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School funded research recently published in Epidemiology and Infection, recommends that strategies for preventing flu and complications arising from flu in the community should be targeted at children with asthma and neurological conditions.

Flu final

Complications related to influenza can occur in anyone, but we found that children with asthma and neurological conditions are at higher risk. The risk is also higher in young children, meaning otherwise healthy infants and babies have more complications than older children."


- Lead author Dr Joseph Lee

The research looked at risk factors for influenza-related complications in children during the 2009/10 pandemic.

Flu (also called influenza) is a viral infection which is common in children during the winter months and often gets better on its own.  However, some children are believed to be more prone to developing further complications from flu, including chest, ear and throat infections.  Health care professionals need to know which children are at greatest risk of developing complications from flu.  This helps them ensure that these children get their flu vaccination and that if they develop a flu-like illness they are considered for early treatment to prevent further complications.  This is especially important in GP surgeries, where most children with flu-like illness are seen.

To find out which children are at greatest risk of developing complications from flu, researchers at the University of Oxford studied data from the medical records of nearly 17,000 children who were seen in a GP surgery with flu-like illness during the swine flu pandemic in 2009-10.  We found that:

  • Around 1 in 12 children developed further complications from flu, mostly within one day of being seen by a doctor or nurse. 
  • Children with asthma were at greatest risk of complications from flu requiring treatment in the community or admission to hospital. 
  • Children with neurological conditions, such as epilepsy, cerebral palsy, and other medical conditions which affect the brain and nerves, were at greatest risk of being admitted to hospital for any reason, not just complications from flu.

The study found that complications from flu were less common in children who were prescribed antibiotics or antiviral medications (such as Tamiflu®) during their first visit to the GP surgery.  However, it was not possible to tell whether these medications had a direct effect on preventing complications in these children. 

Findings suggest that:

  • Strategies for preventing flu and complications from flu in the community should be targeted at children with asthma and neurological conditions. 
  • More research is needed to find out whether these children might benefit from being treated with antibiotics or antiviral medications early during a flu-like illness to prevent further complications.

Lead author Joseph Lee is based in the Nuffield Department of Primary Care Health Sciences at the University of Oxford.

Publication: Risk factors for influenza-related complications in children during the 2009/10 pandemic: a UK primary care cohort study using linked routinely collected data. JJ Lee, C Bankhead, M Smith, AA Kousoulis