Colds and flu

Updated 04 July 2014

Flu can kill even healthy children

US health officials warn that children, even those without severe medical conditions, can die from the flu in as little as three days after symptoms appear.


Children, even those without severe medical conditions, can die from the flu in as little as three days after symptoms appear, US health officials warn.

Between 2004 and 2012, flu complications killed 830 children in the United States, many of whom were otherwise healthy, according to the US Centres for Disease Control and Prevention.

Most striking is that 35% of these children died before being hospitalised or within the first three days of developing symptoms, according to the report published in Paediatrics.

"We found these influenza-related deaths can occur in children with and without medical conditions and in children of all ages, and that very few of these children have been vaccinated," said lead author Dr Karen Wong, a CDC medical epidemiologist.

Researchers who reviewed those deaths found that only 22% with a high-risk medical condition and just 9% without a significant medical condition had been vaccinated.

Wong doesn't know why so many children die so fast. "About a third of these children die within the first three days of their first reported symptoms," she said.

Lack of knowledge

One expert wasn't surprised that many otherwise healthy children who died did so before being admitted to the hospital.

"First, parents don't realise that flu can be fatal," said Dr Marcelo Laufer, a paediatric infectious diseases specialist at Miami Children's Hospital.

Second, parents of children with chronic diseases "know the system better, so they come earlier than healthy patients," he said.

Because flu can progress so quickly, prevention is really the best strategy, Wong said. "And that's why we recommend every child 6 months or older get vaccinated every year," she said.

Because an infant under 6 months of age can't be given flu vaccine, Wong said it is vital that pregnant women get a flu shot to help protect their newborn, and that everyone likely to be near the baby also be vaccinated so they can't pass flu to the infant.

Especially high risk

Wong said children who get the flu need to be watched carefully. She recommends getting in touch with the child's doctor when symptoms start.

"That's especially true for kids with high-risk medical conditions and for very young children," she explained. "These children are at especially high risk for flu complications."

Laufer, however, said a phone call to the doctor isn't enough. "It's very difficult for a paediatrician on the other side of the phone to understand how sick the child really is," he said.

Parents should take their child to the doctor or emergency department if they're sicker than what one would expect with a common cold, he said.

"Parents should realise that influenza is much more than sniffles," Laufer added. "A kid with influenza is a kid who is very sick, is a kid who is lethargic, has decreased appetite, is not drinking as much and not urinating as much in addition to other flu symptoms," he said.

Anti-viral treatment recommended

Wong added that early anti-viral treatment is recommended for high-risk children who develop symptoms of influenza. "That's another thing they can talk to their health care provider about," Wong added.

Anti-viral drugs include Tamiflu, Relenza, Symmetrel and Flumadine.

In the study, Wong's group found that of the 794 children whose medical history was known, 43% had no medical condition that put them at high risk of dying from flu.

As for children with high-risk medical conditions who died, 33% had neurological conditions such as cerebral palsy or seizure disorder, and 12% had a genetic condition that put them at risk for flu complications.

Asthma, lung disease, heart disease and cancer can also increase a child's odds of dying from flu, the researchers noted.

Each year in the United States, flu causes an estimated 54 000 to 430 000 hospitalisations and 3000 to 49 000 deaths, with infection rates highest among children, according to the CDC.

More information

For more information on children and flu, visit the US Centres for Disease Control and Prevention.

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Flu expert

Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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