{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:54:34Z","timestamp":1791176074188,"version":"4.1.0"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,9,1]]},"abstract":"<jats:p>Infections caused by influenza virus lead to an excess rate of hospitalization of children during winter months. Current recommendations for vaccination target only children &amp;gt;6 months who belong to specific risk groups.<\/jats:p>\n               <jats:p>Objective. To identify possible benefits of universal influenza vaccination, this study aims to determine characteristics of children hospitalized at the Montreal Children\u2019s Hospital (MCH) because of an infection attributable to influenza virus as well as risk factors associated with hospitalization.<\/jats:p>\n               <jats:p>Methods. We retrospectively reviewed records of all children with a laboratory-proven diagnosis of influenza seen at MCH between April 1, 1999, and April 1, 2002. Data were analyzed using the Student t test and logistic regression.<\/jats:p>\n               <jats:p>Results. We identified 182 patients hospitalized because of influenza and 114 patients who were not. Admission diagnoses were suspected sepsis (31%), lower respiratory tract infections (27%), and asthma or bronchiolitis (15%). Mean age of hospitalized patients was 26.1 month (median: 12 months), which was similar to that of patients not hospitalized, and 34% were &amp;lt;6 months. Seventy percent of those hospitalized did not have any underlying medical disorder and only 18% (33) were vaccine candidates according to current recommendations. Of the latter, less than half had been vaccinated. Factors associated with hospitalization were age &amp;lt;12 months (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.1\u20134.8), male gender (OR: 1.9; 95% CI: 1.0\u20133.7), dehydration (OR: 4.3; 95% CI: 1.2\u201316.0), and decreased oxygen saturation (OR: 32.1; 95% CI: 4.1\u2013249).<\/jats:p>\n               <jats:p>Conclusions. Considering that the majority of children hospitalized for influenza do not belong to the specific risk groups targeted by current recommendations, and that one third are &amp;lt;6 months of age, the target population for vaccination needs to be reexamined. Extending vaccination to all young children, to additional high-risk groups, and to pregnant women has potential to reduce the impact of influenza on children.<\/jats:p>","DOI":"10.1542\/peds.112.3.e197","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"e197-e201","source":"Crossref","is-referenced-by-count":87,"title":["Risk Factors Associated With Severe Influenza Infections in Childhood: Implication for Vaccine Strategy"],"prefix":"10.1542","volume":"112","author":[{"given":"Caroline","family":"Quach","sequence":"first","affiliation":[{"name":"Infectious Disease Division, Department of Pediatrics, Province of Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Province of Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Piche\u0301-Walker","sequence":"additional","affiliation":[{"name":"Infectious Disease Division, Department of Pediatrics, Province of Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Province of Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, McGill University, and the Montreal Children\u2019s Hospital Research Institute, Montreal, Province of Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Moore","sequence":"additional","affiliation":[{"name":"Infectious Disease Division, Department of Pediatrics, Province of Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Province of Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,9,1]]},"reference":[{"key":"2021120820253654000_R1","doi-asserted-by":"crossref","unstructured":"Glezen WP, Couch RB. Interpandemic influenza in the Houston area, 1974\u201376. N Engl J Med.1978;298:587\u2013592","DOI":"10.1056\/NEJM197803162981103"},{"key":"2021120820253654000_R2","doi-asserted-by":"crossref","unstructured":"Glezen WP, Taber LH, Frank AL, Gruber WC, Piedra PA. Influenza virus infections in infants. Pediatr Infect Dis J.1997;16:1065\u20131068","DOI":"10.1097\/00006454-199711000-00012"},{"key":"2021120820253654000_R3","doi-asserted-by":"crossref","unstructured":"Wright PF, Ross KB, Thompson J, Karzon DT. Influenza A infections in young children. Primary natural infection and protective efficacy of live-vaccine-induced or naturally acquired immunity. N Engl J Med.1977;296:829\u2013834","DOI":"10.1056\/NEJM197704142961501"},{"key":"2021120820253654000_R4","doi-asserted-by":"crossref","unstructured":"Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med.2000;342:225\u2013231","DOI":"10.1056\/NEJM200001273420401"},{"key":"2021120820253654000_R5","doi-asserted-by":"crossref","unstructured":"Izurieta HS, Thompson WW, Kramarz P, et al. Influenza and the rates of hospitalization for respiratory disease among infants and young children. N Engl J Med.2000;342:232\u2013239","DOI":"10.1056\/NEJM200001273420402"},{"key":"2021120820253654000_R6","doi-asserted-by":"crossref","unstructured":"Simonsen L, Fukuda K, Schonberger LB, Cox NJ. The impact of influenza epidemics on hospitalizations. J Infect Dis.2000;181:831\u2013837","DOI":"10.1086\/315320"},{"key":"2021120820253654000_R7","doi-asserted-by":"crossref","unstructured":"Glezen WP, Decker M, Perrotta DM. Survey of underlying conditions of persons hospitalized with acute respiratory disease during influenza epidemics in Houston, 1978\u20131981. Am Rev Respir Dis.1987;136:550\u2013555","DOI":"10.1164\/ajrccm\/136.3.550"},{"key":"2021120820253654000_R8","doi-asserted-by":"crossref","unstructured":"Neuzil KM, Wright PF, Mitchel EF Jr, Griffin MR. The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr.2000;137:856\u2013864","DOI":"10.1067\/mpd.2000.110445"},{"key":"2021120820253654000_R9","doi-asserted-by":"crossref","unstructured":"Glezen WP. Influenza and hospitalizations in children. N Engl J Med.2000;342:1752\u20131753","DOI":"10.1056\/NEJM200006083422313"},{"key":"2021120820253654000_R10","doi-asserted-by":"crossref","unstructured":"Chiu SS, Lau YL, Chan KH, Wong WH, Peiris JS. Influenza-related hospitalizations among children in Hong Kong. N Engl J Med.2002;347:2097\u20132103","DOI":"10.1056\/NEJMoa020546"},{"key":"2021120820253654000_R11","doi-asserted-by":"crossref","unstructured":"Neuzil KM, Zhu Y, Griffin MR, et al. Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis.2002;185:147\u2013152","DOI":"10.1086\/338363"},{"key":"2021120820253654000_R12","unstructured":"National Advisory Committee on Immunization. Statement on influenza vaccination for the 2002\u20132003 season. Can Commun Dis Rep.2002;28:1\u201320"},{"key":"2021120820253654000_R13","unstructured":"Notice to readers: expansion of eligibility for influenza vaccine through the Vaccines for Children Program. MMWR Morb Mortal Wkly Rep.2002;51:864"},{"key":"2021120820253654000_R14","doi-asserted-by":"crossref","unstructured":"Belshe RB, Mendelman PM, Treanor J, et al. The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenzavirus vaccine in children. N Engl J Med.1998;338:1405\u20131412","DOI":"10.1056\/NEJM199805143382002"},{"key":"2021120820253654000_R15","doi-asserted-by":"crossref","unstructured":"Belshe RB, Gruber WC, Mendelman PM, et al. Efficacy of vaccination with live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine against a variant (A\/Sydney) not contained in the vaccine. J Pediatr.2000;136:168\u2013175","DOI":"10.1016\/S0022-3476(00)70097-7"},{"key":"2021120820253654000_R16","doi-asserted-by":"crossref","unstructured":"Luce BR, Zangwill K, Palmer CS, et al. Cost-effectiveness analysis of an intranasal influenza vaccine for the prevention of influenza in healthy children. Pediatrics.2001;108(2). Available at: http:\/\/www.pediatrics.org\/cgi\/content\/full\/108\/2\/e24","DOI":"10.1542\/peds.108.2.e24"},{"key":"2021120820253654000_R17","doi-asserted-by":"crossref","unstructured":"Zangwill KM. Cold-adapted, live attenuated intranasal influenza virus vaccine. Pediatr Infect Dis J.2003;22:273\u2013274","DOI":"10.1097\/01.inf.0000057440.24094.ac"},{"key":"2021120820253654000_R18","doi-asserted-by":"crossref","unstructured":"Quach C, Newby D, Daoust G, Rubin E, McDonald J. QuickVue influenza test for rapid detection of influenza A and B viruses in a pediatric population. Clin Diagn Lab Immunol.2002;9:925\u2013926","DOI":"10.1128\/CDLI.9.4.925-926.2002"},{"key":"2021120820253654000_R19","doi-asserted-by":"crossref","unstructured":"Daley AJ, Nallusamy R, Isaacs D. Comparison of influenza A and influenza B virus infection in hospitalized children. J Paediatr Child Health.2000;36:332\u2013335","DOI":"10.1046\/j.1440-1754.2000.00533.x"},{"key":"2021120820253654000_R20","unstructured":"Ryan-Poirier K. Influenza virus infection in children. Adv Pediatr Infect Dis.1995;10:125\u2013156"},{"key":"2021120820253654000_R21","doi-asserted-by":"crossref","unstructured":"Chiu SS, Tse CYC, Lau YL, Peiris M. Influenza A infection is an important cause of febrile seizures. Pediatrics.2001;108(4). Available at: http:\/\/www.pediatrics.org\/cgi\/content\/full\/108\/4\/e63","DOI":"10.1542\/peds.108.4.e63"},{"key":"2021120820253654000_R22","doi-asserted-by":"crossref","unstructured":"Morishima T, Togashi T, Yokota S, et al. Encephalitis and encephalopathy associated with an influenza epidemic in Japan. Clin Infect Dis.2002;35:512\u2013517","DOI":"10.1086\/341407"},{"key":"2021120820253654000_R23","doi-asserted-by":"crossref","unstructured":"Bjornson GL, Scheifele DW, Halperin SA; Canadian Paediatric Society\/Health Canada Immunization Monitoring Program, Active. Population-based epidemiology of invasive pneumococcal infection in children in nine urban centers in Canada, 1994 through 1998. Pediatr Infect Dis J.2002;21:947\u2013950","DOI":"10.1097\/00006454-200210000-00012"},{"key":"2021120820253654000_R24","doi-asserted-by":"crossref","unstructured":"Rennels MB, Meissner C, AAP Committee on Infectious Diseases. Technical report: reduction of the influenza burden in children. Pediatrics.2002;110(6). Available at: http:\/\/www.pediatrics.org\/cgi\/content\/full\/110\/6\/e80","DOI":"10.1542\/peds.110.6.e80"},{"key":"2021120820253654000_R25","unstructured":"Bridges CB, Fukuda K, Uyeki TM, Cox NJ, Singleton JA. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.2002;51(RR-3):1\u201331"},{"key":"2021120820253654000_R26","doi-asserted-by":"crossref","unstructured":"Heikkinen T, Ruuskanen O, Waris M, Ziegler T, Arola M, Halonen P. Influenza vaccination in the prevention of acute otitis media in children. Am J Dis Child.1991;145:445\u2013448","DOI":"10.1001\/archpedi.1991.02160040103017"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/3\/e197\/1006847\/pe090300e197.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/3\/e197\/1006847\/pe090300e197.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:23:05Z","timestamp":1639009385000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/112\/3\/e197\/28687\/Risk-Factors-Associated-With-Severe-Influenza"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,9,1]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2003,9,1]]},"published-print":{"date-parts":[[2003,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.112.3.e197","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,9,1]]}}}