Children Hit Hard By Flu Epidemic

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Children Hit Hard By Flu EpidemicCDC to monitor flu complications in children

 

Dec. 9, 200313 states report widespread influenza activity. A federal health official told NBC's 'Today' the epidemic is still spreading across the country.NEW YORK — The nation's health agency said it would closely watch flu complications among children, who have swamped hospitals in some states and surprised doctors with the severity of their illnesses. A new concern is the rise of a common drug-resistant staph infection that is undermining efforts to treat children with the flu, an official with the Centers for Disease Control and Prevention said Monday.DR. TIM Uyeki, epidemiologist with the influenza branch of CDC, said that some children have died from the staph infections - a phenomenon the CDC has not seen before.Flu complications for children have always been dire: pneumonia, kidney and heart failure, possible brain damage.“We’ve just never seen them in the proportions we’ve seen them this year,” said Dr. Steve Schexnayder, chief of pediatric critical care at Arkansas Children’s Hospital in Little Rock.From Texas to California, children’s hospitals have been swamped with sick children - many of them desperately ill.Eight children have died in Colorado over the last three weeks and another death of a child is suspected to be flu-related, state health department officials said on Monday. Usually one or two children die every year in Colorado from the flu. So far 6,306 Colorado residents have been diagnosed with the flu.The waiting room at Children’s Hospital Central California in Madera was standing room only during the Thanksgiving holiday, and hospital officials said nearly every child tested positive for the flu.Children’s Medical Center in Dallas has seen more than 500 kids with the flu since October. One day last week, two dozen more appeared, most with enough lung disease to be put on ventilators, said Dr. Jane Siegel.“Because it seems to be a strain that has not circulated in the U.S. before and is not well-covered by the existing vaccine, we’re seeing far more cases,” said Dr. James director of epidemiology of Denver Children’s Hospital. “Just because you’re seeing more cases, you’re seeing more complications.”Flu death toll growsMedical experts worry as the deadly flu epidemic continues, lines get longer and the vaccine supplies grow shorter. Doctors say some children are coming into hospitals with so much damage they are put on heart-lung bypass machines just to stay alive.Others face additional problems: Nine-year-old Nick Collins at Arkansas Children’s Hospital needed four chest tubes to drain fluid from holes in his lungs caused by bacterial pneumonia. Doctors are trying to prevent a blood clot from killing him.He also had methicillin-resistant staphylococcus aureus (MRSA), a usually mild infection which led to his severe pneumonia. Staph bacteria are commonly found on the skin or in the nose and often go undetected.Uyeki said the children with staph-related flu likely picked up the bacteria before they were hospitalized. In October CDC warned parents that many school athletes had been found to carry MRSA. Feeling sniffly? These infections don’t normally cause pneumonia without the flu virus, said Dr. Frederick Hayden, a flu expert and professor of internal medicine at the University of Virginia.But the flu virus can impair the body’s ability to fight the bacteria and expel it. The bacteria, in turn, can produce enzymes that enhance the flu’s ability to infect cells, he said.Nick, a healthy boy until he got the flu in early November, is doing better, having been removed from a ventilator on Friday. But he’ll likely have to stay in the hospital through the end of the year, his mother says.“It’s scary to find that something as common as the flu can cause something this major every year,” said his mother, Kim Collins of Texarkana, Texas. “We sit around for days in awe of the fact the flu has caused all of this.”Flu and its complications are the sixth leading cause of death nationally among children age 4 and younger, according to the CDC.Children have smaller trachea and bronchi making it harder to fight the flu. They are also more vulnerable because they might wash their hands less often than adults and are in contact with other children either in the classroom or the playground.On Monday, a CDC doctor said the flu epidemic could get worse before it gets better. At a time when some states are facing vaccine shortages, Dr. Julie Gerberding of the Centers for Disease Control and Prevention told NBC’s ‘Today’ Monday that the outbreak is still spreading across the country.“We’ll be seeing more flu before it’s over,” she said. The CDC reported widespread influenza activity in 13 states, including Colorado, Pennsylvania, Texas and Washington, for the week ending Nov. 29. This year the agency is planning to collect data on children who die from the flu, those with MRSA, and those who develop brain damage. Anecdotally, this flu season seems to be worse for children. But because the CDC doesn’t keep track of flu deaths, it’s unclear how much worse. This year the agency is planning to collect data on children who die from the flu, those with MRSA, and those who develop brain damage, said Dr. Keiji Fukuda, chief of epidemiology in the CDC’s influenza branch.It’s also uncertain whether any of the children who have died from the flu were vaccinated or how many may have had underlying health issues. Some connected with the CDC say there may be a push to add school-age children to the list of those most strongly urged to get the flu shot - the best protection against the virus. The current recommendation for children covers those from 6 months to 2 years and those who have certain chronic conditions.“My own prediction is what you’ll continue to see is a broadening of the recommendation for influenza immunization,” said Dr. Greg Poland, a Mayo Clinic professor and a member of the CDC advisory committee on immunization.Pregnant women - urged to get the flu shot if they are in their second or third trimester - have also become a concern this year The CDC is looking closely at some cases in which pregnant women have displayed high pulse rates - which could be a symptom of a dangerous, and potentially fatal, inflammation of the heart, said Dr. William Schaffner, a flu expert with Vanderbilt University Medical Center. Texas in particular has reported several such cases.In North Carolina health officials made it a point last month to single out both pregnant women and children up to age 9 as risk groups that should get the vaccine.Despite the complications seen among sick children, however, better medical care is keeping alive many of those who do develop the flu. The Little Rock, Ark., hospital has not had a flu death yet, despite the severity of their illnesses.“Even 15 years ago, Nick would have probably succumbed to his illness,” Schexnayder said. “But we have better technology to support an incredibly ill patient.”As a result of shortages in striken areas, health officials, those in Colorado in particular, are urging healthy people under age 49 to use the new, and more expensive, FluMist nasal spray, which is still in abundance. Its maker, MedImmune Vaccines, has almost 5 million doses available.The spray has limitations—it cannot be used by older people, children under 5 years of age, or at-risk people with chronic ailments. Data indicates that the spray is as effective as a shot. NOT A PANDEMICAs serious as the early outbreak is, health experts said Monday it is not the killer pandemic they have been warning will eventually come. “It’s not the big nasty that everyone was worried about,” said Richard Webby, an influenza virus expert at St. Jude Children’s Research Hospital in Memphis.This year, extra attention has been focused on flu because of the outbreak earlier in the year of the new Severe Acute Respiratory Syndrome or SARS virus, experts said. Flu symptoms include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, and muscle aches. Children may also suffer nausea, vomiting, and diarrhea.A history of worldwide InfluenzaThe origins of influenza are unknown, but the malady is never absent for more than a few decades. The worst pandemic occurred in the late 19th century, when more than 20 million people were killed.400 B.C.: Hippocrates records an outbreak of a cough, followed by pneumonia and other symptoms, at Perinthus in northern Greece (now part of Turkey). Several possible identifications have been suggested, including influenza, whooping cough and diphtheria.212 B.C.: The historian Livy describes an infectious disease, perhaps influenza, which strikes the Roman army.1781-'82: Considered among the greatest manifestations of disease in history, this pandemic afflicts two-thirds of the people of Rome and three-quarters of the population of Britain. Influenza also spreads widely in North America, the West Indies and Spanish America. 1789: A widespread epidemic hits New England, New York and Nova Scotia in the fall. Most deaths appear to come from secondary pneumonia.1829-'32, 1836-'37: An epidemic begins in Asia late in 1829. From there it spreads to Indonesia by January 1831. The disease also breaks out in Russia in the winter of 1830-'31 and spreads westward. By November it reaches the United States.1889-'90: Named the Russian flu, this worldwide influenza epidemic, the most devastating to that time, begins in Central Asia in the summer of 1889, spreads north into Russia, east to China and west to Europe. It eventually strikes North America, parts of Africa and major Pacific Rim countries. By conservative estimates, 250,000 die in Europe, and the world death total is two to three times that.| 1917-'19: The Spanish flu, the most lethal influenza pandemic ever, kills more than 20 million people. More people die as a result of this flu than die during World War I. Its spread is facilitated by troop movements in the closing months of the war. Mortality rates are unusually high for flu, especially among young, otherwise healthy adults.1957-'58: The Asian flu starts in southwest China in February 1957, possibly having originated in 1956 in Vladivostok, Russia, then spreads throughout the Pacific. Globally it affects 10 percent to 35 percent of the population, but overall mortality is much lower than in the 1918 epidemic, about 0.25 percent.1968-'69: Hong Kong flu claims 700,000 lives worldwide, 34,000 in the United States.1976: The Swine flu, isolated in New Jersey in a young army recruit, instills fear of a new pandemic and leads to a massive influenza-immunization program. The vaccinations lead to Guillain-Barre syndrome, an ascending paralysis, in 100,000 people and kills 5 percent of those afflicted.1986: Avian variation of the swine flue in the Netherlands results in one severe case of pneumonia.1988: The Swine flu kills a pregnant woman exposed to a sick pig in Wisconsin.1993: Strain of the swine flu in the Netherlands sickens two children. The fathers are believed to have come in contact with infected pigs.1995: One adult contracts conjunctivitis in the United Kingdom after infection with the duck virus.1997: The Hong Kong Poultry virus infects at least 18 people, killing 6 of them.