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We evaluated the presentation, outcomes, and the risk of serious bacterial infection (SBI) in infants3 months old with influenza virus infection.We identified demographic, hospitalization, and microbiologic data from computerized medical records for all infants and children24 months of age, with laboratory confirmed influenza infection cared for at a tertiary care children's hospital during 4 winter seasons (2004-2008). We compared those3 months of age with older groups.We identified 833 children24 months of age with laboratory-confirmed influenza. Of those, 218 were3 months old. Influenza accounted for 3.6% of all evaluations of febrile infants and 12% of febrile infant encounters during winter. Infants3 months of age were less likely to have a high risk chronic medical condition, but were more likely to be hospitalized than children 3 to24 months old (P0.005). Infants3 months with influenza had fewer prolonged hospital stays than those 3 to6 months old [P = 0.056; OR: 0.5 (0.24-1.0)] and 6 to12 months old [P = 0.011; OR: 0.43 (0.24-0.83)]. Five (2.3%) infants3 months old had SBI.Infants3 months of age with influenza virus infection often present with fever alone. Although they are more likely to be hospitalized than those 3 to24 months old, hospital stays are short and outcomes generally good. Infants with influenza virus infection have a low risk of concomitant SBI.

BACKGROUND The surveillance case definition for confirmed pertussis requires that an individual with a positive polymerase chain reaction (PCR) result for Bordetella pertussis have 2 weeks or more of cough and at least one of the following: paroxysmal coughing, inspiratory "whoop," or posttussive vomiting. OBJECTIVES Determine (1) proportion of individuals with a positive PCR result who met additional criteria for surveillance confirmed pertussis, (2) whether the likelihood of PCR-positive individuals meeting additional elements of surveillance case definition varied by age or vaccination status, and (3) whether elements of the current case definition influence the likelihood of pertussis confirmation in PCR-positive individuals. METHODS Pertussis PCR results were compared with case investigation data. RESULTS Eighty-eight percent (165/188) of PCR-positive individuals met requirements for confirmed pertussis. Sixty-one percent (14/23) of PCR-positive individuals who had less than 2 weeks but more than 1 week of cough had at least one other reported sign or symptom. Fourteen (100%) reported paroxysmal coughing, 7 (50%) "whoop," and 7 (50%) posttussive vomiting. Infants who met case definition were more likely to have reported apnea than were older individuals (15/17 vs 45/86, OR = 6.8, 95% CI = 1.4-64.2). CONCLUSIONS Decreasing cough duration from 2 weeks or more to more than 1 week would result in 95 percent of those with positive PCR results meeting confirmation criteria for pertussis. Apnea should be considered an additional sign for pertussis confirmation in infants.