Fatal flu infections in otherwise healthy children
Cytokine storm? Healthy died faster
Influenza poses a rare but real risk of fatal infection in otherwise healthy children, a Centers for Disease and Control and Prevention epidemiologist reports.
Karen K. Wong, MD, reviewed case reports for the 2004 to 2012 influenza seasons in data presented recently in San Diego at the IDWeek conference.1
"Almost half the children who died had been previously healthy," she says. "The numbers demonstrate how important it is for all children, even children who are otherwise healthy, to get a flu vaccine every year, and underscore why all children with severe illness should get treated early with influenza antiviral medications."
Wong and colleagues analyzed U.S. pediatric influenza-associated deaths over an eight-year period, finding that 43% of the deaths occurred in children with no health conditions, such as asthma or diabetes, that would have predisposed them to being at high risk of serious flu complications. Moreover, the study found that those young, previously healthy patients succumbed faster. The median duration of illness from onset of initial symptoms to death was four days in children with no underlying high-risk health conditions compared with seven days in children with at least one such condition.
The CDC study reviewed influenza-associated deaths among children younger than 18, as reported by city and state health departments and confirmed through laboratory testing. From Aug. 1, 2004 through Sept. 1, 2012, there were 829 such deaths, most of which were associated with influenza A infection. Of the 793 children with a known medical history, 341 had no high-risk health conditions. Of the remaining cases, more than half were children with neurological disorders, and nearly half had pulmonary disease. The median age at death was 7. About a third of the children died in the emergency department or outside the hospital, the researchers found.
"Children with and without underlying medical conditions can die from influenza, and death can occur rapidly," Wong says. "Caregivers should be aware of early warning signs of severe influenza virus infection in children — including labored breathing, decreased fluid intake or urination, drowsiness or a lack of interaction — and should seek medical attention for them quickly."
Reference
- Wang S, et al. Influenza-Associated Pediatric Deaths — United States, 2004–2012. IDWeek 2012. San Diego, CA. Oct 17-21 2012.
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