• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.164-170
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• 2014

Influenza causes acute respiratory infections and various complications. Children in the high-risk group have higher complication and hospitalization rates than high-risk elderly individuals. Influenza prevention in children is important, as they can be a source infection spread in their communities. Influenza vaccination is strongly recommended for high-risk children with chronic underlying circulatory and respiratory disease, immature infants, and children receiving long-term immunosuppressant treatment or aspirin. However, vaccination rates in these children are low because of concerns regarding the exacerbation of underlying diseases and vaccine efficacy. To address these concerns, many clinical studies on children with underlying respiratory diseases have been conducted since the 1970s. Most of these reported no differences in immunogenicity or adverse reactions between healthy children and those with underlying respiratory diseases and no adverse effects of the influenza vaccine on the disease course. Further to these studies, the inactivated split-virus influenza vaccine is recommended for children with underlying respiratory disease, in many countries. However, the live-attenuated influenza vaccine (LAIV) is not recommended for children younger than 5 years with asthma or recurrent wheezing. Influenza vaccination is contraindicated in patients with severe allergies to egg, chicken, or feathers, because egg-cultivated influenza vaccines may contain ovalbumin. There has been no recent report of serious adverse events after influenza vaccination in children with egg allergy. However, many experts recommend the trivalent influenza vaccine for patients with severe egg allergy, with close observation for 30 minutes after vaccination. LAIV is still not recommended for patients with asthma or egg allergy.

• Korean Journal of Clinical Pharmacy
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• v.13 no.1
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• pp.5-12
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• 2003

Influenza virus is a major cause of respiratory infection in the epidemic season. Especially, the elderly with underlying health problems are at increased risk for complications of influenza. The objective of this study was to investigate that influenza vaccination can reduce the hospital admission rate related to the respiratory diseases. This study was a retrospective study of two age groups, who are the healthy children aged 6 months to 9 years (n=237) and the adults aged over 20 years with respiratory disease (n=327). The vaccinated groups were compared to the controls that were matched in sex and age. The children were vaccinated in winter season of 1995-96 and the adults were vaccinated in 1996-97. The efficacy of influenza vaccine was evaluated with the number of outpatient visits in children group, the admission rate and the mean admission days in both children and adult group. As results, there were not significant differences between the vaccinated and the control group of children. In the elderly over 61 years, however, the influenza vaccination can reduce the admission rate $(8.9\%\;vs.\;25.6\%,\;p<0.05)$ and the mean admission days (1.3 vs. 3.8 days, p<0.05) compared to the control. In conclusion, influenza vaccination can effectively reduce the events related to respiratory infection in the elderly than the children. The elderly should be recommended for influenza vaccination.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.53-61
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• 2020

Purpose: To compare differences and changes in the parents' awareness regarding influenza and influenza vaccination for their children according to educational intervention. Methods: This study involved 1,034 parents with children aged 6-59 months, who lived in five areas in northern Seoul and Gyeonggi Province in 2015; the study was conducted using the questionnaire survey method. Survey items included awareness regarding influenza and influenza vaccination for children and future intentions of influenza vaccination and the underlying reasons. The participants were divided into 3 groups and differences according to education (group A: no education, group B: provided education) and the changes before and after education (group C) were analyzed. Results: Differences according to education between groups A and B were seen in the recognition of high-risk of influenza in their children, effectiveness of influenza vaccination, and cost of the influenza vaccine. Changes before and after education in group C were seen in the recognition of high-risk of influenza in their children, safety of influenza vaccination, cost of the influenza vaccine, and negativity toward the influenza vaccine. Conclusions: Educated parents were more aware regarding influenza and influenza vaccination for their children aged 6-59 months.

• Journal of the Korean Society of School Health
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• v.24 no.1
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• pp.61-70
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• 2011

Purpose: To identify factors associated with children's discriminatory attitudes towards fully recovered children who contracted the 2009 Influenza A (H1N1), in order to provide fundamental information to improve health education for children. Methods: Cross-sectional data were collected from the entire 6th grade classes (N=2,323) of 11 elementary schools randomly selected from 11 school districts in the Seoul Metropolitan Area of South Korea. Questionnaires were used to assess participants' knowledge of and attitudes towards the Influenza A (H1N1) virus. Results: Multiple regression analyses were used to investigate the factors associated with children's discriminatory attitudes toward fully recovered children who had contracted the 2009 Influenza A (H1N1). Multiple regression analysis revealed that perceived risk of contracting and knowledge of 2009 influenza A (H1N1) were significant factors in predicting a child's attitude toward fully recovered Influenza A (H1N1) patients, after controlling for socioeconomic variables. Conclusion: The findings suggests that perceived risk and knowledge play important roles in formulating children's appropriate attitudes towards Novel influenza A (H1N1) patients who are fully recovered from the disease. To promote and maximize children's attitudes in this area, health education needs to be directed at children to reduce excessive concern about contracting the virus and to improve their overall health knowledge.

• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.13-23
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• 2009

Acute otitis media (AOM) and pneumonia are among the most common infectious diseases of children. Both are mucosal infections and share many common features such as etiological agents, pathogenesis and immunity. Influenza plays an important role in the pathogenesis of AOM and pneumonia. A vaccine against influenza may have substantial impact on these diseases during the influenza season. In clinical trials, influenza vaccine has reduced the incidence of AOM and pneumonia complicating influenza in children. However, the efficacy of vaccines has been controversial in children less than 2 years of age. Similarly, vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), both common causes of AOM and pneumonia, have the potential to reduce the impact of disease. Clinical trials showed that the currently licensed 7-valent pneumococcal conjugate vaccine (PCV), administered during infancy, had an efficacy of 6-7% for the prevention of AOM, however, visits to the clinic for AOM were reduced by up to 20-30% after routine use in the U.S. Both Hib and PCVs have a proven effectiveness of >20% for prevention of radiologically confirmed pneumonia in children. The recently introduced pnuemococcal vaccine conjugated with protein D is expected to reduce AOM and pneumonia caused by non-typable H. influenzae, in addition to its effects on pneumococcal diseases. Considering their high incidence in children, recent achievements in the prevention of AOM and pneumonia with vaccines may have a significant economic and social impact.

• Clinical and Experimental Pediatrics
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• v.60 no.8
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• pp.254-260
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• 2017

Purpose: Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. Methods: A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews. The participating parents were asked to rank their agreement with each statement of the survey questionnaire on a scale from 1 (strongly disagree) to 5 (strongly agree), and the scores between pre- and postintervention were compared. Results: Before the educational intervention, 105 out of 639 participants reported not to agree to vaccinate their children against influenza. After the intervention, 46 out of the 105 parents changed their opinions about childhood vaccination. The physicians' recommendation received the highest agreement score and was the most important driver to vaccination, whereas the cost of vaccination was the strongest factor for not vaccinating children. In general, the participants significantly changed the agreement scores between pre- and postintervention. However, the unfavorable opinions about vaccination and the convenience of receiving the influenza vaccine did not change significantly. Conclusion: The results of this study indicate that a specific educational intervention involving caregivers is very effective in increasing the influenza vaccination coverage of children aged less than 60 months.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.221-226
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• 2018

Purpose: Febrile seizures (FSs) are the most common type of seizure in the first 5 years of life and are frequently associated with viral infections. Influenza infection is associated with a variety of neurological conditions, including FSs. The purpose of this study was to evaluate the clinical implications of influenza infection in FSs. Methods: In total, 388 children with FS were divided into two groups: FS with influenza infection (n=75) and FSs without influenza infection (n=313). Their medical records, including seizure type, frequency, duration, and familial history of FSs or epilepsy, were retrospectively reviewed and the clinical characteristics of the two groups were compared. Results: In total, 75 of the 388 children (19.3%) had FSs associated with influenza infection; such children were significantly older than those with FSs without influenza infection ($34.9{\pm}22.3$ months vs. $24.4{\pm}14.2$ months; P<0.001). The children who had more than two febrile seizures episodes were more prevalent in children with FS with influenza infection [40/75 (53.3%) vs. 92/313 (29.4%); P<0.01]. Children older than 60 months were more likely to have influenza infection compared to those aged less than 60 months [11/22 (50%) vs. 64/366 (17.5%); P=0.001]. Conclusion: Influenza infection may be associated with FSs in older children, and with recurrence of FSs. Its role in the development of afebrile seizures or subsequent epilepsy requires further investigation with long-term follow-up.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.171-179
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• 2020

Purpose: In Korea, seasonal influenza is an important respiratory illness afflicting children every year. We aimed to investigate the childhood epidemiology in Jeju during the 2017-2018 and 2018-2019 seasons. Methods: Children aged <13 years, who were tested for influenza at the Jeju National University Hospital during the 2017-2018 and 2018-2019 influenza seasons, were included. Demographics and the influenza test results were retrospectively reviewed from their medical records. Results: This study included 5,219 cases of influenza-like illness (ILI) (2017-2018: n=2,279; 2018-2019: n=2,940). The mean age of the eligible children was 2.85±2.79 years, and the most common age among ILI patients in each season was 1 year group. There were 902 (17.3%, 902/5,219) confirmed influenza cases during the 2 seasons. The rate of influenza confirmed by rapid influenza diagnostic test or polymerase chain reaction among ILI patients in the 2017-2018 and 2018-2019 seasons was 10.4% (236/2,279) and 10.3% (303/2,940) for influenza A, and 9.1% (208/2,279) and 5.3% (155/2,940) for influenza B, respectively. The mean age of influenza-confirmed cases was 4.09 years and 5.05 years in the 2017-2018 and 2018-2019 seasons, respectively (P<0.05). Weekly distribution of influenza was similar to that of ILI in the clinical sentinel surveillance system in both seasons. Conclusion: The difference in the influenza epidemic trend and age-group distribution between the 2017-2018 and 2018-2019 seasons was distinct in Jeju. Steady epidemiological studies on influenza in Jeju are needed for comparison with other regions of Korea.

• Clinical and Experimental Pediatrics
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• v.54 no.8
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• pp.329-334
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• 2011

Purpose: The purpose of this article is to describe the clinical and epidemiologic features and outcomes among children hospitalized with pandemic influenza A/H1N1 2009 infection. Methods: We retrospectively reviewed the charts of hospitalized pediatric patients (<18 years) diagnosed with pandemic influenza A/H1N1 2009 infection by reverse-transcriptase polymerase chain reaction at a tertiary hospital in Seoul, Korea, between September 2009 and February 2010. Results: A total of 72 children were hospitalized with pandemic influenza A/H1N1 2009 infection (median age, 6.0 years; range, 2 months to 18 years). A total of 40% had at least 1 underlying medical condition, including asthma (17%), malignancies (19%), and heart diseases (17%). Of the 72 patients, 54 (76%) children admitted with H1N1 infection showed radiographic alterations compatible with pneumonia. There was no significant difference in pre-existing conditions between pandemic influenza A/H1N1 infected patients with or without pneumonia. Children with pandemic influenza A/H1N1 pneumonia were more likely to have a lower lymphocyte ratio (P=0.02), higher platelet count (P=0.02), and higher level of serum glucose (P=0.003), and more commonly presented with dyspnea than did those without pneumonia (P=0.04). Conclusions: No significant differences in age, sex, or presence of preexisting conditions were found between children hospitalized with pandemic influenza A/H1N1 H1N1 influenza infection with pneumonia and those without pneumonia. Higher leukocyte count, higher glucose level, and a lower lymphocyte ratio were associated with the development of pandemic A/H1N1 2009 influenza pneumonia.

• Korean Journal of Health Education and Promotion
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• v.27 no.1
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• pp.9-19
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• 2010

Objectives: This study is to identify the factors which affect children's preventive behavior for novel influenza A(H1N1) and to provide basic data to health education for children. Methods: The subject of this study were 551 children who were attending on the 4~6th grade in elementary school in Seoul. The data were collected using a self-reporting questionnaire for 5 days from October 12 through 16, 2009. Data were all digitized and analyzed using SPSS 17.0K. Results: As for relationship between preventive behavior and the other variables, correlations were observed with sensibility, self efficacy, respond efficacy and behavior intention, and it was statistically significant(p<.001). According to the result of analyzing factors affecting preventive behavior for Novel Influenza A(H1N1), it was affected by variables such as perceived threat, perceived efficacy, behavior intention. Behavior intention was the most influencing variable and has shown influence in order of self efficacy, sensibility, severity and respond efficacy as follows. Conclusion: The results showed effects on preventive behavior of perceived threat, perceived efficacy and behavior intention. It may be beneficial to improve empowerment for students to prevent influenza A(H1N1) by focusing on perceived threat, perceived efficacy, behavior intention.