Study of Flu Related Deaths in Children Shows Even Healthy Children at Risk

A CDC study published today in the journal Pediatrics highlights the tragic impact of flu disease on U.S. children each year. The study, titled “Influenza-Associated Pediatric Deaths in the United States, 2004-2012,” analyzed reported flu-related deaths in children younger than 18 years over the course of eight flu seasons, from October 2004 through September 2012. Results showed that flu-related deaths occurred in many healthy children, as well as those with one or more underlying health conditions. In addition, most of the children reported to have died during the study period had not received a seasonal flu vaccination. The findings support CDC’s recommendation that all children 6 months of age and older should receive a flu vaccination each year.

Other results underscore how quickly the flu can progress to becoming life-threatening in children. One-third of children died within three days of developing symptoms. Over one-third of them died either at home, on the way to the hospital, or in the emergency department. In addition, previously healthy children (children without medical conditions predisposing them to serious flu complications) were actually more likely to die before hospital admission than children who had a high-risk condition. This highlights the importance of parents taking flu illness just as seriously in healthy children as children who are more medically fragile due to a high risk condition. The overall message is parents should seek prompt medical care for all children with flu symptoms.

The greatest number of pediatric deaths in the study occurred during the 2009-2010 season, largely due to the 2009 H1N1 pandemic virus, while the fewest deaths occurred during the 2011-12 season. Flu “A” viruses were associated with the majority of deaths in children (78%), while flu “B” viruses accounted for around 20% of deaths.

Bacterial co-infections were more common among otherwise healthy children than among children with a high- risk medical condition. Nearly half of bacterial co-infections were Staph infections.

This study also shows that adherence to CDC’s recommendations for antiviral treatment in children is poor. Antiviral treatment was reported in less than half of the children who died during the 2010-2011 and 2011-2012 seasons in the study. CDC recommends that children who are hospitalized, who have severe illness, or who are at high risk of complications (due to being younger than 2 years of age or because of an underlying medical condition) receive treatment with flu antiviral drugs as soon as possible.

The study is available online from the Pediatrics website at Influenza-Associated Pediatric Deaths in the United States, 2004–2012.