Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial

Objectives: This study aimed to evaluate the clinical efficacy and safety of vitamin D for preventing influenza A in 400 infants in a multicenter, randomized, open, controlled clinical trial. Methods: The infants were randomized into low-dose and high-dose vitamin D groups, and serum calcium, inorganic phosphorus and 25-hydroxyvitamin D levels were detected thrice in 4 months. Infants infected with influenza A were monitored for symptoms including fever, cough and wheezing. Pathogen levels and safety of vitamin D treatment were also evaluated. Results: Of 121 cases in total, 78 and 43 cases of influenza A infection occurred in the low-dose and high-dose vitamin D groups, respectively. There was a significant difference between the groups (&khgr;2 = 14.6324, P = 0.0001). Among the cases of influenza infection, the median durations for fever, cough and wheezing were shorter in the high-dose vitamin D group than in the low-dose vitamin D group. The viral loads showed a downward trend in both groups and were significantly different between the groups at the second and third detections. Additionally, the incidences of adverse events and severe adverse events were very low and not significantly different between the 2 groups. Conclusion: High-dose vitamin D (1200 IU) is suitable for the prevention of seasonal influenza as evidenced by rapid relief from symptoms, rapid decrease in viral loads and disease recovery. In addition, high-dose vitamin D is probably safe for infants.

[1]  David A. Jolliffe,et al.  Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data , 2017, British Medical Journal.

[2]  Y. Qian,et al.  [Prevalence characteristics of influenza viruses in children in Beijing during 2014-2015 and 2015-2016 influenza seasons]. , 2016, Zhonghua er ke za zhi = Chinese journal of pediatrics.

[3]  H. Spiller,et al.  Vitamin D exposures reported to US poison centers 2000–2014 , 2016, Human & experimental toxicology.

[4]  K. Shen,et al.  Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis , 2016, PloS one.

[5]  X. Cui,et al.  [Vitamin D level in children with bloodstream infection]. , 2016, Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics.

[6]  Tao Zhang,et al.  Viral etiology of medically attended influenza‐like illnesses in children less than five years old in Suzhou, China, 2011–2014 , 2016, Journal of Medical Virology.

[7]  A Nicoll,et al.  Assessment of human influenza pandemic scenarios in Europe. , 2015, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[8]  Y. Shoenfeld,et al.  Vitamin D: a new anti‐infective agent? , 2014, Annals of the New York Academy of Sciences.

[9]  Gang Chen,et al.  Two severe cases of H7N9 pneumonia patients with immunoneuroendocrine axis dysfunction and vitamin D insufficiency , 2014, BMC Infectious Diseases.

[10]  S. Walter,et al.  Serum 25-Hydroxyvitamin D Level and Influenza Vaccine Immunogenicity in Children and Adolescents , 2014, PloS one.

[11]  H. Yoshikura.  Spanish flu, Asian flu, Hong Kong flu, and seasonal influenza in Japan under social and demographic influence: review and analysis using the two-population model. , 2014, Japanese journal of infectious diseases.

[12]  I. Rudan,et al.  An evaluation of the emerging vaccines against influenza in children , 2013, BMC Public Health.

[13]  Bruce Y. Lee,et al.  Prevention of influenza in healthy children , 2012, Expert review of anti-infective therapy.

[14]  J. Standing,et al.  Oseltamivir Pharmacokinetics and Clinical Experience in Neonates and Infants during an Outbreak of H1N1 Influenza A Virus Infection in a Neonatal Intensive Care Unit , 2012, Antimicrobial Agents and Chemotherapy.

[15]  Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)--United States, 2012-13 influenza season. , 2012, MMWR. Morbidity and mortality weekly report.

[16]  M. Lipsitch,et al.  Shortcomings of Vitamin D-Based Model Simulations of Seasonal Influenza , 2011, PloS one.

[17]  S. Esposito,et al.  Present and future of influenza prevention in pediatrics , 2011, Expert opinion on biological therapy.

[18]  A. Marfin,et al.  Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt , 2011, Emerging infectious diseases.

[19]  R. Striker,et al.  Vitamin D and the anti-viral state. , 2011, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[20]  Byung-Kwang Yoo.  How to Improve Influenza Vaccination Rates in the U.S. , 2010, Journal of preventive medicine and public health = Yebang Uihakhoe chi.

[21]  M. Jehn,et al.  Effect of School Closure on the Incidence of Influenza among School-Age Children in Arizona , 2010, Public health reports.

[22]  E. Acosta,et al.  Oseltamivir dosing for influenza infection in premature neonates. , 2010, The Journal of infectious diseases.

[23]  M. Urashima,et al.  Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. , 2010, The American journal of clinical nutrition.

[24]  Benjamin J. Cowling,et al.  School Closure and Mitigation of Pandemic (H1N1) 2009, Hong Kong , 2010, Emerging infectious diseases.

[25]  S. Talbird,et al.  Oseltamivir for influenza postexposure prophylaxis: economic evaluation for children aged 1-12 years in the U.S. , 2009, American journal of preventive medicine.

[26]  S. Cauchemez,et al.  CME ACTIVITY: Face Mask Use and Control of Respiratory Virus Transmission in Households , 2009, Emerging Infectious Diseases.

[27]  A. Monto,et al.  The risk of seasonal and pandemic influenza: prospects for control. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[28]  W. Glezen.  Clinical practice. Prevention and treatment of seasonal influenza. , 2008, The New England journal of medicine.

[29]  L. Mccann.  Should children under treatment for juvenile idiopathic arthritis receive flu vaccination? , 2007, Archives of Disease in Childhood.

[30]  S. Madronich,et al.  Epidemic influenza and vitamin D , 2006, Epidemiology and Infection.

[31]  J. Dolitsky,et al.  Effect of Daily Cod Liver Oil and a Multivitamin-Mineral Supplement with Selenium on Upper Respiratory Tract Pediatric Visits by Young, Inner-City, Latino Children: Randomized Pediatric Sites , 2004, The Annals of otology, rhinology, and laryngology.