소아 인플루엔자 입원 환자에 있어서 항원형에 따른 최근 역학 및 임상적 특성의 비교

Abstract

Purpose: I did this study to know the epidemiological and clinical characteristics of childhood influenza A and B by comparison of them. Methods: I collected clinical informations of influenza patients who had been diagnosed and admitted at the Department of Pediatrics, Yogin Severance Hospital from September 2013 to August 2016. Influenza infection was decided by rapid antigen test from nasopharyngeal swab. Their features for that mentioned above were compared by influenza antigenic type. Results: There were 65 cases for type A and 45 cases for type B. The peak month for type A and B were February (61.5%) and March (51.1%), respectively ( P =0.004). Their age and male to female ratio were not significantly different between two antigenic types (65.2±49.2 months old for type A vs. 69.2±45.0 months old for type B, 33:32 for type A vs. 18:27 for type B). Their major clinical manifestations were fever (100.0% for both types), cough (93.8% for type A vs. 91.1% for type B), rhinorrhea (78.5% for type A vs. 82.3% for type B), sputum (69.2% for type A vs. 75.6% for type B). Pre-admission fever duration of influenza A and B were 1.9±1.4 days and 2.8±1.9 days, respectively ( P =0.004). Nausea was shown on two cases (3.1%) in type A and 6 cases (13.3%) in type B ( P =0.049). Lower respiratory tract involvements were noticed on 42 cases (64.6%) in type A and 26 cases (57.8%) in type B. Their admission duration were comparable with each other (3.2±1.1 days for type A and 3.3±1.2 days for type B). Regarding to laboratory findings, there were differences between them such as mean platelet count (247,846.2±85,400.4/µL for type A vs. 213,590.9 ±61,747.9/µL for type B, P =0.024), mean uric acid level (4.5±1.1 mg/dL for type A vs. 3.9±1.4 mg/dL for type B, P =0.022) and frequency of cases with abnormal level of C-reactive protein (56.9% for type A vs. 28.6% for type B, P =0.004). Conclusion: Although there are some differences for initial epidemiological and clinical findings influenza A and B in children, the overall clinical features and prognosis are comparable with each other. Further investigation should be performed to elucidate the clinical significance of antigenic typing in childhood influenza.