• Mathias Altmann, Lena Fiebig, Silke Buda, Rüdiger von Kries, Manuel Dehnert, and Walter Haas.
• Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Postfach 65 02 61, 13302 Berlin, Germany. altmannm@rki.de
• Emerging Infect. Dis. 2012 Nov 1; 18 (11): 1755-62.

AbstractWe conducted a nationwide hospital-based prospective study in Germany of influenza A(H1N1)pdm09 cases among children <15 years of age admitted to pediatric intensive care units and related deaths during the 2009-10 pandemic and the 2010-11 postpandemic influenza seasons. We identified 156 eligible patients: 112 in 2009-10 and 44 in 2010-11. Although a shift to younger patients occurred in 2010-11 (median age 3.2 vs. 5.3 years), infants <1 year of age remained the most affected. Underlying immunosuppression was a risk factor for hospital-acquired infections (p = 0.013), which accounted for 14% of cases. Myocarditis was predictive of death (p = 0.006). Of the 156 case-patients, 17% died; the difference between seasons was not significant (p = 0.473). Our findings stress the challenge of preventing severe postpandemic influenza infection in children and the need to prevent nosocomial transmission of influenza virus, especially in immunosuppressed children.

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