Featured Research

from universities, journals, and other organizations

Early lessons from the H1N1 pandemic: Critical illness in children unpredictable but survivable

Date:
January 11, 2010
Source:
Johns Hopkins Medical Institutions
Summary:
Lessons learned from the first 13 children at Johns Hopkins Children's Center to become critically ill from the H1N1 virus show that although all patients survived, serious complications developed quickly, unpredictably, with great variations from patient to patient and with serious need for vigilant monitoring and quick treatment adjustments.

Lessons learned from the first 13 children at Johns Hopkins Children's Center to become critically ill from the H1N1 virus show that although all patients survived, serious complications developed quickly, unpredictably, with great variations from patient to patient and with serious need for vigilant monitoring and quick treatment adjustments.

These and other findings were published online on Dec. 31 in the journal Pediatric Critical Care Medicine, in what is believed to be the first published analysis of critical H1N1 illness in children.

The Johns Hopkins analysis shows that 12 out of the 13 very ill children had underlying medical conditions that made them more vulnerable, including sickle cell disease, asthma and HIV. Complications varied from temporary kidney failure to acute respiratory distress syndrome, dangerously low oxygen levels and dangerously low blood pressure.

An important finding was that rapid screening tests were initially negative in eight out of the 13 children, underscoring the need for more sensitive tests.

Therefore, researchers say, all critically ill children with flu-like symptoms regardless of test results should be treated preemptively with antiviral medications. Past research has shown that antiviral medications are most effective in healthy people with the flu if taken within 12 to 48 hours after symptoms begin. Johns Hopkins currently treats all hospitalized patients with unexplained fever and flu-like symptoms regardless of test results.

"Our most surprising, and perhaps most important finding, is that the H1N1 virus behaves unpredictably and variably from one patient to the other and even within the same patient from day to day, so we must be on our toes and react fast by adjusting therapy," says lead investigator Justin Lockman, a pediatric critical-care specialist at Johns Hopkins Children's.

Investigators caution that more and larger studies are needed to guide future practice and recommendations for H1N1 treatment in children.

"Our analysis did reveal some interesting patterns and trends, but it also showed us how much more we have to learn about the behavior of this new and intriguing virus," says senior investigator David Nichols, M.D., professor of anesthesiology/critical care and pediatrics at the Johns Hopkins School of Medicine.

The Hopkins team analyzed data from 140 pediatric patients diagnosed with H1N1 between June 2009 and August 2009, of whom 13 went on to develop critical illness and were admitted to the pediatric intensive care unit (PICU) at Hopkins Children's. The novel flu strain, originally called swine flu, emerged for the first time in April 2009.

Other findings reported in the article include:

  • Asthma was the most common underlying chronic condition (11 of the 13 children had it), followed by neuromuscular diseases like cerebral palsy.
  • Nearly half of the children became so sick they needed a ventilator to help them breathe. However, no children died or required ECMO (extra-corporeal membrane oxygenation), a last-resort critical-care device that takes over the patient's lungs and heart to oxygenate and circulate the blood when the patient's organs can no longer do so.
  • One-fourth of the children developed dangerous secondary bacterial infections, more often than previously believed, which points to the need for watchful monitoring for such infections in children with H1N1.

Co-investigators include William Fischer, M.D.; Trish Perl, M.D., M.Sc.; and Alexandra Valsamakis, M.D. Ph.D.; all of Hopkins.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "Early lessons from the H1N1 pandemic: Critical illness in children unpredictable but survivable." ScienceDaily. ScienceDaily, 11 January 2010. <www.sciencedaily.com/releases/2010/01/100107114733.htm>.
Johns Hopkins Medical Institutions. (2010, January 11). Early lessons from the H1N1 pandemic: Critical illness in children unpredictable but survivable. ScienceDaily. Retrieved September 18, 2014 from www.sciencedaily.com/releases/2010/01/100107114733.htm
Johns Hopkins Medical Institutions. "Early lessons from the H1N1 pandemic: Critical illness in children unpredictable but survivable." ScienceDaily. www.sciencedaily.com/releases/2010/01/100107114733.htm (accessed September 18, 2014).

Share This



More Health & Medicine News

Thursday, September 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Artificial Sweetener Could Promote Diabetes

Artificial Sweetener Could Promote Diabetes

Newsy (Sep. 17, 2014) Doctors once thought artificial sweeteners lacked the health risks of sugar, but a new study says they can impact blood sugar levels the same way. Video provided by Newsy
Powered by NewsLook.com
Ebola Vaccine Trial Gets Underway at Oxford University

Ebola Vaccine Trial Gets Underway at Oxford University

AFP (Sep. 17, 2014) A healthy British volunteer is to become the first person to receive a new vaccine for the Ebola virus after US President Barack Obama called for action against the epidemic and warned it was "spiralling out of control." Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Obesity Rates Steady Even As Americans' Waistlines Expand

Obesity Rates Steady Even As Americans' Waistlines Expand

Newsy (Sep. 17, 2014) Researchers are puzzled as to why obesity rates remain relatively stable as average waistlines continue to expand. Video provided by Newsy
Powered by NewsLook.com
President To Send 3,000 Military Personnel To Fight Ebola

President To Send 3,000 Military Personnel To Fight Ebola

Newsy (Sep. 16, 2014) President Obama is expected to send 3,000 troops to West Africa as part of the effort to contain Ebola's spread. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins