FLU NEWS SCAN: Treating pneumonia in kids, ILI vs flu

Aug 31, 2011

IDSA, PIDS release guidelines for treating pneumonia in children
A new set of guidelines on diagnosing and treating community-acquired pneumonia (CAP) in infants and children, published by two medical societies, emphasizes preventing bacterial pneumonia as a top priority. The guidelines, containing 92 recommendations, were developed by the Infectious Diseases Society of America (IDSA) and the Pediatric Infectious Diseases Society (PIDS) and published online in Clinical Infectious Diseases. In a press release, the IDSA said bacterial pneumonia is the most serious type in children, and it tends to take a different course in children than in adults, with the result that practices vary among hospitals and physicians. The guidelines provide "a roadmap to the most scientifically valid diagnosis and treatment recommendations," the IDSA said. "Diagnostic methods and treatments that work well in adults may be too risky and not have the desired result in children," John S. Bradley, MD, of the University of California at San Diego, lead author of the guidelines, said in the release. The guidelines also stress that immunizations, including annual flu vaccination, are the best way to protect children from life-threatening pneumonia. The IDSA said most pneumonia in preschool children is caused by viruses, such as flu, and cases usually run their course without leading to serious complications, but sometimes they lead to bacterial pneumonia. The guidelines also warn against overtreatment, such as using antibiotics to treat viral pneumonia.
Aug 30 Clin Infect Dis guidelines

Study finds low percentage of H1N1 among ILI cases at pandemic's peak
Researchers who analyzed case records at four Chicago area hospitals covering the peak of the 2009 H1N1 influenza pandemic found that only 23% of patients with influenza-like illness (ILI) had the pandemic virus, according to a report in Infection Control and Hospital Epidemiology. By examining electronic medical records for Oct 18 through Nov 14, 2009, the researchers identified 460 patients who had signs and symptoms consistent with ILI within 1 day after presenting at a hospital emergency department. Healthcare providers recognized ILI in 412 (90%) of these patients, as evidenced by their ordering a flu test or mentioning flu as a possible diagnosis. Of the 412 patients, 85% were placed under airborne or droplet isolation precautions and 53% received antiviral treatment. Of 401 patients who were tested for flu, only 91 (23%) tested positive. Given this low percentage, "public health officials should use caution in interpreting ILI surveillance data," the report states. Also, because none of the patients with confirmed flu had a sore throat without a cough, the authors said future prospective studies should evaluate whether to include sore throat in the ILI case definition.
Aug 30 Infect Control Hosp Epidem iol report

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