An outbreak investigation of paediatric severe acute respiratory infections requiring admission to intensive care units – Fiji, May 2016
DOI:
https://doi.org/10.5365/wpsar.v9i2.582Abstract
Introduction: Influenza-associated severe acute respiratory infections (SARI) are a major contributor to global morbidity and mortality. In May 2016, an investigation was initiated to determine whether there was an increase of paediatric SARI cases admitted to divisional hospital intensive care units in Fiji, following a cluster of SARI cases and deaths in pregnant women who tested positive for influenza A(H1N1)pdm09.
Methods: Retrospective case finding was conducted at the paediatric intensive care units (PICUs) in Fiji’s three divisional hospitals. Data were collected from the period 1 January 2013 to 26 May 2016. Cases were identified using a list of clinical diagnoses compatible with SARI.
Results: A total of 632 cases of paediatric SARI with complete details were identified. The median age of cases was 6 months (Interquartile range 2–14 months). In May 2016, children aged less than five years had a higher rate of paediatric SARI requiring admission to a divisional hospital PICU compared to the same month from 2013–2015 (Incidence rate ratio: 1.7 [95% CI: 1.1–2.6]). This increase was not observed in children aged 5–14 years. The case-fatality ratio was not significantly higher in 2016 compared to previous years.
Conclusion: The investigation enabled targeted public health response measures, including enhanced SARI surveillance at divisional hospitals and an emergency influenza vaccination campaign in the Northern Division. The introduction of an influenza vaccination policy for high risk groups should be considered to address the burden of paediatric SARI in Fiji.
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