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Pandemic (H1N1) 2009 Influenza in Pediatric Hematology/Oncology Units in Lebanon

Noun, Peter MD; Farah, Roula MD; Bechara, Elie MD; Hage, Pierre MD; Hajj, Marie-Joelle MD; Audi, Nadia MD; Khalifeh, Marie-Claude F. MD

Journal of Pediatric Hematology/Oncology: March 2013 - Volume 35 - Issue 2 - p 144–147
doi: 10.1097/MPH.0b013e31827e4c68
Original Articles

Background: The impact of pandemic (H1N1) 2009 influenza on immunocompromised patients in western countries has been described, but reports from pediatric patients in the Middle East or Arab countries are deficient. In this study, we describe the clinical characteristics of children with hematological malignancies and laboratory-proven H1N1 influenza.

Patients and Methods: Patients were recruited from 3 pediatric hematology/oncology units in Lebanon. A confirmed case of pandemic (H1N1) 2009 influenza is a clinically suspected case with positive H1N1 test by either a rapid immunofluorescence test or by real-time polymerase chain reaction. Data were collected retrospectively from the medical charts.

Results: From October 2009 to March 2010, 14 immunocompromised children were infected with H1N1 influenza. Eight were male and 6 were female. The median age of patients was 4.5 years (range, 1 to 14). All children were hospitalized and treated with oseltamivir. Twelve children responded to treatment; the other 2 patients with severe respiratory distress were transferred to intensive care unit and resuscitated but died after 7 and 12 days.

Conclusions: Immunocompromised children infected with pandemic 2009 influenza may respond very well when the diagnosis and treatment are rapid. However, on the basis of our experience, if the underlying disease is more severe (immunodeficiency with significant immunosuppressive treatment and induction of high-risk leukemia), the odds of mortality are likely greater.

*Hematology/Oncology Unit, Department of Pediatrics, Geitaoui Lebanese Hospital, Beirut

Department of Pediatrics, Saint George Hospital University Medical Center

Department of Pediatrics, Notre Dame de Secours University Hospital, Byblos, Lebanon

The authors declare no conflict of interest.

Reprints: Peter Noun, MD, Sin-El-Fil, Beirut Hall, Horch Tabet, Beirut 55225, Lebanon (e-mail:

Received January 26, 2012

Accepted August 22, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.