Differences and Similarities between Three Flu Seasons in Children’s Clinical Hospital Brasov, Romania

Background: In Romania the Flu vaccination coverage is low.

Objective: The study evaluates three flu seasons regarding social, demographic, clinical and paraclinical aspects of children with Influenza infection that have been attending ER at Children`s Clinical Hospital Brasov in Romania.

Methods: The study is an observational, descriptive, retrospective study that enrolled a number of 2337 children from Children`s Clinical Hospital Brasov. All children had a positive Influenza virus result in pharyngeal/nasal secretion detected by immunochromatography. The three flu seasons studied are 2017-2018, 2018-2019 and 2019-2020. All data involved were studied evaluating the patients’ files from the hospital’s Emergency Room’s archive.

Results: First season 2017-2018 had 226 cases, second season 2018-2019 had 558 cases and the third season 2019-2020 had 1553 cases. Type B was predominent in the first and the third season. Regarding seasonality March had the highest number of cases for the first season, December for the second season and February for the third season. More boys than girls were in all three seasons. Children were predominantly from urban areas in all three seasons. 6-12 years old group was the highest in the second season, in the other two seasons 1-5 years old group was more present. The symptoms onset before ER presentation was around 2 days in all three seasons. All three seasons presented children with over 80% respiratory symptoms, over 65% normal white blood count and between 7 and 23 cases of CRP>1 mg/dL in all three seasons. Antibiotic use was highest in second season 17.6%.

Conclusion: Type A flu was predominant only in 2018-2019 season. Regarding gender–males were more than female in all three seasons. The three seasons had a different monthly peaks. Clinical and paraclinical findings were all typical for viral infection in all three seasons. The antibiotic use was high.