Influenza a pneumonia in the pediatric population in the post-pandemic era
DOI:
https://doi.org/10.56294/saludcyt20251867Keywords:
influenza a, pediatric pneumonia, h1n1, oseltamivirAbstract
Introduction:Influenza A pneumonia is an acute viral infection that affects the respiratory tract and is transmitted through droplets expelled when coughing or sneezing. In the pediatric population, it presents with symptoms such as fever, cough, rhinorrhea, and respiratory distress, which can lead to complications like respiratory distress or bacterial superinfection. Objective:The aim was to identify Influenza A as a cause of pneumonia in children aged 1 year to 10 years in the post-pandemic context. Methods:A prospective, observational, and analytical study was conducted in 265 children without previous comorbidities, admitted between 2023 and 2025 at the Ambato General Hospital IESS. Patients aged 1 year to 10 years, diagnosed through nasopharyngeal swabs for Influenza A, were included. Results: 53 % of the cases were female, and 47 % male, with the majority of cases in the 3 to 5 years group (27 %). 82 % had contact with individuals with prior respiratory symptoms. The most common symptoms were cough (23 %), fever (22 %), rhinorrhea (21 %), and respiratory distress (50 %). Radiological images showed hyperinflation (19 %) and interstitial patterns (18 %). Influenza A and Respiratory Syncytial Virus were the predominant etiological agents. Conclusions:Influenza A is a significant cause of pneumonia in children, particularly in those under 5 years old, with a higher incidence in winter months, especially in February. The implementation of epidemiological surveillance protocols and early treatment is recommended to reduce mortality.
References
1. Palestino-Frías C, Escobedo-Guajardo BL. El virus de la influenza y su resurgimiento después de la pandemia de COVID-19. Revista Ciencia UANL [Internet]. 2025 Mar 3 [cited 2025 May 15];28(130):28–35. Available from: https://cienciauanl.uanl.mx/ojs/index.php/revista/article/view/425
2. Peter Chin-Hong, Elizabeth A. Joyce, Manjiree Karandikar, Mehrdad Matloubian, Luis Alberto Rubio, Brian Schwartz, et al. Levinson. Microbiología médica e inmunología. Una guía acerca de las enfermedades infecciosas, 18e | AccessMedicina | McGraw Hill Medical. In: Microbiología médica e inmunología [Internet]. 18th ed. 2024 [cited 2025 May 15]. Available from: https://accessmedicina.mhmedical.com/book.aspx?bookID=3503
3. Wu NC, Wilson IA. Influenza hemagglutinin structures and antibody recognition. Cold Spring Harb Perspect Med [Internet]. 2021 Aug 1 [cited 2025 May 16];10(8):1–20. Available from: https://pubmed.ncbi.nlm.nih.gov/31871236/
4. Bouvier NM, Palese P. The biology of influenza viruses. Vaccine [Internet]. 2008 Sep 12 [cited 2025 May 15];26(SUPPL. 4). Available from: https://pubmed.ncbi.nlm.nih.gov/19230160/
5. Ratre YK, Vishvakarma NK, Bhaskar LVKS, Verma HK. Dynamic Propagation and Impact of Pandemic Influenza A (2009 H1N1) in Children: A Detailed Review [Internet]. Vol. 77, Current Microbiology. 2021 [cited 2025 May 15]. p. 3809–20. Available from: https://doi.org/10.1007/s00284-020-02213-x
6. Azziz-Baumgartner E, Bruno A, Daugherty M, Chico ME, Lopez A, Arriola CS, et al. Incidence and seasonality of respiratory viruses among medically attended children with acute respiratory infections in an Ecuador birth cohort, 2011–2014. Influenza Other Respir Viruses [Internet]. 2022 Jan 1 [cited 2025 May 15];16(1):24–33. Available from: /doi/pdf/10.1111/irv.12887
7. Monto AS, Kuhlbusch K, Bernasconi C, Cao B, Cohen HA, Graham E, et al. Efficacy of Baloxavir Treatment in Preventing Transmission of Influenza. New England Journal of Medicine [Internet]. 2025 Apr 24 [cited 2025 May 15];392(16):1582–93. Available from: http://www.ncbi.nlm.nih.gov/pubmed/40267424
8. Carter T, Iqbal M. The Influenza A Virus Replication Cycle: A Comprehensive Review. Viruses [Internet]. 2024 Feb 19 [cited 2025 May 15];16(2):316. Available from: https://www.mdpi.com/1999-4915/16/2/316
9. Hook JL, Bhattacharya J. The pathogenesis of influenza in intact alveoli: virion endocytosis and its effects on the lung’s air-blood barrier [Internet]. Vol. 15, Frontiers in Immunology. Frontiers Media SA; 2024 [cited 2025 May 16]. Available from: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1328453/full
10. Fodor E, Velthuis AJWT. Structure and function of the influenza virus transcription and replication machinery. Cold Spring Harb Perspect Med. 2020 Sep 1;10(9):1–14.
11. Bauer L, Rijsbergen LC, Leijten L, Benavides FFW, Noack D, Lamers MM, et al. The pro-inflammatory response to influenza A virus infection is fueled by endothelial cells. Life Sci Alliance. 2023 Jul 1;6(7).
12. Lork M, Childs L, Lieber G, König R, Hale BG. Influenza A Virus NS1 Limits Recognition of Double-Stranded Transposable Elements by Cytosolic RNA Sensors. bioRxiv [Internet]. 2024 May 25; Available from: http://biorxiv.org/lookup/doi/10.1101/2024.05.24.595739
13. Białka S, Zieliński M, Latos M, Skurzyńska M, Żak M, Palaczyński P, et al. Severe Bacterial Superinfection of Influenza Pneumonia in Immunocompetent Young Patients: Case Reports. J Clin Med [Internet]. 2024 Oct 1 [cited 2025 May 15];13(19):5665. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11476596/
14. Jugulete G, Olariu MC, Stanescu R, Luminos ML, Pacurar D, Pavelescu C, et al. The Clinical Effectiveness and Tolerability of Oseltamivir in Unvaccinated Pediatric Influenza Patients during Two Influenza Seasons after the COVID-19 Pandemic: The Impact of Comorbidities on Hospitalization for Influenza in Children. Viruses [Internet]. 2024 Oct 7 [cited 2025 May 15];16(10). Available from: http://www.ncbi.nlm.nih.gov/pubmed/39459910
15. Miron VD, Bar G, Filimon C, Craiu M. From COVID-19 to Influenza—Real-Life Clinical Practice in a Pediatric Hospital. Diagnostics. 2022 May 1;12(5).
16. Bouzada FM, Mestre B, Vaquer A, Tejada S, de la Rica R. Detecting Respiratory Pathogens for Diagnosing Lower Respiratory Tract Infections at the Point of Care: Challenges and Opportunities. Vol. 15, Biosensors. Multidisciplinary Digital Publishing Institute (MDPI); 2025.
17. Carbonell R, Moreno G, Martín-Loeches I, Bodí M, Rodríguez A. The Role of Biomarkers in Influenza and COVID-19 Community-Acquired Pneumonia in Adults. Vol. 12, Antibiotics. MDPI; 2023.
18. Jilani TN, Siddiqui AH. H1N1 Influenza (Swine Flu). In: StatPearls [Internet]. StatPearls Publishing; 2023 [cited 2025 May 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513241/
19. López-Medrano F, Alfayate S, Carratalà J, Chamorro-Camazón J, Cordero E, Cruz-Cañete M, et al. Executive summary – Diagnosis, treatment and prophylaxis of influenza virus infection – Consensus statement of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Pediatric Infectious Diseases (SEIP), the S. Aten Primaria [Internet]. 2023 Jun 1 [cited 2025 May 15];55(6). Available from: https://www.elsevier.es/es-revista-atencion-primaria-27-articulo-executive-summary-diagnosis-treatment-S0212656723000628
20. Kanecki K, Lewtak K, Goryński P, Tyszko P, Bogdan M, Rzad M, et al. Hospitalization of Children Aged <5 Years Due to Influenza: Study Based on the National Hospitalization Registry. Children. 2022 Jul 1;9(7).
21. Rafeek RAM, Divarathna MVM, Morel AJ, Noordeen F. Clinical and epidemiological characteristics of influenza virus infection in hospitalized children with acute respiratory infections in Sri Lanka. PLoS One [Internet]. 2022 Sep 1 [cited 2025 May 23];17(9 September). Available from: https://pubmed.ncbi.nlm.nih.gov/36054097/
22. Infecciones Respiratorias Agudas en [Internet]. Available from: http://www.jah
23. Elizabeth J, Martrus R, Erika ;, Alarcón Chávez J, Karla ;, Paredes Zambrano A, et al. Prevención y diagnóstico virus de la influenza Prevention and diagnosis of influenza virus Prevenção e diagnóstico do vírus influenza. 2020;4(1).
24. Baker J, Block SL, Matharu B, Burleigh Macutkiewicz L, Wildum S, Dimonaco S, et al. Baloxavir marboxil single-dose treatment in influenza-infected children: A randomized, double-blind, active controlled phase 3 safety and efficacy trial (miniSTONE-2). Pediatric Infectious Disease Journal. 2020 Aug 1;39(8):700–5.
25. Randolph AG, Xu R, Novak T, Newhams MM, Wardenburg JB, Weiss SL, et al. Vancomycin monotherapy may be insufficient to treat methicillin-resistant staphylococcus aureus coinfection in children with influenza-related critical illness. Clinical Infectious Diseases. 2019 Jan 18;68(3):365–72.
26. Wang Q yu, Yuan L, Lin J yi, Zhuo Z qiang, Wang Y mei, Li S si, et al. Clinical characteristics of severe influenza virus-associated pneumonia complicated with bacterial infection in children: a retrospective analysis. BMC Infect Dis. 2023 Dec 1;23(1).
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Copyright (c) 2025 Paredes Lascano, Patricia, Toapanta Yugcha, Iván, Mejía Ortiz, Ruth, Bravo Paredes, Leonardo, Aguayo Escobar, Andrea (Author)
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