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Children with asthma and neurological conditions could benefit from flu preventing strategies

Infographic which children are most at risk of complications from flu NIHR School for Primary Care Research

Strategies for preventing flu and complications arising from flu in the community should be targeted at children with asthma and neurological conditions, recommends a study led by Oxford University researchers with the London School of Hygiene and Tropical Medicine.

Some children are believed to be more prone to developing further complications from flu, including chest, ear and throat infections. Health care professionals need to know which children are at greatest risk of developing complications from flu to help them ensure that these children get their flu vaccination and that if they develop a flu-like illness they are considered for early treatment to prevent further complications. This is especially important in GP surgeries, where most children with flu-like illness are seen.

Published in Epidemiology and Infection, the researchers looked at risk factors for influenza-related complications by studying the routinely collected medical records of nearly 17,000 children who were seen in a GP surgery with flu-like illness during the swine flu pandemic in 2009-10. 

Lead author Dr Joseph Lee, a GP and NIHR In Pfactice Fellow at Oxford University's Nuffield Department of Primary Care Health Sciences, said: "Complications related to influenza can occur in anyone, but we found that children with asthma and neurological conditions are at higher risk. The risk is also higher in young children, meaning otherwise healthy infants and babies have more complications than older children."

The researchers found that around 1 in 12 children developed further complications from flu, mostly within one day of being seen by a doctor or nurse. They also found that children with asthma were at greatest risk of complications from flu requiring treatment in the community or admission to hospital, and children with neurological conditions, such as epilepsy, cerebral palsy, and other medical conditions which affect the brain and nerves, were at greatest risk of being admitted to hospital for any reason, not just complications from flu.

Importantly, complications from flu were less common in children who were prescribed antibiotics or antiviral medications (such as Tamiflu®) during their first visit to the GP surgery. However, it was not possible to tell whether these medications had a direct effect on preventing complications in these children. 

The findings suggest that strategies for preventing flu and complications from flu in the community should be targeted at children with asthma and neurological conditions. The researchers suggest future studies should investigate whether these children might benefit from being treated with antibiotics or antiviral medications early during a flu-like illness to prevent further complications.

The study was funded by the NIHR School for Primary Care Research. 

Article adapted from the NIHR SPCR website.

Publication:

Risk factors for influenza-related complications in children during the 2009/10 pandemic: a UK primary care cohort study using linked routinely collected data.
JJ Lee, C Bankhead, M Smith, AA Kousoulis, CC Butler, K Wang, Epidemiology & Infection: DOI: 10.1017/S0950268818000353

Oxford research team:

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