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Background: Influenza virus is one of the most important causes of acute lower respiratory tract infections (ALRTI) in children. We
aimed to assess the burden of influenza among hospitalized children less than 5 years in Egypt.
Methods: We enrolled 3075 patients, of which 77.8% were children less than 5 years old diagnosed with ALRTI admitted to Cairo
University Hospitals during five-year period from 2010 to 2014. Nasopharyngeal aspirates were obtained from the patients and tested
for influenza among 16 respiratory viruses by mutliplex PCR.
Results: Patients had a mean age of 4 months, 53.4% were males. Average hospitalization duration was 5 days, 35% were positive
for one or more virus. Influenza A and influenza B were detected in 6.2% and 3.2% of children respectively. All influenza patients
presented with cough and fever. More than 80% had tachypnea and nasal flare. Complications were associated with chronic lung
and heart conditions. The most common complications were ARDS (81.8%), requiring ICU admission (12%) and death in 8.2%;
though seasonal distribution was not consistent, yet 80% of influenza cases occurred in winter and early spring seasons (p<0.001).
Nosocomial transmission occurred in 2 outbreaks in a Surgical Pediatric Intensive care units, affecting 7 children.
Conclusion: Influenza is an important etiology of ALRTI in children below 5 years of age. As it is more prevalent in winter and tends
to cause severe infection in high risk group, vaccination, rapid diagnosis and early start of antiviral therapy are essential.