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. 2016 Jun 10:16:267.
doi: 10.1186/s12879-016-1614-z.

Influenza-associated outpatient visits among children less than 5 years of age in eastern China, 2011-2014

Tao Zhang  1   2   3 , Jun Zhang  4 , Jun Hua  5 , Dan Wang  1   2   3 , Liling Chen  4 , Yunfang Ding  5 , Shanshan Zeng  1   2   3 , Jing Wu  1   2   3 , Yanwei Jiang  1   2   3 , Qian Geng  1   2   3 , Suizan Zhou  6 , Ying Song  6 , A Danielle Iuliano  6 , Carolyn M Greene  6 , Jeffrey McFarland  6 , Genming Zhao  7   8   9
Affiliations

Influenza-associated outpatient visits among children less than 5 years of age in eastern China, 2011-2014

Tao Zhang et al. BMC Infect Dis. .

Abstract

Background: The disease burden of influenza in China has not been well described, especially among young children. The aim of this study was to estimate the incidence of outpatient visits associated with influenza in young children in Suzhou, a city of more than 11 million residents in Jiangsu Province in eastern China.

Methods: Influenza-like illness (ILI) was defined as the presence of fever (axillary temperature ≥38 °C) and cough or sore throat. We collected throat swabs for children less than 5 years of age with ILI who visited Suzhou University Affiliated Children's Hospital (SCH) outpatient clinic or emergency room between April 2011 and March 2014. Suzhou CDC, a national influenza surveillance network laboratory, tested for influenza viruses by real-time reverse transcription-polymerase chain reaction assay (rRT-PCR). Influenza-associated ILI was defined as ILI with laboratory-confirmed influenza by rRT-PCR. To calculate the incidence of influenza-associated outpatient visits, we conducted community-based healthcare utilization surveys to determine the proportion of hospital catchment area residents who sought care at SCH.

Results: The estimated incidence of influenza-associated ILI outpatient visits among children aged <5 years in the catchment area of Suzhou was, per 100 population, 17.4 (95 % CI 11.0-25.3) during April 2011-March 2012, 14.6 (95 % CI 5.2-26.2) during April 2012-March 2013 and 21.4 (95 % CI: 10.9-33.5) during April 2013-March 2014. The age-specific outpatient visit rates of influenza-associated ILI were 4.9, 21.1 and 21.2 per 100 children aged 0- <6 months, 6- <24 months and 24- <60 months, respectively.

Conclusion: Influenza virus infection causes a substantial burden of outpatient visits among young children in Suzhou, China. Targeted influenza prevention and control strategies for young children in Suzhou are needed to reduce influenza-associated outpatient visits in this age group.

Keywords: Children; China; Influenza; Influenza-like illness; Outpatient visit.

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Figures

Fig. 1
Fig. 1
Map of the jurisdiction of Suzhou and the catchment area of Soochow University Affiliated Children’s Hospital (SCH)
Fig. 2
Fig. 2
Seasonal distribution of enrolled influenza-like illness (ILI) cases positive for influenza among children <5 years of age and percent of ILI among all outpatient visits for children <5 years of age in Suzhou University Affiliated Children’s Hospital, Suzhou, April 2011-March 2014
See this image and copyright information in PMC

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