Pediatric H1N1 deaths already rival seasonal flu total

Oct 9, 2009 (CIDRAP News) – Seventy-six children and teenagers have died of H1N1 flu since the novel strain emerged in April, the Centers for Disease Control and Prevention (CDC) said today, representing both an increase of 19 in a week and a total that rivals the child deaths for entire past flu seasons.

And with the pandemic strain becoming establishing across the country, widespread in 37 states compared with 27 last week, deaths and case counts are expected to rise.

"In the past 3 years, the total pediatric influenza deaths ranged from 46 to 88," Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, said in a press briefing. "It is only the beginning of October. Of course, the flu season will often last all the way to May, and so it is very early for us to predict exactly what is going to happen."

The CDC has only counted pediatric deaths from flu since 2003-04, when an early, harsh flu season killed a number of children in Western states. In the 2008-09 season, which officially ended last weekend, 147 children and teens died from influenza, including the 76 cases attributed to the new flu, according to CDC numbers released Friday.

Up to 30% of the children who died from H1N1 flu had no underlying conditions that would make them vulnerable, and bacterial co-infections were "a very important problem" in that group, Schuchat said, adding that the CDC is alerting clinicians to use antibiotics when bacterial infections are suspected and encouraging use of pneumococcal vaccines to reduce the chance of illness.

Meanwhile, vaccines against both the novel strain and the seasonal flu are moving out across the country, though officials acknowledged that demand is high and the process is not smooth. As of Thursday, manufacturers had produced 6.8 million doses of vaccine against H1N1 flu, of which states have placed orders for 3.7 million, Schuchat said, adding that both numbers are moving targets that shift from day to day.

"We are at a point where we don't have enough vaccine for everybody who wants to be vaccinated today, but we will have enough vaccine in the weeks and months ahead for everybody who wants to be vaccinated," she said. "Where we are right now is that there is probably more demand than supply."

Beginning next week, the CDC will place twice-weekly updates on H1N1 vaccine production and deliveries on its Web site, with one of the updates devoted to a state-by-state breakdown, Schuchat said.

In addition, manufacturers have produced 77 million doses of vaccine against seasonal flu strains, "more than we have ever had at this time of year," Schuchat said. The agency has also been informed of spot shortages of seasonal vaccine but expects that pipeline to fill as well. "More people want it than seem to be able to get it," she said. "It will take several weeks to get the full supply going."

Government researchers also confirmed that a single dose of the new H1N1 vaccine will be enough to produce immunity in most recipients. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, announced in the briefing that follow-up data from a clinical trial show that adults do not gain any increased immune protection from taking a second dose of the vaccine.

In addition, results from a separate trial indicate that it is safe to give both the H1N1 and seasonal injectable vaccines at the same time, in different arms, Fauci said, citing early data from 50 volunteers within an 800-person trial. However, Schuchat added that the government is still cautioning against giving two forms of the nasal-spray vaccines in the same visit.

Clinical trials of the new vaccine in pregnant women are continuing, and new trials of the vaccine in individuals who have asthma and in those who are infected with HIV will begin shortly, Fauci said.

The CDC also said today that:

  • The agency has found no evidence in its data for the Canadian contention that seasonal flu vaccine makes recipients more vulnerable to H1N1 infection.
  • No adverse events have been recorded so far among H1N1 vaccine recipients.
  • Cities and regions that last week reported slight dips in H1N1 flu activity are now seeing the curve climb back up, to higher than it was 2 weeks ago.

See also:

CDC 2009 H1N1 Flu Situation Update: Oct 9, 2009

CDC Weekly Influenza Surveillance Report, Week 39 ending Oct 3, 2009: Posted Oct. 9

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