Pulmonary abscess of viral-bacterial etiology in a neonate.
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Anti-Infective Agents↗
Biomedical subjects
Ville Peltola
Publications and source records attributed to Ville Peltola.
Respiratory viruses in children with invasive pneumococcal disease.
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Child↗
Cost-effectiveness of influenza vaccination of healthy children.
Influenza vaccination of children 6-23 months of age is recommended in the United States and Canada because of high rates of influenza-associated hospitalisations, but few other countries have adopted similar policies. Most children with influenza are treated in the primary care setting, and the cost-effectiveness of influenza vaccination of children has not been fully established. We used a decision analysis model to assess the cost-effectiveness of influenza vaccination of children 6 months to 13 years of age in Finland. The analyses were based on comprehensive clinical data on virologically confirmed influenza infections, hospital medical records, and national registers. We estimated the impact of influenza on outpatient and hospitalised children and their families, and performed the analyses from the health care provider and societal perspective. Influenza vaccination resulted in savings in all programs including children <or=13 years of age from both the health care provider and societal perspective. Investing 1.7 million euros in vaccination of children <5 years of age yielded savings of 2.7 million euros in health care costs. From the health care provider perspective, the savings per vaccinated child ranged between 5.7 and 12.6 euros in any program including children up to 13 years of age. The vaccination was cost saving in all age groups even with assumed vaccine efficacy of 60%. The results show that influenza vaccination would be cost saving in all children <or=13 years of age in Finland, which advocates reconsideration of the current influenza vaccine recommendations in all countries.
Adolescent↗
Comparison of total white blood cell count and serum C-reactive protein levels in confirmed bacterial and viral infections.
We report the association of reaction in inflammatory markers with the microbiologic etiology of infection in children. Total white blood cell counts were increased in most pneumococcal and Escherichia coli infections, but in less than one-half of Staphylococcus aureus infections. Adenoviruses were the only viral agents that often increased total white blood cell counts or serum C-reactive protein levels.
Adenoviridae Infections↗
Influenza pneumonia.
BACKGROUND: Influenza and pneumonia are common childhood illnesses, but few studies have been conducted on influenza-related pneumonia in children. The aim of this study was to describe the frequency and characteristics of laboratory-documented and radiologically detected influenza pneumonia in children. METHODS: This study involved children treated at the Department of Pediatrics, Turku University Hospital, from 1980 through 2003. Influenza A or B infection was documented with the use of antigen detection from nasopharyngeal aspirates. Children with chest radiographs obtained during influenza episodes were identified. Chest radiographs were reevaluated by a pediatric radiologist for verification of pneumonic infiltrates. Clinical and laboratory data were collected from medical records. RESULTS: Pneumonia was detected in 134 (14%) of 936 children with influenza infection. The most frequent signs of influenza pneumonia were fever and cough. Of these children, 47% had no specific clinical signs or symptoms suggesting pneumonia. White blood cell count was <15 x 10/L in 89% and serum C-reactive protein concentration <80 mg/L in 85% of the children. One-half of the children had solely interstitial infiltrates, one-fourth solely alveolar and one- fourth both alveolar and interstitial infiltrates on the chest radiograph. The hospitalization rate was 68%, and the median duration of hospitalization was 2 days. Complicated pneumonias were rare, and mortality was low (0.7%). CONCLUSIONS: Pneumonia is detected in a minority of children treated for influenza at a tertiary center. Unlike in adults, influenza pneumonia in children is usually a benign illness, and the mortality is low.
C-Reactive Protein↗
Accuracy of clinical diagnosis of influenza in outpatient children.
In a prospective study, children < or =13 years of age with respiratory infections were examined. At each visit, a nasal swab specimen was obtained for the detection of influenza, and the physician recorded his or her opinion on whether the child had influenza. Among 2288 infections, the overall sensitivity of the clinical diagnosis of influenza was 38% and the positive predictive value was 32%.
Adolescent↗
Burden of influenza in children in the community.
BACKGROUND: Influenza vaccination of healthy children is encouraged because children are frequently hospitalized for influenza-attributable illnesses. However, most children with influenza are treated as outpatients, and scarce data are available on the burden of influenza in these children. METHODS: We performed a prospective study of respiratory infections in preenrolled cohorts of children < or = 13 years old during 2 consecutive respiratory seasons (2231 child-seasons of follow-up). At any sign of respiratory infection, we examined the children and obtained a nasal swab for the detection of influenza. The parents filled out daily symptom diaries. Of all the enrollees, 94% remained active participants in the study. RESULTS: The average annual rate of influenza was highest (179 cases/1000 children) among children < 3 years old. Acute otitis media developed as a complication of influenza in 39.7% of children < 3 years old. For every 100 influenza-infected children < 3 years old, there were 195 days of parental work loss (mean duration, 3.2 days). CONCLUSIONS: Influenza causes a substantial burden of illness on outpatient children and their families. Vaccination of children < 3 years old might be beneficial for reducing the direct and indirect costs of influenza in children.
Acute Disease↗
[Empyema--increasingly common complication connected to pneumonia in children].
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Adolescent↗
Influenza A and B virus infections in children.
To obtain data on the clinical manifestations of infection, the age distribution, and the underlying conditions of children with influenza severe enough to lead to hospital referral, we performed a retrospective study of children treated at Turku University Hospital (Turku, Finland) in 1980-1999. Influenza A or B antigen was detected in the nasopharyngeal aspirates of 683 of the 15,420 children studied. The median age of children with influenza A was 2.0 years (n=544), and that of children with influenza B was 4.2 years (n=139) (P<.001). One-fourth of the children had an underlying medical condition. High fever, cough, and rhinorrhea were the most frequently recorded symptoms. Acute otitis media developed in 24% of the children, and pneumonia developed in 9% of the children. The study shows that the majority of patient hospitalizations for pediatric influenza involve previously healthy infants and young children. Laboratory confirmation of influenza is particularly important for children because the clinical presentation of the infection is less characteristic than that seen in adults.
C-Reactive Protein↗
Incidence of influenza in Finnish children.
BACKGROUND: Influenza is an important cause of respiratory illness in children, but data on virologically confirmed influenza infections in children treated as outpatients are limited. METHODS: We carried out a prospective cohort study of normal children younger than 13 years (n = 1338) in the winter of 2000 to 2001. During the study period of 32 weeks, the children were examined at the study clinic whenever they had fever or signs of respiratory infection. Nasal swabs were obtained during each episode of infection for determination of the viral etiology of the illness. RESULTS: The overall attack rate of influenza in the cohort was 18.8%. Influenza viruses were isolated from the children from the beginning of November 2000 through May 2001. Virtually in each week between mid-November and the end of April (a period of 24 weeks), influenza viruses accounted for at least 5% of all respiratory infections in the children. During the peak of the epidemic, the percentage of influenza-positive children exceeded 20%. CONCLUSIONS: This study confirms the important role of influenza as a cause of acute respiratory infections in children, even in winters of mild or moderate influenza activity. The study also shows that influenza viruses may circulate in the community at substantial levels much longer than previously thought.
Acute Disease↗
Clinical courses of croup caused by influenza and parainfluenza viruses.
Influenza viruses have occasionally been associated with severe manifestations of croup, but no comparative studies of different viral etiologies are available. In a retrospective study we compared the clinical courses of croup caused by influenza and parainfluenza viruses in hospitalized children. By several indicators the clinical picture of croup caused by influenza viruses was significantly more severe than that caused by parainfluenza viruses.
Child↗