Children born prematurely are among groups who at high risk from flu – but do not appear in guidelines, researchers say today.
A study at Oxford University, UK, challenges current wisdom about which children are most at risk from the virus.
Researchers highlight prematurity and sick cell disease as two issues that place children at high risk of complications.
Researchers analysed data from some 27 pieces of research involving more than 14,000 children to identify the factors linked to children with flu ending up in hospital.
The findings are reported in The Lancet Respiratory Medicine.
They confirm the risks faced by children who currently appear in most existing guidelines – those with neurological disorders, diabetes and immunosuppression.
But the researchers say they did not find evidence that obesity or respiratory disorders, such as asthma, were linked to flu complications – although they stress this may depend on the severity of the condition.
They compared guidelines from the World Health Organisation, the UK and the USA.
Researcher Dr Kay Wang said the finding that prematurity was a key factor was a major public health issue.
Dr Wang said: “Until now, guidelines highlighting groups at greater risk of developing complications from influenza, such as pneumonia, have been based on consensus opinion rather than on systematic assessment of the evidence.
“Considering that around 10% (12.9 million) of the world’s babies are born prematurely (before 37 weeks gestation)— with preterm delivery rates of around 6% in Europe, 11% in North America, and 12% in Africa—it’s a significant public health issue and has major implications for policy makers."
Writing in the journal Harish Nair, from Edinburgh University, UK, adds: “Several options exist to better prevent severe outcomes in young children.
"Examples include the introduction, or increasing the uptake of, influenza and PCV vaccination globally, immunisation of mothers against influenza to protect very young infants, and exploration of other vaccine types such as adjuvanted vaccines that may be more immunogenic and cross-protective against non-matched strains.
"Implementation of these options should not wait for the next influenza pandemic, but be explored now to prevent the disproportionate burden of seasonal influenza on susceptible children every year.”
Identification of children at risk of influenza-related complications in primary and ambulatory care: a systematic review and meta-analysis. Lancet Respiratory Medicine 4 December 2014 [abstract]
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