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Commentary
US Pediatric
Flu Deaths Jump To 33
Recombinomics
Commentary 14:00
January 11, 2013
The above data from the reportable disease page of the week 1 MMWR indicate today’s week 1 FluView will report two additional pediatric deaths raising the seasonal total to 20. However, media reports and state lab reports describe a sharp rise in recent pediatric deaths, raising the seasonal total to 33 (see list below).
Most of those not reported in the week 1 FluView are lab confirmed, and the delay in reporting these cases in the FluView may be linked to the recent holidays. In addition, a small sub-set of the cases are not in the FluView because of an absence of lab testing.
Although pediatric flu deaths are now reportable in the United States, they are not reported if not lab confirmed, which is true for the vast majority of pediatric deaths. In some cases like the week 48 Ohio death (17F), the flu linkage is in an obituary report, but the diagnosis is not lab confirmed. In other cases, such as recent Texas case (6F) a flu diagnosis is made at the hospital, but a high volume of flu cases coupled with a low sensitivity of some flu tests, a diagnosis is made without lab confirmation. In other cases such as the Texas teen (17M) who became ill while vacationing in Wisconsin, but died in a Minnesota hospital, the case may go unreported because of travel (Minnesota won’t report because the patients wasn’t a resident and wasn’t infected in Minnesota. Similarly, Wisconsin won’t report because the patient wasn’t a resident and the lab confirmation was in Minnesota. In addition Texas may not report because the resident was infected in Wisconsin but diagnosed in Minnesota.
In any event, the lab confirmed adolescent deaths are a gross underestimate of the actual number of deaths, but the figure is related to influenza activity, and the state lab and media reports reflect a clear spike in cases in week 1, which are not reflected in the week 1 MMWR or FluView.
FluView pediatric cases
Week Number Location
01 2 KS TX
52 2 MI NY
51 8 AR FL ME MI(2) TX WA WI
50 2 NJ
49 1 TX
48 3 IN FL SC
46 1 TX
41 1 TN
Pediatric deaths not in FluView
01 8 MI MN NE NY PA SC TX WI
52 2 IN MN
50 2 CO
48 1 OH
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