Flu is especially deadly in some children

Children with neurologic disorders died at a disproportionately high rate during the 2009 H1N1 pandemic, report researchers at the Centers for Disease Control and Prevention (CDC). Their study showed that 68% of the 343 influenza-related deaths in children during the 2009 pandemic occurred in children with underlying medical conditions, the most common being a neurologic disorder.

Of the children with influenza who died in 2009, 146 had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy, representing 43% of all children with influenza-related mortality. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23%) had received the seasonal influenza vaccine, and only 2 (3%) were fully vaccinated for 2009 H1N1.

The most commonly reported complications for children with neurologic disorders in this study were influenza-associated pneumonia and acute respiratory distress syndrome. Seventy-five percent of children with a neurologic condition who died from 2009 H1N1 influenza-related infection also had an additional high-risk condition such as a pulmonary disorder, metabolic disorder, heart disease, or a chromosomal abnormality that increased their risk for influenza complications.

“Children with neurologic disorders might be at increased risk of complications from influenza due to compromised pulmonary function and inability to handle an excess of secretions,” researchers said.

The 343 pediatric deaths associated with 2009 H1N1 virus infection reported to the CDC during the pandemic was more than 5 times the median number of pediatric deaths that were reported in the 5 flu seasons prior to the pandemic.

Annual influenza vaccination for all persons 6 months and older is the best method for preventing influenza and its complications, they remind pediatricians.

Go back to the current issue of the eConsult.