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Pediatrics Journal - Children with neurologic disorders at high risk of death from flu

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  • Pediatrics Journal - Children with neurologic disorders at high risk of death from flu

    My bolding.


    Press Release
    CDC Media


    August 29, 2012




    Children with neurologic disorders at high risk of death from flu
    Health care and advocacy groups join to protect children most vulnerable to influenza

    A disproportionately high number of children with neurologic disorders died from influenza-related complications during the 2009 H1N1 pandemic, according to a study by scientists with the Centers for Disease Control and Prevention. The report in the journal Pediatricsunderscores the importance of influenza vaccination to protect children with neurologic disorders. CDC is joining with the American Academy of Pediatrics, Families Fighting Flu and Family Voices to spread the message about the importance of influenza vaccination and treatment in these children.
    The Pediatrics study looked at influenza-related deaths in children during the 2009 H1N1 pandemic based on data submitted to CDC from state and local health departments. The number of pediatric deaths associated with 2009 H1N1 virus infection reported to CDC during the pandemic was more than five times the median number of pediatric deaths that were reported in the five flu seasons prior to the pandemic. Sixty-eight percent of those deaths occurred in children with underlying medical conditions that increase the risk of serious flu complications.

    Of the 336 children (defined as people younger than 18 years) with information available on underlying medical conditions who were reported to have died from 2009 H1N1 flu-associated causes, 227 had one or more underlying health conditions.

    One hundred forty-six children (64 percent) had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1. “We’ve known for some time that certain neurologic conditions can put children at high risk for serious complications from influenza,” said Dr. Lyn Finelli, chief of the surveillance and outbreak response team in CDC’s Influenza Division. “However, the high percentage of pediatric deaths associated with neurologic disorders that occurred during the 2009 H1N1 pandemic was a somber reminder of the harm that flu can cause to children with neurologic and neurodevelopmental disorders.”
    “Flu is particularly dangerous for people who may have trouble with muscle function, lung function or difficulty coughing, swallowing or clearing fluids from their airways,” said study coauthor and pediatrician Dr. Georgina Peacock. “These problems are sometimes experienced by children with neurologic disorders,” said Peacock, of CDC’s National Center on Birth Defects and Developmental Disabilities.
    The most commonly reported complications for children with neurologic disorders in this study were influenza-associated pneumonia and acute respiratory distress syndrome (ARDS). Seventy-five percent of children with a neurologic condition who died from 2009 H1N1 influenza-related infection also had an additional high risk condition that increased their risk for influenza complications, such as a pulmonary disorder, metabolic disorder, heart disease or a chromosomal abnormality.
    CDC is partnering with the American Academy of Pediatrics and influenza advocacy groups to help promote awareness about the importance of influenza prevention and treatment in these high risk children. Since the H1N1 pandemic, children with neurologic conditions continue to represent a disproportionate number of influenza-associated pediatric deaths. CDC, the American Academy of Pediatrics (AAP), Family Voices, and Families Fighting Flu recognize the need to communicate with care takers about the potential for severe outcomes in these children if they are infected with flu.
    “Partnering with the American Academy of Pediatrics, influenza advocacy groups and family led-organizations CAN help prevent influenza in children at highest risk,” said CDC Director Dr. Thomas R. Frieden.

    The partnering organizations are working to coordinate communication activities with their constituents, which include parents and caregivers, primary care clinicians, developmental pediatricians and neurologists in hopes to increase awareness about flu prevention and treatment in children with neurologic disorders.
    “The American Academy of Pediatrics, Families Fighting Flu and Family Voices were all natural partners when we thought about how to reach as many key people as possible with this message,” Dr. Peacock adds. “The collaboration and energy around this effort has been fabulous.”
    “Our network of physicians is committed to influenza prevention in all children, and especially in reducing complications in those children at higher risk for experiencing severe outcomes as a result of influenza-like illness,” says Robert W. Block, M.D., president of the AAP. “This coalition can more broadly engage the entire community of child caregivers to express how serious flu can be for these children. These efforts emphasize why the medical home is so important for children and youth with special health care needs.”
    Family Voices is a national family-led organization supporting families and their children with special health care needs. Ruth Walden, a parent of a child with special needs and president of the Family Voices Board of Directors, says, “It’s frightening to think that flu can potentially lead to so many complications or even death. We’re pleased to see organizations working together to educate families and providers about the importance of prevention.”
    Families Fighting Flu, an advocacy group dedicated to preventing influenza, has a long history of reaching out to families who’ve lost loved ones to flu. “Throughout the years we’ve seen firsthand how flu can affect these kids and their families’ lives. We understand that prevention is absolutely critical,” explains Laura Scott, executive director of Families Fighting Flu. “Working with other groups only expands our mission of keeping kids safe throughout the flu season.”
    CDC recommends that everyone aged 6 months and older get an annual influenza vaccination, including people who are at high risk of developing serious complications. Flu vaccine is the best prevention method available. Antiviral drugs, which can treat flu illness, are a second line of defense against flu.

    To learn more about influenza, visit www.cdc.gov/flu.

    About American Academy of Pediatrics

    The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

    About Family Voices

    Family Voices provides families with resources to make informed decisions, advocate for improved public and private policies, build partnerships among professionals and families, and serve as a trusted resource on health care. There are Family Voices representatives in each state and territory across the country ready to assist you with issues related to the health care of a child or youth with a special need or disability. More information is available at www.familyvoices.org, or by calling 1-888-835-5669.

    About Families Fighting Flu

    Families Fighting Fluis a nonprofit, 501(c)(3) volunteer-based advocacy organization dedicated to protecting the lives of children. Our members include families whose children have suffered serious medical complications or died from influenza, as well as health care practitioners and advocates committed to flu prevention. In honor of our children, we work to increase awareness about the seriousness of the disease and to reduce the number of childhood hospitalizations and deaths caused by the flu each year by increasing vaccination rates. Families Fighting Flu offers support to other families and communities who have been severely affected by the flu through resources available at www.familiesfightingflu.org.


    ----------------------------------------


    Neurologic Disorders Among Pediatric Deaths Associated With the 2009 Pandemic Influenza

    1. Lenee Blanton, MPH<sup>a</sup>,
    2. Georgina Peacock, MD, MPH, FAAP<sup>b</sup>,
    3. Chad Cox, MD, MPH<sup>a</sup>,
    4. Michael Jhung, MD, MPH<sup>a</sup>,
    5. Lyn Finelli, DrPH<sup>a</sup>, and
    6. Cynthia Moore, MD, PhD<sup>b</sup>

    + Author Affiliations
    1. <address><sup>a</sup>Influenza Division, National Center for Immunization and Respiratory Diseases, and </address>
    2. <address><sup>b</sup>National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia </address>


    Abstract

    OBJECTIVE: The goal of this study was to describe reported influenza A (H1N1)pdm09 virus (pH1N1)-associated deaths in children with underlying neurologic disorders.


    METHODS: The study compared demographic characteristics, clinical course, and location of death of pH1N1-associated deaths among children with and without underlying neurologic disorders reported to the Centers for Disease Control and Prevention.


    RESULTS: Of 336 pH1N1-associated pediatric deaths with information on underlying conditions, 227 (68&#37 children had at least 1 underlying condition that conferred an increased risk of complications of influenza. Neurologic disorders were most frequently reported (146 of 227 [64%]), and, of those disorders, neurodevelopmental disorders such as cerebral palsy and intellectual disability were most common. Children with neurologic disorders were older (P = .02), had a significantly longer duration of illness from onset to death (P < .01), and were more likely to die in the hospital versus at home or in the emergency department (P < .01) compared with children without underlying medical conditions. Many children with neurologic disorders had additional risk factors for influenza-related complications, especially pulmonary disorders (48%). Children without underlying conditions were significantly more likely to have a positive result from a sterile-site bacterial culture than were those with an underlying neurologic disorder (P < .01).


    CONCLUSIONS: Neurologic disorders were reported in nearly two-thirds of pH1N1-associated pediatric deaths with an underlying medical condition. Because of the potential for severe outcomes, children with underlying neurologic disorders should receive influenza vaccine and be treated early and aggressively if they develop influenza-like illness.




  • #2
    Re: Pediatrics Journal - Children with neurologic disorders at high risk of death from flu

    hat tip Michael Coston

    Study: Kids, Underlying Conditions, And The 2009 Pandemic Flu



    Credit CDC FluView

    # 6522

    The chart above illustrates the sharp rise in pediatric deaths from flu-related complications during the 2009-2010 H1N1 pandemic seasons in the United States. As grim as this charts is, it probably doesn?t fully represent the burden the 2009 pandemic placed on the pediatric community.
    In another chart, again from the CDC, we get an estimate of deaths related to the 2009 pandemic, broken down by age groups through April of 2010.


    While just over 300 pediatric deaths were recorded during this time period, the CDC estimates that 4 times (n=1280) that many children likely died from flu-related illness in the United States.
    Globally, the number was undoubtedly many times higher than that (see Lancet: Estimating Global 2009 Pandemic Mortality).

    All of which serves as prelude to a new study that appears today in the journal Pediatrics, that looks at 336 documented pH1N1-associated deaths, and finds a high number of kids with underlying neurologic conditions.

    Two-thirds of all deaths in children under the age of 17 occurred in kids with at least 1 underlying medical condition (n=227), and just under half of all cases (n=146) involved neurological disorders, such as cerebral palsy, epilepsy, or intellectual disability.

    Neurologic Disorders Among Pediatric Deaths Associated With the 2009 Pandemic Influenza

    Lenee Blanton, MPH<sup>a</sup>,Georgina Peacock, MD, MPH, FAAP<sup>b</sup>, Chad Cox, MD, MPH<sup>a</sup>, Michael Jhung, MD, MPH<sup>a</sup>, Lyn Finelli, DrPH<sup>a</sup>, and Cynthia Moore, MD, PhD<sup>b</sup>
    ABSTRACT (Excerpts)
    RESULTS: Of 336 pH1N1-associated pediatric deaths with information on underlying conditions, 227 (68%) children had at least 1 underlying condition that conferred an increased risk of complications of influenza. Neurologic disorders were most frequently reported (146 of 227 [64%]), and, of those disorders, neurodevelopmental disorders such as cerebral palsy and intellectual disability were most common.
    CONCLUSIONS: Neurologic disorders were reported in nearly two-thirds of pH1N1-associated pediatric deaths with an underlying medical condition. Because of the potential for severe outcomes, children with underlying neurologic disorders should receive influenza vaccine and be treated early and aggressively if they develop influenza-like illness.
    According to a statement released last night by the CDC:
    Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1.

    With September just around the corner, the annual push for flu vaccinations is upon us, and today?s study will hopefully help inspire parents to get all kids ? regardless of underlying conditions - vaccinated against influenza.

    While the effectiveness of flu vaccines vary from year-to-year, and indeed, from one person to the next, they remain the single most important preventative step you can take to avoid getting the flu each year.

    Despite the hyperbolic anti-vaccine rhetoric often found on the Internet, the truth is, serious adverse reactions to the vaccine are exceedingly rare (see the CDC?s Influenza Vaccine Safety).
    With two new strains of seasonal flu expected to be in circulation this winter (Yamagata B, and the Victoria H3N2) ? ones that will be covered by this year?s vaccine ? getting the flu shot this year is doubly important.

    CDC recommends that just about everyone aged 6 months and older get an annual influenza vaccination, and stresses their importance for those who are at greater risk of serious complications.

    For more on vaccine safety and effectiveness, the CDC maintains extensive web pages, and resources, on seasonal flu vaccines, including:
    Posted by Michael Coston at <a class="timestamp-link" href="http://afludiary.blogspot.com/2012/08/study-kids-underlying-conditions-and.html" rel="bookmark" title="permanent link"><abbr class="published" title="2012-08-29T09:13:00-04:00">9:13 AM</abbr>

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