153 Child Deaths Linked to Flu During 2003-2004 Season

Many were previously healthy; most were under 6 months old, CDC report finds

WEDNESDAY, Dec. 14 (HealthDay News) - During the 2003-2004 flu season, more than 150 children under 18 died from complications of the flu, a new study from the U.S. Centers for Disease Control and Prevention finds.

The report highlights the ongoing need for annual flu vaccinations, even for healthy children.

Of the flu-related deaths, almost half occurred in children who were previously healthy, with no underlying, chronic health conditions.

"This is the first time that we are looking at lab-confirmed outcomes in children on a national level," said study author Dr. Niranjan Bhat, a medical epidemiologist from the influenza branch of the CDC.

"One hundred and fifty three influenza deaths were reported for the season. Compared to the millions who get influenza, fatalities are a relatively uncommon result," he said.

Results of the study appear in the Dec. 15 issue of the New England Journal of Medicine.

Each year, the CDC estimates that between 5 percent and 20 percent of Americans will develop the flu. About 200,000 people will be hospitalized due to flu complications, and as many as 36,000 will die as a result of the illness, according to the CDC. Those most at risk from influenza are the elderly, children and people with chronic health conditions.

Bhat and his colleagues asked all state and local health departments to report any fatalities that occurred during the 2003-2004 flu season in children under 18 who had influenza confirmed in laboratory studies.

Forty state health departments reported 153 deaths. The average age of the children who died was 3, and 63 percent were under the age of 5. The highest mortality rate was seen in youngsters under 6 months old.

Just under half died outside of the hospital. Forty-five percent of the children died very quickly -- within three days -- of the onset of the flu.

Forty-seven percent of the children were previously considered healthy, and had no underlying medical conditions. Bhat said the CDC will be looking into how and why these infections can become so severe in previously healthy children.

The chronic health conditions that were seen most frequently in the children who died were neurological disorders, neuromuscular disorders, heart disease and lung disorders, such as asthma.

"Influenza can be a very serious illness. Influenza can kill, even though rarely. The best prevention we have is vaccination," said Bhat.

Dr. Graham Krasan, a pediatric infectious disease specialist at William Beaumont Hospital in Royal Oak, Mich., said he wasn't surprised by the findings. He said he recalls that 2003-2004 was a busy year in terms of flu.

"There were sporadic reports of deaths among relatively healthy children. That was very alarming to parents, and we had a lot of ER visits due to flu that year. Also, the vaccine wasn't well-matched to the major strain circulating that year," he said.

Even though the vaccine isn't always 100 percent, both Bhat and Krasan said the best defense against flu is to get vaccinated every year. And parents shouldn't just get their children vaccinated, according to Krasan. They should get vaccinated themselves, so they don't bring the virus into the home. He also recommended frequent and thorough hand washing by all members of the family as a way to help prevent the flu virus from spreading.

Unfortunately, the group at highest risk of influenza-related mortality -- infants under 6 months -- isn't eligible to be vaccinated. Bhat said researchers are studying whether a mother's immunization during pregnancy might confer some immunity to her infant after birth. While that question remained unanswered, he did say that a vaccinated mother is less likely to transmit the virus to her baby.

Parents should be concerned about any child under 6 months of age who seems lethargic, has a fever, a cough, isn't feeding well or displays a visible rib cage because he or she is breathing so hard, Krasan said. These signs indicate that the child has a serious illness and needs to be seen by a doctor right away, he said.

In older children a high fever, a cough and sometimes a runny nose or diarrhea may all be signs of flu. Krasan said parents should get their child to a physician quickly so that they can begin taking antiviral medication. These drugs works best when given soon after symptoms begin.

"Tamiflu or Relenza may ameliorate some of the severity of the flu if given within the first 48 hours," Krasan said.

More information

For more information on the flu and the flu vaccine, visit the U.S. Centers for Disease Control and Prevention.

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