Clinical Profile and Outcome of Influenza A/H1N1 in Pediatric Oncology Patients During the 2015 Outbreak: A Single Center Experience from Northern India.

Background: Owing to their immunocompromised status, childhood cancer patients on chemotherapy are at a greater risk for Influenza infection and its associated complications. There is limited data available on the clinical profile and outcome of Influenza A/H1N1 in this subset of patients.

Methods: A retrospective study was performed of Influenza A/H1N1 cases diagnosed between January 2015 to December 2015 in the in-patients of Pediatric Oncology unit of a tertiary care hospital from Northern India.

Results: In total, 16 children were diagnosed with laboratory confirmed H1N1. Most frequent symptoms were fever and cough. Oseltamivir was administered to all patients. Complications encountered were delay/interruption of antineoplastic therapy (9), need for respiratory support (5), and air leaks (1). Prolonged viral shedding was encountered in 50% of patients who were retested for H1N1 in their throat swabs. There were 2 deaths, 1 in a child of Acute Lymphoblastic Leukemia on induction therapy and another in a child with anaplastic Wilms tumor.

Conclusions: Childhood cancer patients infected with Influenza A/H1N1 are at risk of serious illness and higher mortality. Delay of anticancer treatment is a concern in these infected children. Prompt initiation of antivirals and an optimum duration of treatment are warranted to reduce the morbidity and mortality.