Pediatric Deaths From Influenza

     Winter is upon us and it is the time to talk about influenza. Influenza in children usually causes symptoms for a few days and then goes away without treatment or complication. However, it can cause more serious problems: pneumonia, brain infection and death.

     In 2004, the Center for Disease Control began collecting information about pediatric deaths from influenza and some of that information was reported in the November issue of Pediatrics.

     In looking at the children who died of influenza between 2004 and 20012, it was found that half of them had pre-existing medical conditions such as asthma, cerebral palsy or chromosomal abnormalities. These children have always been known to have a high risk of death from influenza. Most of these children were in the hospital when they died. But 43% of the children who died from influenza were healthy children without previous high-risk medical problems. For reasons that we don’t understand, these previously healthy children usually died within 3 days of the onset of the influenza symptoms – the influenza became severe so rapidly that the healthy children died at home or in the emergency room rather than in the hospital.

     People have many reasons for not vaccinating their children against influenza. Some say, “My child is healthy and should be able to fight off influenza without problems”. This study showed that previously healthy children actually got severely ill faster than children with other medical problems. Other people say that they know of people who got the vaccine and still got influenza. It is true that the vaccine is not 100% effective – 9% of the healthy children in the study who died had been given full immunization – but that still means that 91% of the children who died were not fully vaccinated, so vaccination proved to be very effective in preventing severe complications of influenza. The study also shows the importance of immunizing younger children. Parents sometimes say that they don’t want to vaccinate their younger children “because they are too small” yet children between 6 months and 5 years of age were found to be at greater risk of dying from influenza, especially children under 2.

     The vaccine against influenza comes in many forms and parents should talk to their caregiver about which is best for their child. It is not recommended for infants under 6 months of age, so caregivers of these infants should be vaccinated and the infants should not have contact with adults and children who have not been vaccinated or who have any influenza symptoms. Any child who develops influenza symptoms should receive anti-viral medications as soon as the diagnosis is made. Children who have severe symptoms, who are in the hospital, who have previous medical problems or who are under 2 years old should receive the anti-viral therapy without waiting for lab results to confirm the diagnosis.