Children still die from influenza in the United States. The Centers for Disease Control and Prevention (CDC) encourages better vaccination coverage to prevent these deaths.
Lenee Blanton and colleagues found 115 reported cases of pediatric mortality in the United States between September 2010 and August 2011. Only about half of them had recognized high-risk medical conditions.
The CDC study found the following characteristics of children who died from influenza in the 2010-2011 flu season:
1. The median age of patients was 6 years.
2. Males were in the majority (63 percent).
3. Of the 64 children who were tested for secondary bacterial infection, 39 percent were found to be infected.
4. Common complications of influenza were pneumonia, sepsis, acute respiratory distress syndrome, and encephalopathy or encephalitis.
5. The majority of deaths occurred in late January and early February.
6. Of the 74 children for whom vaccination information was available, only 23 percent were fully vaccinated against influenza.
The recognized high-risk medical conditions for children with the flu include:
1. Neurologic disorders
2. Pulmonary disease
3. Chromosomal abnormality or genetic disorder
4. Congenital heart disease or other cardiac disorder
5. Asthma or reactive airway disease
In the CDC study, 57 of the 115 children who died had one or more of these conditions. Children with no high-risk conditions had a shorter interval between illness onset and death, and were more likely to die at home or in an emergency department. Blanton suggested that physicians were more likely to hospitalize children with high-risk conditions.
“This report emphasizes the importance of continued surveillance for influenza-associated pediatric mortality,” Blanton concluded. Measures to prevent these deaths include influenza vaccination, antiviral medication, and antibiotics for secondary bacterial infection.
The effectiveness of childhood influenza vaccination was investigated by Anne Gatewood Hoen of Children's Hospital Boston and colleagues. In the 2006-2007 flu season, the US Advisory Committee on Immunization Practices expanded its recommendations to include children aged 6 to 23 months. The parallel Canadian organization did not include this age group.
Hoen found a 34 percent decrease in rates of influenza in the affected children in Children's Hospital Boston, compared to a similar hospital in Montreal, following this difference in vaccination policies.
Today the CDC recommends influenza vaccination for all healthy individuals six months of age and older.
References:
1. Centers for Disease Control and Prevention (CDC), “Influenza-associated pediatric deaths – United States, September 2010 – August 2011”, MMWR Morbidity and Mortality Weekly Report 2011 Sep 16; 60(36): 1233-8. http://www.ncbi.nlm.nih.gov/pubmed/21918492
2. Hoen AG et al, “Effect of expanded US recommendations for seasonal influenza vaccination: comparison of two pediatric emergency departments in the United States and Canada”, CMAJ 2011 Sep 20; 183(13): 1025-32.
Abtract: http://www.ncbi.nlm.nih.gov/pubmed/21930745
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.
Review November 15, 2011
by Michele Blacksberg RN
Edited by Jody Smith