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First published online July 1, 2011

Detection of Respiratory Viruses in the 2009 Winter Season in Rome: 2009 Influenza a (H1N1) Complications in Children and Concomitant Type 1 Diabetes Onset

Abstract

We investigated clinical characteristics and complications, particularly type 1 diabetes onset, in children hospitalized for 2009 pandemic influenza A (H1N1) virus and compared number of consultations, rate of hospitalization and virus identification in children hospitalized for acute respiratory symptoms (ARS) during the winter season 2009–2010 and 2004–2005. Patients were tested for 2009 H1N1 virus and 14 respiratory viruses on pharyngeal brush/nasal aspirates, using a RT-PCR or nested PCR assays. Consultations and hospitalizations were extracted from operative system GIPSE. The total number of consultations increased by 12%, consultation rate for ARS by 13% and number of hospitalizations by 56% from 2004–2005 to 2009–2010. In 2004–2005, Influenza A virus was identified in only 7% of hospitalized children, while in 2009–2010 the 2009 H1N1 virus was identified in 21%. Three children attending the hospital for ARS and 2009 H1N1 infection had ketoacidosis as the onset manifestation of type 1 diabetes. By comparing the number of new diabetes diagnoses among the two winter seasons, we found a higher number of new diagnoses in October 2009 January 2010 than in the same period in 2004–2005 (19 vs 10). Six children (13%), all presenting with pre-existing diseases, were admitted to the pediatric intensive care unit. No children died. The outbreak of this novel virus has increased pediatric consultation rates and hospitalizations compared with previous winters without causing deaths. The children at highest risk for severe infection are those with comorbidities. The 2009 H1N1 virus seems in some way involved in the pathogenesis of type 1 diabetes.

References

1. Neumann G, Noda T, Kawaoka Y. Emergence and potential of swine-origin H1N1 influenza virus. Nature 2009; 459:931–39.
2. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009; 361:680–88.
3. Jain S, Kamimoto L, Bramley AM, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 2009; 361: 1935–44.
4. ANZIC Influenza Investigators, Webb SA, Pettilä V, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 2009; 361:1925–34.
5. Halasa NB. Update on the 2009 pandemic influenza A H1N1 in children. Curr Opin Pediatr 2010; 22:83–87.
6. Libster R, Bugna J, Coviello S, et al. Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina. N Engl J Med 2010; 362:45–55.
7. Larcombe PJ, Moloney SE, Schmidt PA. Pandemic (H1N1) 2009: a clinical spectrum in the general paediatric population. Arch Dis Child 2011; 96:96–98.
8. Hackett S, Hill L, Patel J, et al. Clinical characteristics of paediatric H1N1 admissions in Birmingham, UK. Lancet 2009; 374:605.
9. Calitri C, Gabiano C, Garazzino S, et al. Clinical features of hospitalised children with 2009 H1N1 influenza virus infection. Eur J Pediatr 2010; 169: 1511–15.
10. Lera E, Wörner TN, Sancosmed M, et al. Clinical and epidemiological characteristics of patients with influenza A (H1N1) 2009 attended to at the emergency room of a children's hospital. Eur J Pediatr 2011; Epub.
11. Pierangeli A, Gentile M, Di Marco P, et al. Detection and typing by molecular techniques of respiratory viruses in children hospitalized for acute respiratory infection in Rome, Italy. J Med Virol 2007; 79:463–68.
12. Allander T, Tammi MT, Eriksson M, et al. Cloning of a human parvovirus by molecular screening of respiratory tract samples. PNAS 2005; 102:12891–96.
13. Lockman JL, Fischer WA, Perl TM, et al. The critically ill child with novel H1N1 influenza A: a case series. Pediatr Crit Care Med 2010; 11:173–78.
14. Lister P, Reynolds F, Parslow R, et al. Swine-origin influenza virus H1N1, seasonal influenza virus, and critical illness in children. Lancet 2009; 374:605–7.
15. Fisman DN, Savage R, Gubbay J, et al. Older age and reduced likelihood of 2009 H1N1 virus infection. N Engl J Med 2009; 361:1945–52.
16. Ortiz JR, Sotomayor V, Uez OC, et al. Strategy to enhance influenza surveillance worldwide. Emerg Infect Dis 2009; 15:1271–78.
17. Watkins P, Soler NG, Fitzgerald MG, et al. Diabetic ketoacidosis during the influenza epidemic. BMJ 1970; 4:89–91.
18. Winter WE, Harris N, Schatz D. Immunological markers in the diagnosis and prediction of autoimmune type la diabetes. Clin Diabetes 2002; 20:183–91.
19. Maclaren N, Lan M, Coutant R, et al. Only multiple autoantibodies to islet cells (ICA), insulin, GAD65, IA-2 and IA-2beta predict immune-mediated (type 1) diabetes in relatives. J Autoimmun 1999; 12:279–87.

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Published In

Article first published online: July 1, 2011
Issue published: July 2011

Keywords

  1. 2009 pandemic influenza A (H1N1) virus
  2. respiratory viruses
  3. type 1 diabetes
  4. children

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© 2011 SAGE Publications.
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PubMed: 21978697

Authors

Affiliations

R. Nenna
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
P. Papoff
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
C. Moretti
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
A. Pierangeli
Virology Section, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
G. Sabatino
Paediatric Department, “G. d'Annunzio” University of Chieti, Italy
F. Costantino
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
F. Soscia
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
G. Cangiano
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
V. Ferro
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
M. Mennini
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
S. Salvadei
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
C. Scagnolari
Virology Section, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
G. Antonelli
Virology Section, Department of Experimental Medicine, “Sapienza” University of Rome, Rome
F. Midulla
Paediatric Department, Department of Experimental Medicine, “Sapienza” University of Rome, Rome

Notes

Mailing address: Prof. Fabio Midulla, Paediatric Department, “Sapienza” University of Rome, V.le Regina Elena 324, 00161, Rome Italy. Tel: ++390649979363; Fax: ++390649977412, e-mail: [email protected]

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