Pediatric mortality - US to week 36

[Ronan Kelly]

From the FluView surveillance report:
http://www.cdc.gov/flu/weekly/

"Influenza-Associated Pediatric Mortality
Two influenza-associated pediatric deaths were reported to CDC during week 36 (Kansas and Tennessee). These deaths were associated with 2009 influenza A (H1N1) virus infection, and occurred between August 23 and September 12, 2009. Since September 28, 2008, CDC has received 114 reports of influenza-associated pediatric deaths that occurred during the current influenza season (25 deaths in children less than 2 years, 12 deaths in children 2-4 years, 34 deaths in children 5-11 years, and 43 deaths in individuals 12-17 years). Forty-six of the 114 deaths were due to 2009 influenza A (H1N1) virus infections.

Of the 47 children who had specimens collected for bacterial culture from normally sterile sites, 18 (38.3%) were positive; Staphylococcus aureus was identified in 12 (66.7%) of the 18 children. Five of the S. aureus isolates were sensitive to methicillin and seven were methicillin resistant. Sixteen (88.9%) of the 18 children with bacterial coinfections were five years of age or older and 12 (66.7%) of the 18 children were 12 years of age or older. Sixteen (34.8%) of the 46 children with confirmed 2009 influenza A (H1N1) infection had a specimen collected from a normally sterile site; four (25.0%) of the 16 children had a positive bacterial culture (methicillin sensitive S. aureus, methicillin resistant S. aureus [2], and Streptococcus constellatus).

 

[Laidback Al]

Re: Pediatric mortality - US to week 36

The following graph of cumulative influenza-related pediatric deaths is from the CDC link in the post above. The cumulative numbers in the graph are presented for four 12-month periods (i.e. 2005-2006, 2006-2007, 2007-2008, and 2008-2009) for pediatric deaths, with 46, 78, 88, and 114 deaths, respectively. The CDC text states that since September 28, 2008 there have been 114 pediatric deaths with 46 attributed to H1N1, which suggests the 52-week cumulative period starts on Week 40 of the 2008 and ends at Week 39 in 2009. Subtracting 46 from 114 indicates that through week 36 of 2009 there were only 68 pediatric deaths since September 28, 2008 (Week 40 of 2008) that were attributable to seasonal influenza. This is within the range of variation of seasonal influenza pediatric deaths report for the preceding three periods. This also suggests that there are 3 more weeks of pediatric deaths that will be included in the 2008-2009 total, most likely all of them will be H1N1 associated. Based on seasonal influenza pediatric deaths for the past several years for Weeks 37 to 39 there should be few, if any, additional pediatric deaths.

If more pediatric deaths accumulate over the next three weeks from H1N1, it will signal a high fatality rate for young people infected with the novel H1N1 virus.

 

[Ronan Kelly]

Re: Pediatric mortality - US to week 36

Here's a comparison between sum of the 06-07 and 07-08 seasonal flu fatalities and the 08-09 combined seasonal and novel H1N1 fatalities;

2006-2008 2008-2009

<2 years 43 (28.5%) 25 (21.9%
2-4 years 27 (17.9%) 12 (10.5%
5-17 years 81 (53.6%) 77 (67.5%)
Total: 151 114

As the 08-09 statistics contain 68 seasonal flu deaths, it's not possible to say anything definintive, but there does seem to be a shift toward a greater proportion of fatalities in the 5-17 year category.