[OP1.4-16] Influenza Morbidity Among Children: Two Seasons’ Data from a Tertiary Paediatric Hospital in Greece

Foteini Zafeiropoulou 1, Maria Vasilopoulou 1, Souzana Hatzinikolaou 2, Dimitrios Kalendakis 2, Olga Giannouli 1, Zoi Mpeka 1, Leda Sianidou 1

Introduction: Influenza is a common cause of outpatient medical visits and hospitalizations among young children. According to data from the National Centre for Disease Control and Prevention, influenza morbidity and mortality during the period 2015-16 (predomimant virus type A / H1N1) was more severe than that of the previous period (predomimant virus type B). However, influenza type A caused the majority of deaths during both periods.

Purpose: The purpose of this study is to compare the influenza morbidity between the periods 2014-15 and 2015-16 among the paediatric population based on data from the Penteli General Children’s Hospital in Athens, Greece.

Materials and Methods: Retrospective cohort study during two viral seasons (2014-15, 2015-16). Inclusion criteria: Children <18 years of age, who were hospitalized with laboratory confirmed influenza infection (Rapid Infuenza Antigen Detecting Test, Polymerase Chain Reaction). The immunization status for influenza and the underlying health conditions were documented.

Results: A total of 58 children were hospitalized due to influenza over 2 viral seasons. 2014-15: Total of 16 admissions, 1 (6.25%) PICU admission (previously healthy child with encephalitis due to H3N2 virus). Influenza type: A: 87.5%, B: 12.5%. None of the children were vaccinated. Children in PICU with underlying conditions: 0%. Period 2015-16: Total of 42 admissions, 3 (7.14%) PICU admissions (two adolescents with Diabetes Melitus type I and Dravet syndrome respectively and a previously healthy child with influenza and Respiratory Syncytial Virus co-infection. All presented with respiratory failure due to H1N1 infection that required invasive ventilation). Influenza type: A: 78.57% (H1N1), B: 21.42%. None of the children were vaccinated. Children in PICU with underlying conditions: 66%. Children in PICU with underlying conditions during both virus seasons: 50%.

Conclusion: Influenza morbidity was higher during the period 2015-16 among children, which is in agreement with national data. However, in spite of influenza type B prevalence on the general population during the period 2014-15, higher morbidity due to type A was documented among children in our hospital. Interestingly, the percentage of children with underlying conditions that exhibited severe disease that led to PICU admission was equal to those with no co-morbidities. The fact that influenza morbidity each season cannot be predicted as well as the fact that all children admitted in PICU were unimmunized, highlight the importance of vaccination against influenza among the whole of the paediatric population.

1Paediatric intensive Care Unit, Penteli Children’s Hospital, Athens, Greece; 2Paediatric Department, Penteli Children’s Hospital, Athens, Greece;

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Vaccines are the best form of preventative medicines we have and are considered, in most countries, of paramount importance for children's health by the majority of healthcare professionals, parents and governments. However, significant discrepancies have developed due to a number of barriers based on regional characteristics (social and economic), established practices and significant educational gaps. The most common barriers are: (1) Delays by policymakers in updating their vaccination policies based on the latest scientific evidence or accepting vaccination programme costs due to the economic pressures they face in their national healthcare systems, (2) The reluctance of parents, due to perceived safety concerns which trigger vaccine hesitancy, (3) Social and ethical concerns especially for the vaccines that are related to sexual activity, (4) Educational gaps among practitioners on safety evidence and efficacy – especially of the new conjugate type of vaccines. With the above in mind, the EiP Institute's Vaccines Initiative has the sole aim of increasing vaccination rates globally by overcoming these barriers and as a result protecting children from avoidable illness.