A new report underscores what health professionals know but parents may not: The flu can be fatal to children, even healthy kids who don't have other medical conditions.
Researchers with the Centers for Disease Control and Prevention found that 830 kids died from flu-related complications between October 2004 and September 2012, and most of those children had not gotten a flu vaccine. Pneumonia was the most commonly reported complication among the kids who died. Their median age was 7.
The report also shows that 43% of the kids who died from flu complications were otherwise healthy and didn't have high-risk medical conditions such as asthma, diabetes, certain types of cancer, congenital heart defects or neurological disorders such as cerebral palsy or epilepsy. Children with those types of health problems are at a greater risk of dying from flu complications.
The CDC "recommends that all children 6 months or older get the flu vaccine every year, and this report shows that any child can be at risk for severe complications from influenza," says the report's lead author, Karen Wong, a CDC medical officer. These findings reinforce that "prevention is the best strategy, and the best strategy we have is vaccination," she says.
"The most sobering message is that almost half of these children had no underlying medical condition - these were normal, healthy children," says William Schaffner, professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine. He was not involved in this report but is a member of the CDC's advisory committee on immunization practices. "That's a profound fact when you think about it. Everyone in the United States older than 6 months of age should be vaccinated against influenza."
Schaffner says children younger than 9 who are receiving the vaccine for the first time need two doses. "If they only get one, it's as though they are not vaccinated that season."
CDC director Tom Frieden says, "All too often, people dismiss flu as a mild illness, but every year, children, including healthy children, die from flu."
The CDC says 56.6% of kids, ages 6 months to 17 years, got one or more doses of the flu vaccine during the 2012-13 season.
The pediatric deaths from the influenza complications are reported to a national surveillance system, but the numbers may be underestimated because they include only deaths that were confirmed by a flu test, Wong says. The tally of 830 deaths doesn't include the 167 pediatric deaths from last year's flu season.
The flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat and lungs, the CDC says. The flu can cause mild to severe illness. Signs and symptoms include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue. Some people may have vomiting and diarrhea, though this is more common in children than adults.
Among the findings from the report, out in November's Pediatrics, published online Monday:
• Of the 794 children who died whose medical history was known, 43% had no high-risk medical conditions; 33% had neurological disorders; 12% had genetic or chromosomal disorders.
• 35% of the children died before hospital admission. "They died at home or on the way to the hospital or in the emergency room," Wong says.
• Children without medical conditions were more likely to die before hospital admission.
• 63% of the children died within seven days of the onset of the flu symptoms.
• Cerebral palsy, which affects less than 1% of the kids in this country, was reported among 10% of children who died while infected with the flu. Kids with medical conditions such as this should definitely get a vaccine every year, and, as an additional way to protect them, everyone in the household should, too, Wong says.
One reason people may not get a flu shot: "There is a myth that the flu vaccine can cause the flu, but that's what it is - a myth. It does not cause the flu," she says.
Schaffner says, "The vaccine isn't perfect, but it's good. You might still get the flu, but if you do, it will be a milder case and you are less likely to get the complications of pneumonia, hospitalization and death."
The percentage* of kids by age who got flu vaccines in 2012-13:
6-23 months, 77%
2-4 years, 66%
5-12 years, 59%
13-17 years, 43%
*Percentages have been rounded
Source: Centers for Disease Control and Prevention
Some facts about the flu:
• Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes.
• Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching his own mouth, eyes or possibly nose.
• Certain people are at greater risk for serious complications if they get the flu. They include older people, young children, pregnant women and people with certain health conditions (such as asthma, diabetes or heart disease), as well as those who live in facilities such as nursing homes.
• Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of annual flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people.
Source: Centers for Disease Control and Prevention