Lack of information on clinical an immunological features in pediatric population with H1N1VI, delay detection of patients at risk of contracting it. This study aims to identify specific immunologic and/or clinical features of pediatric patients with H1N1VI in a federal Hospital in Mexico city.
Methods: Single-center, observational, non-experimental, prospective trail from September to October 2009, for pediatric patients arriving to Emergency room of Juarez Hospital, with suspicion of H1N1VI, needing to be younger than 17 years, and agree and sign the consent form by tutor.
Samples obtained were peripheral blood, and pharyngeal exudate. From blood LS, Cytokine levels, and routine measurements (CBC, BCH) were investigated; the pharyngeal sample underwent PCR study to viral genetic material. Complementary studies such as arterial blood gases or Torax radiography were realized as needed.
Results: 32 patients participated. PCR results confirmed 18 cases (56%), 1 patient resulted positive for SII. The average age was 9 years old; 12 (67%) were female, and 6 (33%) were male. The mean amount of days from symptom onset to receiving medical attention was 2.5 days. Main symptoms and signs were fever, malaise, cough, rhinorrhea, and headache. Associated risk factors included malnutrition and tobacco exposure. It was demonstrated an elevation of IL-8, followed by IL-6, IL-12 and IL-10. Blood analysis proved no significant findings, though cases of neutrophilia and leukopenia were detected.
Conclusions: Limited resources, restricted participation from all the possible H1N1VI patients, thus biasing results due to small sample size. However, the obtained data is consistent with existing reports, nevertheless the information is not enough to establish standardized recommendations. Further collaboration among centers, is needed to identify features that can prompt H1N1VI early identification and prevention in pediatric population.
SII= Stational Influenza infection; LS = lymphocyte subpoulations; CBC = Complete blood count, BCH (blood chemistry) = Includes levels of glucose, urea, creatinine, ALT, AST, CPK CPK-MB, amylase and lipase.