{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T16:53:43Z","timestamp":1771001623412,"version":"3.50.1"},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"14","license":[{"start":{"date-parts":[[2015,2,2]],"date-time":"2015-02-02T00:00:00Z","timestamp":1422835200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>A novel influenza virus emerged in the United States in spring 2009, rapidly becoming a global pandemic. Children were disproportionally affected by the novel influenza A(H1N1) pandemic virus [A(H1N1)pdm]. This retrospective electronic medical record review study aimed to identify clinical predictors of disease severity of influenza A(HIN1)pdm infection in paediatric patients. Disease severity was defined on an increasing three-level scale from non-hospitalized, hospitalized, and admitted to the intensive care unit (ICU). From April 2009 to June 2010, 696 children presented to Texas Children's Hospital's emergency department, 38% were hospitalized, and 17% were admitted to the ICU. Presenting symptoms associated with severe influenza were dyspnoea [odds ratio (OR) 5\u00b782], tachycardia (OR 2\u00b761) and fatigue (OR 1\u00b796). Pre-existing health conditions associated with disease severity included seizure disorder (OR 4\u00b771), obesity (OR 3\u00b728), lung disease (OR 2\u00b784), premature birth (OR 2\u00b753), haematological disease (OR 2\u00b722), and developmental delay (OR 2\u00b720). According to model fitness tests, presenting symptoms were more likely to predict severe influenza than underlying medical conditions. However, both are important risk factors. Recognition of clinical characteristics associated with severe disease can be used for triaging case management of children during future influenza outbreaks.<\/jats:p>","DOI":"10.1017\/s0950268815000114","type":"journal-article","created":{"date-parts":[[2015,2,2]],"date-time":"2015-02-02T03:44:32Z","timestamp":1422848672000},"page":"2939-2949","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":29,"title":["Clinical predictors of disease severity during the 2009\u20132010 A(HIN1) influenza virus pandemic in a paediatric population"],"prefix":"10.1017","volume":"143","author":[{"given":"M. N.","family":"GARCIA","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. C.","family":"PHILPOTT","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. O.","family":"MURRAY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"ONTIVEROS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. A.","family":"REVELL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"CHANDRAMOHAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. M.","family":"MUNOZ","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,2,2]]},"reference":[{"key":"S0950268815000114_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70264-0"},{"key":"S0950268815000114_ref6","unstructured":"Texas Department of State Health Services. Texas Influenza Summary Report, 2009\u20132010 season (12 April 2009\u20132 October 2010) overview. 2013 (http:\/\/www.dshs.state.tx.us\/idcu\/disease\/influenza\/surveillance\/2010\/). Accessed 3 January 2014."},{"key":"S0950268815000114_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2014.04.026"},{"key":"S0950268815000114_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906695"},{"key":"S0950268815000114_ref7","unstructured":"Centers for Disease Control and Prevention. Influenza season summary. 2009\u20132010 (http:\/\/www.cdc.gov\/flu\/weekly\/weeklyarchives2009-2010\/09-10summary.htm). Accessed 3 January 2014."},{"key":"S0950268815000114_ref2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-1475"},{"key":"S0950268815000114_ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.40"},{"key":"S0950268815000114_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2011.02.010"},{"key":"S0950268815000114_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-012-0784-y"},{"key":"S0950268815000114_ref10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4836"},{"key":"S0950268815000114_ref14","unstructured":"Centers for Disease Control and Prevention. Final estimates for 2009\u201310 seasonal influenza and influenza A(H1N1) 2009 monovalent vaccination coverage\u00a0\u2013\u00a0United States, August 2009 through May 2010 (http:\/\/www.cdc.gov\/flu\/professionals\/vaccination\/coverage_0910estimates.htm). Accessed 11 November 2013."},{"key":"S0950268815000114_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2011.07.014"},{"key":"S0950268815000114_ref13","first-page":"1","article-title":"Surveillance of influenza vaccination coverage-United States, 2007\u201308 through 2011\u201312 influenza seasons","volume":"62","author":"Lu","year":"2013","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268815000114_ref5","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302197"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268815000114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,20]],"date-time":"2019-04-20T15:26:31Z","timestamp":1555773991000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268815000114\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,2]]},"references-count":14,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["S0950268815000114"],"URL":"https:\/\/doi.org\/10.1017\/s0950268815000114","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,2]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2015\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}