{"doi":"10.1093/cid/ciac734","title":"The Spectrum of Influenza in Children","abstract":"BACKGROUND: Children constitute an important component of the influenza burden and community transmission, but the frequency of asymptomatic infection and post-influenza sequelae at the community level is poorly understood. METHODS: Two community-based prospective cohort studies (2011-2020, 2017-2020) and 1 case-ascertained study (2012-2017) were conducted in Managua, Nicaragua. Non-immunocompromised children aged 0-14 years with ≥1 influenza infections, determined by polymerase chain reaction and hemagglutination inhibition assay, were included. RESULTS: A total of 1272 influenza infections occurred in the household-based portion of the study. Influenza infection was asymptomatic in 84 (6.6%) infections, and the asymptomatic fraction increased with age (1.7%, 3.5%, and 9.1% for ages 0-1, 2-4, and 5-14, respectively; P < .001). Of asymptomatic children, 43 (51.2%) shed virus, compared to 1099 (92.5%) symptomatic children (P < .001). Also, 2140 cases of influenza occurred in the primary care portion of the study. Sequelae of influenza were rare, with the most common being pneumonia (52, 2.4%) and acute otitis media (71, 3.3%). A/H1N1 had higher age-adjusted odds of acute otitis media (odds ratio [OR] 1.99, 95% confidence interval [CI]: 1.14-3.48; P = .015) and hospitalization (OR 3.73, 95% CI: 1.68-8.67; P = .002) than A/H3N2. B/Victoria had higher age-adjusted odds of pneumonia (OR 10.99, 95% CI: 1.34-90.28; P = .026) than B/Yamagata. CONCLUSIONS: Asymptomatic influenza infection is much less common in children than adults, although viral shedding still occurs in asymptomatic children. Post-influenza sequelae are rare in children in the community setting, and virus strain may be important in understanding the risk of sequelae.","journal":"Clinical Infectious Diseases","year":2022,"id":239831,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":48,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9301,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":236672,"name":"Guillermina Kuan","orcid":"0000-0002-5251-173X","position":1,"is_corresponding":false},{"id":390629,"name":"Roger López","orcid":"0000-0002-1091-5955","position":2,"is_corresponding":false},{"id":236668,"name":"Nery Sánchez","orcid":"0000-0002-0070-3895","position":3,"is_corresponding":false},{"id":671861,"name":"Brenda López","orcid":null,"position":4,"is_corresponding":false},{"id":236667,"name":"Sergio Ojeda","orcid":"0000-0003-2512-2306","position":5,"is_corresponding":false},{"id":671376,"name":"Hannah E. Maier","orcid":"0000-0001-5761-0801","position":6,"is_corresponding":false},{"id":391633,"name":"Mayuri Patel","orcid":null,"position":7,"is_corresponding":false},{"id":414839,"name":"Steph Wraith","orcid":null,"position":8,"is_corresponding":false},{"id":841187,"name":"Alyssa Meyers","orcid":null,"position":9,"is_corresponding":false},{"id":866235,"name":"Lora Campredon","orcid":"0000-0001-5150-6165","position":10,"is_corresponding":false},{"id":236673,"name":"Ángel Balmaseda","orcid":"0000-0003-1174-4235","position":11,"is_corresponding":false},{"id":227052,"name":"Aubree Gordon","orcid":"0000-0002-9352-7877","position":12,"is_corresponding":false},{"id":706638,"name":"Gregory Hoy","orcid":"0000-0001-9512-7941","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":null,"created_at":"2026-07-19T00:22:41.699779Z","pmid":"36069178","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}