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Pediatr Infect Dis J . Influenza-related Deaths in Young Children: Observations From a German Case Series

tetano

Editor, Senior Moderator
Pediatr Infect Dis J


. 2026 Jun 5.
doi: 10.1097/INF.0000000000005297. Online ahead of print.
Influenza-related Deaths in Young Children: Observations From a German Case Series

Julian A F Klein[SUP] 1 2 [/SUP], Marianne Wedde[SUP] 3 [/SUP], Ralf Dürrwald[SUP] 3 [/SUP], Katharina Feld[SUP] 4 [/SUP], Gerrit Dunke[SUP] 4 [/SUP], Hans-Georg Kräusslich[SUP] 1 5 [/SUP], Julia Gsenger[SUP] 1 5 [/SUP], Julia Tabatabai[SUP] 1 5 6 [/SUP]


Affiliations
Abstract

Background: Seasonal influenza virus infections remain a major public health burden. During the last years, several case reports of severe influenza infections in children have been published.
Cases: We report 4 fatal influenza cases in young children (2-6 years old) which occurred in Southwest Germany in the seasons 2022/23 and 2023/24. All 4 children were previously healthy; a forensic autopsy was conducted due to an unknown cause of death. Postmortem samples from the respiratory tract and organ tissues were tested for respiratory viruses via real-time polymerase chain reaction (RT-PCR) and analyzed by whole-genome sequencing.
Results: In 1 child, RT-PCR revealed influenza B virus, and 3 children died with influenza A (H1N1)pdm09 infection. No mutations associated with high virulence were detected. In 1 case, influenza A(H1N1)pdm09 could be cultivated in cell culture from brain tissue.
Conclusions: This case series underlines the potential risk of fatal outcomes of influenza infections in children. This should be considered when re-evaluating the vaccination recommendations for healthy children.

Keywords: influenza-associated encephalitis; myocarditis; neurologic complications; vaccination status.

 
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