Thirty-nine severe influenza-associated complications and two fatalities were reported among the 20 children ( Table 3 ). The most frequently reported complication was influenza-associated pneumonia in 12 (60%) patients, followed by bronchitis/bronchiolitis in 6 patients (30%). Secondary bacterial pneumonia was observed in 5 (25%) patients; in 4 cases in combination with influenza-associated pneumonia. ARDS was reported in 5 (25%) patients, all suffering from influenza-associated pneumonia, and in three patients together with sepsis. All 5 patients with ARDS had predisposing underlying chronic conditions. Encephalitis/encephalopathy occurred in a total of 5 (25%) patients (including one fatal case), in three cases in combination with bronchitis/bronchiolitis.