CDC study: Swine flu deaths higher in older kids

[Pathfinder]

Thursday, September 03, 2009
CDC study: Swine flu deaths higher in older kids
By MIKE STOBBE

About one in 13 U.S. swine flu deaths have been children and most of the kids have been of school age, the federal government said Thursday in its first study of the new flu's youngest victims.

More than 40 U.S. children have died from the virus since it was first identified in this country in April. The report from the U.S. Centers for Disease Control and Prevention takes a comprehensive look at the first 36 deaths, and found some important differences in the pediatric death toll from swine flu as compared to seasonal flu:

_ Normally, half or more of the children who die from flu are age 4 and younger. But more than 80 percent of the kids who died with swine flu were 5 or older.

_ Almost two-thirds of the children who died with swine flu had epilepsy, cerebral palsy or other neurodevelopmental conditions. In a previous flu season, only a third of pediatric deaths had those conditions.

_ Bacterial co-infections were a big danger, and were blamed in most of the deaths of otherwise healthy children. Co-infections usually occur when a patient, weakened by a virus, then gets hit by a bacterial bug.

The CDC released the report through one of its publications, Morbidity and Mortality Weekly Report.

Swine flu has caused more than 1 million illnesses in the United States, the CDC estimates. More than 550 deaths and 8,800 hospitalizations have been reported to date.

It's hard to say whether children have accounted for a higher proportion of deaths from swine flu than they normally do from seasonal flu, though CDC officials say that seems to be true. The CDC doesn't monitor seasonal flu deaths as closely as it does swine flu, and it has no comprehensive count of annual seasonal flu deaths to enable such a comparison.

The new report focuses on lab-confirmed swine flu deaths reported through Aug. 8. The CDC hasn't been able to do as complete an analysis of cases that have come in since then, said Dr. Cynthia Moore, a CDC medical officer who was one of the study's co-authors.

Through Aug. 8, there were 477 total swine flu deaths, including 36 in children.

Only about 20 percent of those children were age 4 or younger. That's unusual: Often 50 percent or more of seasonal flu deaths are in infants and toddlers, who have less mature immune systems and smaller air passages and are generally in more danger from respiratory infections.

"There's a lot of school-aged children" in the death count, said Dr. Beth Bell, a CDC epidemiologist who is a leader in the agency's swine flu response efforts.

It's not clear why such a large percentage of the swine flu pediatric deaths are in kids aged 5 and older. It simply may be because older children were more likely to encounter the virus _ at schools, summer camps _ than very young children who spend more time at home, Bell said.

The initial numbers in the report are small and the CDC will need to look at more reports to see if the trends hold up, CDC officials said.

Two-thirds of the children who died had high-risk medical conditions. Nearly all of them had an illness related to the nervous system, including mental retardation, cerebral palsy and epilepsy and other seizure disorders.

Years ago experts recognized that children with neurodevelopmental conditions are at higher risk of serious complications from the flu. But the proportion of swine flu victims with that kind of underlying condition was swine flu percentages are high compared to a previous flu season, CDC officials said.

It's not clear how significant that finding is, because many of the children had other medical problems that had weakened their bodies, CDC officials said.

Of the children who were healthy before they got swine flu, many were probably killed by a one-two punch of swine flu working with a bacterial co-infection, CDC officials said.

Bacterial co-infections have been an increasingly noticed danger since the government started tracking pediatric flu deaths in 2004. So their occurrence with swine flu was not a surprise, but emphasized the needs for parents and doctors to be alert to the danger and give the child antibiotics when appropriate, CDC officials said.

___

On the Net:

CDC report: http://www.cdc.gov/mmwr




http://townhall.com/news/health/2009/09/03/cdc_study_swine_flu_deaths_higher_in_older_kids?page=2

 

[Treyfish]

Re: CDC study: Swine flu deaths higher in older kids

Swine flu more deadly to adolescents than to younger children, officials say

The CDC says older children with underlying health problems should be among the first to be vaccinated.

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By Thomas H. Maugh II September 3, 2009 | 11:41 a.m.

<!-- sphereit start -->Adolescents are at higher risk of dying from the pandemic H1N1 influenza virus than younger children, a situation that is the opposite of that encountered with seasonal flu, health authorities said this morning.

And those with underlying health problems, such as cerebral palsy, muscular dystrophy and neurodevelopmental disorders, are at the highest risk and should be among the first to be vaccinated against the new virus, according to the report in the Centers for Disease Control and Prevention's The government's warning takes on added urgency as schools begin to reopen and increases in infections from the virus, commonly known as swine flu, become apparent. Swine flu outbreaks are already sporadic throughout the country, and they are highest in the Southeast. "The most likely explanation is that schools started earlier there," said Dr. Thomas R. Frieden, director of the CDC.

"It's very unusual to see this many cases this early in the year," he said.

In a separate report, the American College Health Assn. said there were 1,640 swine flu cases during the week of Aug. 22-28 at the 165 universities reporting to it. There was only one hospitalization, however, and no deaths.

From the time of the outbreak of the swine flu pandemic in April until Aug. 8, 36 U.S. children and adolescents died with laboratory-confirmed swine flu infections out of a total of 477 deaths in the nation linked to the virus. Of those 36, seven were younger than 5.

In a normal flu season, at least half of the deaths in children occur in those younger than 5. With swine flu, more than 80% of the fatalities occurred in children ages 5 to 18. In a typical seasonal flu season, 50 to 100 children die from it. The swine flu deaths occurred after the normal seasonal flu outbreak was over.

Of the 36 children who died, 24 had high-risk medical conditions like cerebral palsy or long-standing respiratory or cardiac conditions. Many of those who did not have such a medical condition had a bacterial infection, such as bacterial pneumonia, according to the report.

"When you get the flu, your immune system can become weakened and you are more susceptible to other infections," Frieden said.

The findings emphasize the need for high-risk groups to be immunized against bacterial pneumonia, which can prevent some of the complications of flu, he said.

The CDC is urging the vast majority of people with flu symptoms to avoid going to doctors or the hospital emergency room to prevent the facilities from being swamped. "The overwhelming majority of people [with H1N1 flu] are going to do fine," Frieden said. "They don't need testing; they don't need treatment."

But both children and adults with underlying medical conditions, and pregnant women as well, should seek treatment when a fever from the flu develops. And early treatment is best because the antiviral drugs such as Tamiflu are most effective when given in the early stages of the infection.

Another group who should seek treatment are those whose symptoms have gotten better, but who then suffer a relapse with fever. Such people most likely have pneumonia and should seek help.

The government is still on track to have swine flu vaccine available by mid-October, Frieden noted. Health authorities have gotten some good news from preliminary trials of vaccines in China and Britain.

Swiss drug maker Novartis said that preliminary results from its trial of one vaccine in Britain show that 80% immunity is achieved with only one dose of vaccine and that 90% is achieved with two. Most authorities have thought that two doses of swine flu vaccine will be required to produce adequate immunity, but the new findings suggest that if a shortage of vaccine occurs, one dose might suffice. A separate dose of seasonal flu vaccine will also be required.

The Novartis vaccine cannot be used in the United States, however, because it contains an adjuvant that boosts the immune response to the flu antigens. Flu vaccines containing adjuvants have not been licensed in the U.S.

But Beijing manufacturer Sinovac Biotech, which makes a vaccine very similar to that being tested in the U.S., said this week that it has obtained good immunity with only one dose. Both CDC and World Health Organization officials said they have not yet seen data from the Chinese tests.

The first results from U.S. tests of the vaccine are expected in a couple of weeks.
:tiphat:http://www.latimes.com/news/nationworld/nation/la-sci-swine-flu4-2009sep04,0,2093906.story?track=rss

:tiphat: well.. that clinches it.. my son will not be going back to school this year,and this furthers the need for isolation at my home this fall.