Thursday, March 3, 2005

Childhood deaths from influenza are down drastically this flu season, and health officials say stepped-up pediatric immunizations have played an important part.

As of Feb. 19, nine deaths of children younger than 18 from laboratory-confirmed flu had been reported from nine states, compared with 153 from 40 states last season, according to Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR).

The flu season this year kicked off with the British-based Chiron Corp. — one of two manufacturers that produces vaccines for the United States — pulling its supply off the shelves saying the doses were contaminated. This created a nationwide panic.

The CDC responded to the shortage by identifying at-risk groups, those deemed most in need of the vaccine. Seniors, children and others at risk lined up at hospitals and health clinics for days to get vaccinations.

“This will be a mild flu season. It will not be a big year in terms of either deaths or cases,” said Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University and a member of the board of directors of the National Foundation for Infectious Diseases.

Dr. Schaffner said the low pediatric flu mortality and high volume of childhood immunization were especially rewarding in an influenza season in which the United States started out with only about half of its anticipated vaccine supply.

Pointing out that children were “disproportionately affected” in the previous flu season, Dr. Schaffner notes that the CDC designated babies between 6 months and 23 months old as a priority group for flu vaccinations this season.

He said pediatricians and primary care physicians did a good job of informing parents of the change, as a recent CDC telephone survey found that more than half of the children in the affected age group have been immunized.

Dr. Schaffner said there is “no doubt” the addition of flu shots to the childhood immunization schedule for those between 6 months and 23 months also contributed to the sharp reduction in pediatric flu deaths this season.

The nine children who died were from California, Georgia, Maine, Massachusetts, Mississippi, New Jersey, Ohio, Pennsylvania and Vermont, and the deaths occurred in January and February.

The 2003-04 flu season started more than a month earlier than usual, and there were at least nine deaths in the first weeks.

CDC officials note that “numerous flu outbreaks have been reported in long-term care facilities and among schoolchildren” in recent weeks, and they predict the number of children who die from influenza will increase “before the end of this season.” They do not estimate the size of the increase.

However, data from 11 metropolitan areas that participate in the Emerging Infections Program (EIP) showed that flu-related hospitalization rates for younger children were significantly lower this season than the former.

From Oct. 1 through Feb. 5, the hospitalization rate for children up to age 4 was 0.81 per 10,000 children and for those 5 to 17 was 0.11 per 10,000. But final 2003-04 flu season EIP hospitalization rates were 7.8 per 10,000 for children 4 or younger and 0.8 per 10,000 for those ages 5 to 17.

The editor of the MMWR said U.S. flu activity from October through mid-December was “low … but steadily increased during January and February and might not have peaked,” adding that in 16 of the preceding flu seasons, activity peaked during February or later.

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