Woonsocket Call

Flu reaches decade-high death toll: 172 chil­dren


Flu killed 172 chil­dren be­tween Oc­to­ber and May, mak­ing this sea­son one of the dead­li­est since fed­eral health au­thor­i­ties be­gan track­ing pe­di­atric deaths 14 years ago, ac­cord­ing to a new govern­ment re­port.

The fig­ure re­ported Fri­day by the Cen­ters for Dis­ease Con­trol and Preven­tion ex­ceeds the 171 child deaths re­ported for 2012-2013, the pre­vi­ous record for a reg­u­lar sea­son. Only the 2009 swine flu pan­demic, which killed 358 chil­dren, was worse; that flu was a new strain of the res­pi­ra­tory virus for which peo­ple had no pre­vi­ous ex­po­sure.

About half of this sea­son’s deaths were in oth­er­wise healthy chil­dren. They ranged in age from 8 weeks to 17 years. Of those for whom a flu shot is rec­om­mended, less than one­fourth of the chil­dren who died had been fully vac­ci­nated. That was about the same pro­por­tion as in past win­ter flu sea­sons.

The num­ber of pe­di­atric flu deaths “is a record num­ber since we’ve been keep­ing track, out­side of the pan­demic,” said Daniel Jerni­gan, who heads the CDC’s in­fluenza di­vi­sion. And the num­ber is con­sid­ered an un­der­count be­cause it only in­cludes lab-con­firmed cases that are listed on death cer­tifi­cates and then re­ported to the CDC. It could go even higher be­cause of re­port­ing de­lays.

“It’s prob­a­bly half of what ac­tu­ally oc­curs be­cause there are times when chil­dren die even be­fore they get to the emer­gency room,” Jerni­gan said in an in­ter­view. More than 40 per­cent of this sea­son’s young vic­tims died be­fore they were hos­pi­tal­ized.

States are not re­quired to re­port in­di­vid­ual sea­sonal flu cases or adults’ deaths. The CDC uses math­e­mat­i­cal mod­el­ing to es­ti­mate to­tal flu-re­lated deaths. Be­cause flu sea­sons vary in length and sever­ity, the agency es­ti­mates that flu-re­lated deaths in the United States ranged from a low of 12,000 (dur­ing 2011-2012) to a high of 56,000 (dur­ing 2012-2013).

Data re­leased this week by CDC give the fullest pic­ture so far of a sea­son that was no­table for the vol­ume and in­ten­sity of cases, which over­whelmed hos­pi­tals and led Alabama to de­clare a state of emer­gency. Some hos­pi­tals were forced to pitch tents out­side emer­gency rooms. Other fa­cil­i­ties had bed short­ages that kept am­bu­lances idling out­side.

This sea­son’s pre­dom­i­nant strain was H3N2, the most dreaded flu strain. It’s as­so­ci­ated with more com­pli­ca­tions, hos­pi­tal­iza­tions and deaths, es­pe­cially among chil­dren, peo­ple older than 65 and those with cer­tain chronic con­di­tions.

But even though of­fi­cials knew it was likely to be a harsh sea­son, they weren’t ex­pect­ing vir­tu­ally the en­tire coun­try to be slammed at the same time and across all age groups. In past years, the flu more com­monly ap­peared in dif­fer­ent parts of the coun­try at dif­fer­ent times.

Flu sea­sons typ­i­cally last be­tween 16 to 20 weeks. The 2017-2018 sea­son was 19 weeks.

Flu ac­tiv­ity be­gan ramp­ing up in Novem­ber, reached high lev­els in Jan­uary and Fe­bru­ary, and stayed el­e­vated through March.

Last year, the CDC de­vel­oped a new way to clas­sify flu sea­son sever­ity based on three in­di­ca­tors: the per­cent­age of peo­ple go­ing to doc­tors’ of­fice for fever, cough and other flu­like symp­toms; rate of hos­pi­tal­iza­tions; and per­cent­age of deaths from pneu­mo­nia or flu. Us­ing that in­dex, of­fi­cials an­a­lyzed each sea­son go­ing back to 2003-2004.

Their con­clu­sion: This sea­son was the first – and only – to be clas­si­fied as “high sever­ity” for all age groups.

“It wasn’t just a bad year for some peo­ple. It was bad across the pop­u­la­tion,” said Jerni­gan. “It was hap­pen­ing to ev­ery­one, and it seemed to be hap­pen­ing ev­ery­where.”

A CDC flu sum­mary re­leased Thurs­day noted other in­di­ca­tors of the sea­son’s sever­ity:

• At its peak in early Fe­bru­ary, the per­cent­age of peo­ple go­ing to doc­tors’ of­fices with fever, cough and aches was the third high­est since the 19971998 sea­son, when the CDC sur­veil­lance sys­tem was put in place.

• The per­cent of deaths caused by pneu­mo­nia or flu reached a peak of nearly 11 per­cent, or 1 out of 9 peo­ple, the high­est since the 2014-2015 sea­son, when the same strain was dom­i­nant.

• Hos­pi­tal­iza­tion rates for chil­dren were the high­est of any pre­vi­ous H3N2-pre­dom­i­nant sea­son.

It’s not com­mon for two con­sec­u­tive flu sea­sons to be dom­i­nated by H3N2, al­though that’s what hap­pened in 2016-2017 and 2017-2018. No one knows how the next sea­son will shape up, or whether the same vir­u­lent strain will dom­i­nate, but “some­times we’ve had two or three in a row,” Jerni­gan noted.

This sea­son’s vac­cine of­fered lim­ited pro­tec­tion against the flu viruses that swept the coun­try, with an over­all ef­fec­tive­ness of 36 per­cent fall­ing to 25 per­cent against the H3N2 strain, ac­cord­ing to pre­lim­i­nary data re­leased in Fe­bru­ary. But in chil­dren younger than 9, it of­fered much greater pro­tec­tion, re­duc­ing by more than half the risk of be­com­ing so sick that they needed to see a doc­tor.

Jerni­gan said the com­ing sea­son’s vac­cine pro­duc­tion process in­cludes a strain that is ex­pected to per­form bet­ter

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