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

February 12, 2018 – A CDC study published in the journal Pediatrics shows just how vulnerable U.S. children are to the flu each year. The study, titled “Influenza-Associated Pediatric Deaths in the United States, 2010-2016,” analyzed reported flu-related deaths in children younger than 18 over the course of six flu seasons from October 2010 through September 2016. Results showed that half of flu-related deaths occurred in otherwise healthy children, 22% of whom were fully vaccinated. This is an update to the 2013 Wong, et al paper published in Pediatrics in 2013 that showed similar findings regarding overall flu risk in children. One notable difference, however, was the increase in flu-related deaths among healthy children. Previously, fewer than 40% of children who died had no underlying high-risk medical conditions.

These findings also show antiviral treatment was only given in about half of all pediatric flu deaths. CDC recommends that flu antiviral drugs be started as soon as possible when young children and children with high-risk conditions are suspected of having the flu.

During 2010-2016, young children continued to be at the greatest risk for flu-associated pediatric deaths. The findings show that vaccination coverage was low among these children. This supports CDC’s recommendation that all children 6 months of age and older should receive a flu vaccination each year. Pregnant women and caregivers of infants should also get vaccinated to help protect them.

This study stresses how quickly the flu can become life-threatening for children. Nearly two-thirds of children died within seven days of developing symptoms. Over one-third died at home or in the emergency department prior to hospital admission. In fact, children without other medical conditions that would predispose them to serious flu complications were more likely to die before hospital admission. This is a reminder that parents should seek prompt medical care for young children and children at high risk for flu complications with flu symptoms.

During all six seasons, mortality rates were highest in children younger than 2 years of age. Native Hawaiian/Pacific Islander and American Indian/Alaska Native children were also at higher risk.

The greatest number of pediatric deaths in the study occurred during the 2012-13 season while the fewest occurred during the 2011-12 season. Flu A viruses were associated with the majority of deaths in children (65%), while flu B viruses accounted for 33% of deaths.

Bacterial co-infections were more common among otherwise healthy children than among children with a high-risk medical condition. Clinical complications were reported for 75% of children, with the most common being pneumonia (41%) and sepsis (31%).