza vaccination among elderly in South Korea: A population based cross sectional analysis of the season 2004-2005. J Korean Geriatr Soc. 2009; 13:215–221.

20. Kee SY, Cheong HJ, Chun BC, Kim WJ. Influenza vaccination coverage rate and factors associated with vaccination in people with chronic disease. Infect Chemother. 2011; 43:406–411.

TOOLS

Similar articles