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The state's unusual pneumococcal bacteria strains can pose hazard with flu.
By Lisa Rosetta
The Salt Lake Tribune
Updated: 10/13/2009 07:30:58 PM MDT
Andrew Pavia, chief of the Division of Pediatric Infectious Diseases at the University of Utah.
Utah children who are at high risk for developing complications from the flu may be more worse off than children in almost any other state.
That's because certain serotypes -- or strains -- of pneumococcal bacteria unique to the state aren't targeted by Prevnar, a routine, recommended vaccine given to children born after 2000, said Carrie Byington, a University of Utah professor of pediatrics and infectious diseases.
And research by the Centers for Disease Control and Prevention shows such infections, when combined with the H1N1 flu, can cause severe illness.
The number of Utahns who fall ill from pneumococcal bacteria strains not covered by the shot have risen rapidly, said Byington, who is also a member of the American Academy of Pediatrics' 12-person infectious diseases committee. Those strains likely account for Utah's uncommonly high numbers of complicated bacterial pneumonia -- an area of intense research at the U, she added.
While most children's hospitals around the country see five or fewer cases in a year, she said, Utah's Primary Children's Medical Center sees about 100.
"It makes us very concerned because we know pneumonia increases during influenza season," she said. "So we have real concern for kids in Utah getting through this season."
The CDC recently reported another 19 children have died from the flu -- 16 were confirmed as H1N1 and three were unspecified influenza A, but likely to be H1N1. That brings the total number of laboratory-confirmed H1N1 pediatric deaths in the U.S. since April to 76.
The federal agency has analyzed the 36 pediatric deaths that occurred between April and early August. Among the 23 children whose laboratory results were reported, bacterial infections were confirmed in 10 of them -- or 43 percent.
Those children included all six youth who were older than age 5 years and had no underlying health conditions. That indicates a bacterial infection, in combination with H1N1, can result in severe illness in children who might be otherwise healthy, the CDC noted.
During the first wave of the H1N1 outbreak last spring, an unusually high number of Utah children -- 21 -- were hospitalized with complicated bacterial pneumonia, Byington said. That number is expected to be even higher this fall, when both the H1N1 and seasonal flu strains are circulating at full winter strength.
A new vaccine -- Pneumovax 23 -- is being developed by Merck and will cover the 23 most prevalent types of pneumococcal bacteria, including the six that most frequently cause invasive drug-resistant infections. But it likely won't be released until the end of this year, Byington said.
In the meantime, there are steps parents can take to protect high-risk children from bacterial infections related to the flu, said Andrew Pavia, chief of the U.'s Division of Pediatric Infectious Diseases and a professor of pediatrics.
Pavia urges parents to be aware of whether their child is at increased risk for complications and death. Children under 5 are more likely to have problems, according to the CDC. The younger they are, the higher the risk, Pavia said.
An underlying medical condition -- heart disease, asthma, diabetes or a severe developmental delay, for example -- should also be a red flag.
One step to protect them: Seek out a protective vaccine called Pneumovax -- the predecessor vaccine of Pneumovax 23 -- for children age 2 and older.
The doctors stress, however, that the supply of Pneumovax is limited and in most cases, pediatricians will reserve it for children with underlying health conditions.
Also, when such children fall ill, parents should promptly speak with their doctor. "For some kids at the highest risk, we want to start treating them right away," Pavia said.
In most of the pediatric deaths examined by the CDC, treatment with antiviral medication wasn't started until after two days, Byington said. That means it's critical to get a high-risk child, or any child showing symptoms of serious complications, to a doctor within the first 48 hours.
Still, when to seek treatment isn't straightforward. About 70 percent of the children who died from H1N1 had an underlying medical condition, which means 30 percent didn't, CDC data shows.
Parents looking for warning signs of serious complications should be alert to signs that a child is dehydrated or having difficulty breathing, Byington said. If a child's color changes or he or she has seizures, urgent care is needed.
For children with less serious symptoms, however, care at home may be enough. That includes offering acetaminophen, such as Tylenol, to reduce fever, plenty of fluids and rest, and keeping an ill child out of school or day care.
Byington noted parents should steer clear of aspirin and products that contain it, including Pepto-Bismol, which can cause liver problems.
And prevention is key. Pavia urges parents to get their children the H1N1 vaccine, which he said was more thoroughly tested than the average seasonal flu shot. Parents should be concerned, but level-headed, he said.
"There seem to be two responses: We either panic or we blow it off, and the right response is somewhere in between," he said. "People should be concerned: take precautions, get vaccinated, practice good hygiene to protect themselves. But on the other hand, we don't want to spread panic, because it doesn't warrant panic."
Pediatric H1N1 deaths
Between April and August 8, the Centers for Disease Control and Prevention had received reports of 477 deaths associated with H1N1 flu in the U.S. -- including 36 deaths among children under age 18. It analyzed the children's cases, which were from 15 states.
Of the 36 children who died
19 percent were under 5 years old.
67 percent had one or more of the high-risk medical conditions.
Of the children with high-risk medical conditions
92 percent had neurodevelopmental conditions.
Of the 23 children who had laboratory tests examined by the CDC
Bacterial coinfections were identified in 43 percent -- including all six of the children who were age 5 and older and had no recognized high-risk condition. That indicates a bacterial infection, in combination with H1N1, can result in severe illness in children who might be otherwise healthy.
Past pediatric influenza deaths
The CDC analysis looked only at pediatric deaths that were reported between April and early August. Pediatric deaths across the nation in past full flu seasons:
2003-04 season » 153
2004-05 season » 47
2005-06 season » 46
2006-07 season » 73
:tiphat http://www.sltrib.com/news/ci_13554666?source=rss
By Lisa Rosetta
The Salt Lake Tribune
Updated: 10/13/2009 07:30:58 PM MDT
Andrew Pavia, chief of the Division of Pediatric Infectious Diseases at the University of Utah.
Utah children who are at high risk for developing complications from the flu may be more worse off than children in almost any other state.
That's because certain serotypes -- or strains -- of pneumococcal bacteria unique to the state aren't targeted by Prevnar, a routine, recommended vaccine given to children born after 2000, said Carrie Byington, a University of Utah professor of pediatrics and infectious diseases.
And research by the Centers for Disease Control and Prevention shows such infections, when combined with the H1N1 flu, can cause severe illness.
The number of Utahns who fall ill from pneumococcal bacteria strains not covered by the shot have risen rapidly, said Byington, who is also a member of the American Academy of Pediatrics' 12-person infectious diseases committee. Those strains likely account for Utah's uncommonly high numbers of complicated bacterial pneumonia -- an area of intense research at the U, she added.
While most children's hospitals around the country see five or fewer cases in a year, she said, Utah's Primary Children's Medical Center sees about 100.
"It makes us very concerned because we know pneumonia increases during influenza season," she said. "So we have real concern for kids in Utah getting through this season."
The CDC recently reported another 19 children have died from the flu -- 16 were confirmed as H1N1 and three were unspecified influenza A, but likely to be H1N1. That brings the total number of laboratory-confirmed H1N1 pediatric deaths in the U.S. since April to 76.
The federal agency has analyzed the 36 pediatric deaths that occurred between April and early August. Among the 23 children whose laboratory results were reported, bacterial infections were confirmed in 10 of them -- or 43 percent.
Those children included all six youth who were older than age 5 years and had no underlying health conditions. That indicates a bacterial infection, in combination with H1N1, can result in severe illness in children who might be otherwise healthy, the CDC noted.
During the first wave of the H1N1 outbreak last spring, an unusually high number of Utah children -- 21 -- were hospitalized with complicated bacterial pneumonia, Byington said. That number is expected to be even higher this fall, when both the H1N1 and seasonal flu strains are circulating at full winter strength.
A new vaccine -- Pneumovax 23 -- is being developed by Merck and will cover the 23 most prevalent types of pneumococcal bacteria, including the six that most frequently cause invasive drug-resistant infections. But it likely won't be released until the end of this year, Byington said.
In the meantime, there are steps parents can take to protect high-risk children from bacterial infections related to the flu, said Andrew Pavia, chief of the U.'s Division of Pediatric Infectious Diseases and a professor of pediatrics.
Pavia urges parents to be aware of whether their child is at increased risk for complications and death. Children under 5 are more likely to have problems, according to the CDC. The younger they are, the higher the risk, Pavia said.
An underlying medical condition -- heart disease, asthma, diabetes or a severe developmental delay, for example -- should also be a red flag.
One step to protect them: Seek out a protective vaccine called Pneumovax -- the predecessor vaccine of Pneumovax 23 -- for children age 2 and older.
The doctors stress, however, that the supply of Pneumovax is limited and in most cases, pediatricians will reserve it for children with underlying health conditions.
Also, when such children fall ill, parents should promptly speak with their doctor. "For some kids at the highest risk, we want to start treating them right away," Pavia said.
In most of the pediatric deaths examined by the CDC, treatment with antiviral medication wasn't started until after two days, Byington said. That means it's critical to get a high-risk child, or any child showing symptoms of serious complications, to a doctor within the first 48 hours.
Still, when to seek treatment isn't straightforward. About 70 percent of the children who died from H1N1 had an underlying medical condition, which means 30 percent didn't, CDC data shows.
Parents looking for warning signs of serious complications should be alert to signs that a child is dehydrated or having difficulty breathing, Byington said. If a child's color changes or he or she has seizures, urgent care is needed.
For children with less serious symptoms, however, care at home may be enough. That includes offering acetaminophen, such as Tylenol, to reduce fever, plenty of fluids and rest, and keeping an ill child out of school or day care.
Byington noted parents should steer clear of aspirin and products that contain it, including Pepto-Bismol, which can cause liver problems.
And prevention is key. Pavia urges parents to get their children the H1N1 vaccine, which he said was more thoroughly tested than the average seasonal flu shot. Parents should be concerned, but level-headed, he said.
"There seem to be two responses: We either panic or we blow it off, and the right response is somewhere in between," he said. "People should be concerned: take precautions, get vaccinated, practice good hygiene to protect themselves. But on the other hand, we don't want to spread panic, because it doesn't warrant panic."
Pediatric H1N1 deaths
Between April and August 8, the Centers for Disease Control and Prevention had received reports of 477 deaths associated with H1N1 flu in the U.S. -- including 36 deaths among children under age 18. It analyzed the children's cases, which were from 15 states.
Of the 36 children who died
19 percent were under 5 years old.
67 percent had one or more of the high-risk medical conditions.
Of the children with high-risk medical conditions
92 percent had neurodevelopmental conditions.
Of the 23 children who had laboratory tests examined by the CDC
Bacterial coinfections were identified in 43 percent -- including all six of the children who were age 5 and older and had no recognized high-risk condition. That indicates a bacterial infection, in combination with H1N1, can result in severe illness in children who might be otherwise healthy.
Past pediatric influenza deaths
The CDC analysis looked only at pediatric deaths that were reported between April and early August. Pediatric deaths across the nation in past full flu seasons:
2003-04 season » 153
2004-05 season » 47
2005-06 season » 46
2006-07 season » 73
:tiphat http://www.sltrib.com/news/ci_13554666?source=rss
