Clinical analysis of 19 deaths from severe influenza among children in Shenzhen / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the characteristics and causes of death of severe influenza cases,in order to attract the attention of pediatricians.Methods The data of 19 cases with influenza-associated deaths admitted to Shenzhen Children's Hospital from September 2009 to November 2018 were retrospectively analyzed.Results There were 11 males and 8 females,aged from 4 months to 12 years old,of whom 5 cases were over 5 years old.Five deaths occurred during the 2009 influenza A (H1N1) pandemic,followed by 1 case in 2014,6 cases in 2016,3 cases in 2017 and 4 cases in 2018.Four of the 19 deaths were due to underlying diseases.The time from onset to death was 0.5-36.0 days,and the most common clinical manifestations were high fever,convulsions,coma and dyspnea.Among them,11 cases died of influenza-associated encephalopathy,4 cases died of severe pneumonia,acute respiratory distress syndrome(ARDS) and respiratory failure,3 cases died of sepsis caused by secondary streptococcus pneumoniae infection,and 1 case died of secondary fungal pyothorax and fungal meningitis.Conclusions Children under 5 years of age,even if they were previously healthy,may still be at high risk of dying from influenza.Neurological complications were high and the leading causes of death were influenza-associated encephalopathy,severe pneumonia,ARDS and secondary severe bacterial infection.