CDC says 42 children have died of flu

Robert Roos

Dec 19, 2003 (CIDRAP News) Forty-two children have died recently of influenza-related causes, and at least some of them had no underlying health problems, the director of the Centers for Disease Control and Prevention (CDC) reported today.

"Of the 42 children we have information on right now, about 40% had an underlying medical condition," Julie Gerberding, MD, MPH, said at a news briefing. "The others either didn't have a condition or we haven't completed the investigation."

Speaking a day after the CDC announced that flu was widespread in 36 states, Gerberding referred to the situation as an epidemic. "From a practical perspective of the number of people affected, I think it's fair to refer to it as an epidemic," even though it's still too early to say whether this flu season will go on the record as an unusually severe one, she said.

Gerberding said 55% of the children who died of influenza were younger than 5. Several of the children had not been vaccinated for the flu, and several had not received more than one dose of vaccine, she reported. At least three of the children had bacterial infections in addition to flu. She gave no other details but said the CDC is preparing a report and will release it soon.

Gerberding said she couldn't judge whether 42 deaths is unusually high for this point in the flu season. "We don't have detailed, accurate information on the number of children who die every year from influenza specifically, because it hasn't been a reportable illness," she said. However, mathematical models suggest that about 92 children die of influenza in an average year, she said.

The CDC director said it's too early to tell whether the flu season has peaked or not. "We may see some leveling off in states that had influenza early this year . . . We may see some more red states [with widespread outbreaks] in the next few days."

From a strict epidemiologic or scientific perspective, the flu situation doesn't qualify as an epidemic, she said. "But when we're looking at a map that shows widespread activity in 36 states, we look at it from a common-sense perspective as an epidemic."

She offered tips on how people can tell the flu from a common cold and on when to seek medical attention for possible flu complications. Colds generally develop slowly, typically with a runny nose and sore throat but no fever, whereas the flu usually has a sudden onset and almost always involves a fever. Also, the flu is more likely than a cold to involve body aches.

Trouble with breathing in either adults or children is a signal to get medical attention, Gerberding said. Parents should seek medical attention for a child if he or she has prolonged fever, a blue tinge to the skin, signs of altered mental status, lethargy, or seizures, or if the child can't keep fluids down.

In adults, possible signs of a flu complication include fever lasting more than 4 days, chest pain or discomfort, faintness, and confusion, Gerberding said.

In other comments, Gerberding said the CDC expects to have some information next week about the supply of the four antiviral drugs used for the flu. The CDC said this week that the antiviral supply could run short in some areas. The Association of Professionals in Infection Control (APIC) is polling its members in hospitals around the country to assess the antiviral supply, Gerberding said.