Flu Can Be Deadly in Healthy Kids

A study of influenza-related pediatric deaths from 2004 through 2012 finds that almost half of children who died had no known high-risk medical complications.

The potentially deadly consequences of flu for those with underlying conditions is well known, but the results of a new study suggest that healthy children without additional medical conditions can develop serious complications and die from the flu in a matter of days.

The study, published online on October 28, 2013, in Pediatrics, analyzed influenza-related deaths in children younger than 18 with and without conditions putting them at a higher risk for flu complications from the 2004-2005 through the 2011-2012 flu seasons. To compare the characteristics of high risk children and healthy children, the researchers used data on influenza-associated pediatric deaths reported by state and local health departments to the Centers for Disease Control and Prevention. The data included information on demographics, medical conditions, and influenza vaccination status. Based on recommendations from the Advisory Committee on Immunization Practices, high-risk conditions included asthma, chronic lung disease, heart disease, immunosuppression, pregnancy, and blood, endocrine, neurologic, neurodevelopmental, kidney, liver, and metabolic disorders.

A total of 830 influenza-related pediatric deaths were reported throughout the United States from October 2004 through September 2012, and medical history information was available for 794 of them. Of these 794 children, 57% had at least 1 high-risk complication and 43% were healthy. During the 2006-2007 season, 62% of children who died did not have high-risk medical conditions. What’s more, approximately one-third of the children without medical complications who died from flu did so outside the hospital or in the emergency department just 3 days or less after their symptoms began.

Healthy children who went on to die from flu were also more likely to be younger than 5 and to develop bacterial co-infections than were children with high-risk complications who went on to die from flu. Only 9% of healthy children who died of flu and 22% of high-risk children who died of flu and whose vaccination status was known had received a flu shot. Among children who died of flu and had a high-risk condition, the most common medical condition was neurologic disorders, reported in 33% of these children.

Although many parents may believe that influenza is more dangerous in elderly adults than in children, the study’s results indicate that the flu can be just as deadly in young, healthy children, especially in 2-year-olds. The authors of the study suggest that vaccination is the best way to protect children from the flu. They also recommend early, antiviral treatment for all children with influenza who are hospitalized with severe complications, those who have high-risk conditions, and those aged 2 years and younger.

“Efforts to prevent influenza and its complications in children by ensuring annual influenza vaccination and appropriate early access to antiviral medications should remain a priority for the medical and public health communities,” the authors write.