Influenza in Neonates and Children - Guidelines for Clinical Management of Confirmed or Suspected
|Last review: 21/11/2017|
|Next review: 01/11/2020|
|Approved By: Improving Antimicrobial Prescribing Group|
|Copyright© Leeds Teaching Hospitals NHS Trust 2017|
This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated.
Guidelines for clinical management of neonates and children with confirmed or suspected Influenza
Influenza in Neonates and Children
Influenza virus infection can present in a variety of ways and may therefore be managed according to several existing LTHT children’s infection pathways/guidelines:
Duration of therapy
Influenza viruses are enveloped single-stranded RNA viruses with a segmented genome (8 segments). There are 3 types, A, B and C, determined by surface antigens. Type A infects humans and animals, whereas types B and C usually infect humans only. Influenza C usually causes mild disease, whereas A can cause severe illness and has a significant mortality.
The envelope contains two glycoproteins in its lipid bilayer: haemagglutinin (HA), which attaches the virus to cellular receptors and neuraminidase (NA), which is involved in the release of newly formed viruses from infected cells. Variations in HA and NA structure, brought about by spontaneous mutations, determine subtypes (in humans: H1, H2, H3, N1, N2). NA is the target of the antiviral drugs oseltamivir and zanamivir, which are most commonly used to treat influenza.
All age groups are affected but infection is most common in children. There is seasonal variation in incidence with most cases occurring during the winter months (usually December to March). Pandemics, resulting from the introduction of a new subtype into the population, can occur at any time.
Incubation and infective period
The incubation period prior to the onset of symptoms is usually 1 – 4 days, while the period of infectivity is from a day before onset of symptoms to 7 days after.
Complications of influenza in children
Risk factors for complications (LTHT Internal Only)
Recommendation: A nose and throat swab or nasopharyngeal aspirate should be sent for respiratory viral PCR when influenza is suspected.
Method and details (LTHT Internal Only)
Other investigations will be determined by clinical presentation – see relevant guidelines
Influenza in children
|Target patient group:||Children with suspected influenza|
|Target professional group(s):||Secondary Care Doctors
- British Thoracic Society Pandemic Influenza Guidelines (2009).
- PHE guidance on use of antiviral agents for the treatment and prophylaxis of influenza, 2017-18.
A. Meta-analyses, randomised controlled trials/systematic reviews of RCTs
B. Robust experimental or observational studies
C. Expert consensus.
D. Leeds consensus. (where no national guidance exists or there is wide disagreement with a level C recommendation or where national guidance documents contradict each other)
Improving Antimicrobial Prescribing Group
LHP version 1.0
Equity and Diversity
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