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Influenza Kills – A Sobering Reminder

May 30, 2018

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Influenza killed 675 children from the 2010-11 flu season to the 2015-16 season.  Infants under 6 months had the highest incidence of mortality.  Encourage everyone to get vaccinated.  Antiviral treatment is encouraged in all children under 2, all patients with severe illness, and all hospitalized patients regardless of whether or not the duration of illness exceeds 48 hours.

Why does this matter?
We need to understand the danger of influenza in children.  The combination of influenza/pneumonia kills more children each year than septicemia.  Who dies of flu?  Kids are one of the highest risk groups.  In fact, 156 children have already died of influenza this flu season since October 1, 2017.

Influenza can kill – don’t get lulled to sleep in the sea of rhinorrhea
This was an analysis of influenza seasons from 2010-11 to 2015-16.  Over this period, 675 children died of influenza.  Children < 6 months had the highest incidence of mortality.  Half had no other medical problems.  Most were unvaccinated or under-vaccinated.  Be wary in children with co-morbidities, especially neurological diseases.  Bacterial co-infection with group A strep and S. aureus were common.  Pneumonia, sepsis/shock, and ARDS were the most common flu-related illnesses leading to death.  We can play a small part by encouraging vaccination for all children > 6 months, pregnant women, and anyone in contact with infants – basically everyone.  Even with marginal vaccine efficacy, it cuts mortality in half in children with medical problems and by two-thirds in healthy children. We also can play a part in treating children at the highest risk.  Say what you want about oseltamivir (and I am first to confess there is not much good to say), it is still recommended by the CDC for all children < 2 years with influenza.  This is also an area we may be able to help.  This article is more of a wake up call for us in the ED: Don’t be lulled to sleep by the sheer volume of kids with fever and rhinorrhea, another positive flu test, and playing the odds that they’re just fine.  Children die of influenza, and it is helpful to remember this.

Influenza-Associated Pediatric Deaths in the United States, 2010-2016.  Pediatrics. 2018 Apr;141(4). pii: e20172918. doi: 10.1542/peds.2017-2918. Epub 2018 Feb 12.

Peer reviewed by Thomas Davis

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