Pediatric deaths parallel rise in US flu cases

Feb 20, 2009 (CIDRAP News) – The US Centers for Disease Control and Prevention (CDC) today reported a spike in the number of pediatric influenza deaths, an increase that mirrors a continuing rise in flu activity across the nation.

The CDC said it received six reports of influenza-related flu deaths in children during the week ending Feb 14, though one occurred during the 2006-07 flu season. The remaining five deaths raise the number of pediatric flu deaths this season to nine.

Bacterial coinfections were confirmed in six of the nine children; four involved Staphylococcus aureus, two of which were methicillin resistant. All of the children who had coinfections were age 5 or older.

In May 2007, the CDC issued an alert after noting a sharp increase in the number of S aureus infections in children who had the flu during the 2006-07 season, though the total number of pediatric flu deaths that year was similar to the previous two years. Twenty children that season died of bacterial coinfections, 16 of which were S aureus.

Meanwhile, other states reported more new pediatric flu deaths, which will likely be included in upcoming CDC weekly influenza updates.

Colorado's Department of Public Health and Environment (CDPHE) yesterday announced that four Colorado children have died from influenza-related complications this flu season. The first occurred in mid January, and the last was reported on Feb 18, the CDPHE said in a press release.

The CDPHE said the state's number of pediatric flu deaths has already topped the past four flu seasons, which averaged two fatalities per year.

Three of the children were toddlers, and one was an infant. Two of the children had received partial vaccines (one of two recommended doses), and the other two were unvaccinated. At least two of the children had serious underlying medical conditions, the CDPHE said.

Ken Gershman, chief of the CDPHE's communicable disease program, said in the press release that child flu deaths are tragic, because the disease is often preventable. Last year the CDC expanded its flu vaccination recommendation to include all children from ages 5 though 18. It had already recommended flu immunizations for younger children between the ages of 6 and 59 months.

"The single best way to protect yourself and your family from the flu is to get the flu vaccine, and it's not too late," Gershman said.

Over the past few days other states have reported more pediatric flu deaths, including:

  • Massachusetts, where a 12-year-old boy died on Feb 16, according to the Boston Public Health Commission
  • Arizona, where a teenager from Coconino County died last week, according to the Arizona Department of Health Services
  • Texas, where a 12-year-old boy from Amarillo died on Feb 18, according to a report today from the Amarillo Globe-News

Nationally, the number of states reporting widespread flu activity rose to 24, 8 more than the previous surveillance week that ended Feb 7, the CDC reported. Most of the hardest-hit states are in the eastern part of the country, except for Texas, Colorado, and Nevada. Thirteen additional states reported regional influenza activity.

Nearly all (98.5%) influenza A/H1N1 samples that have been tested showed resistance to oseltamivir (Tamiflu). Of viruses that have been antigenically characterized, all influenza A/H1N1 and influenza A/H3N2 viruses matched the vaccine components.

However, only about a third of the influenza B viruses match the Yamagata lineage that is included in this year's vaccine—the rest were from the Victoria lineage.

See also:

CDC influenza surveillance report for Feb 8-14

Feb 19 CDPHE press release

Feb 19 Arizona Department of Health Services press release

Feb 17 Boston Public Health Commission press release

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