Renewed interest in paediatric influenza arose with the occurrence of the new pandemic influenza A (H1N1) 2009 in Germany from April 2009 onwards [23] . An ongoing ESPED study on children with severe pandemic influenza A (H1N1) 2009 reported 93 cases below 15 years of age from 55 PICUs during a single season (August 2009 to April 2010), including 15 fatalities (11 within PICUs) [24] . This high number of cases reported in the ongoing ESPED study may be partly due to an increased awareness in physicians regarding the new subtype of influenza with unclear severity at the start of the pandemic, resulting in more frequent laboratory testing and diagnosis of influenza [5, 24] . Additionally, the higher number of PICU admissions may be due to a truly higher severity of the pandemic influenza A (H1N1) 2009 subtype in children compared to previous seasonal influenza subtypes [e.g., [18, 25] ], although not all studies report such a difference in severity [26, 27] , or found a difference only regarding risk groups [28] . Thus, a comparison of both ESPED studies on the absolute number of severe influenza cases [24] has to be regarded with caution, and may underestimate the importance of severe seasonal influenza caused by non-pandemic influenza virus subtypes in children in Germany. Further prospective, laboratory-confirmed surveillance in PICUs is needed to clarify the complication rates associated with influenza virus A and B and their different subtypes and lineages.