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Commentary

CDC Updates Flu Advice For Pediatricians
Recombinomics Commentary 21:30
January 15, 2013

Twenty influenza-associated pediatric deaths had been reported to CDC as of January 5. It’s likely that more deaths will be reported since influenza activity will probably continue in the United States for several more weeks. During 2003-04 and 2007-08 – two seasons with comparable patterns in influenza-like-illness --reported pediatric deaths were 153 and 88 respectively for the entire season.

The above comments are from the CDC’s update information for pediatricians.  The historic numbers help put the current season into perspective.  The 153 reported deaths in the 2003-04 seasons led to regulations in the United States which made lab confirmed influenza flu deaths reportable.  Although the reported deaths, continue to grossly underestimate the actual number of deaths because many cases are not tested and therefore not reported, the numbers do allow for comparisons between seasons.

The CDC notes that the number of deaths will increase because of future deaths this season, but the number of reported pediatric deaths is already 38, although the 18 additional cases have not yet been reported by the CDC.  The vast majority of these 18 additional cases have been lab confirmed, and most of those not lab confirmed have been reported recently.  Therefore, the number of deaths will increase significantly due to deaths that have already been reported by state labs or recent media reports.

In week 2 Pennsylvania is reporting 18 additional adult deaths, raising the total to 40, which does not include the pediatric death reported last week.  Moreover, Pennsylvania reported 509 more hospitalizations in week 2 and the total for the past 2 weeks to 1023, signaling more deaths in the near term.

Many of the recent pediatric deaths are due to H3N2 and the frequency of low reactors is on the rise.  The most dominant sub-clade has the 
same loss of a glycoslyation site (position 126 due to T128A) as was seen in the 2003-04 season cited above that was linked to 153 reported pediatric deaths.  The increase in this sub-clade will also continue to lower the vaccine effectiveness which was reported at 55% for influenza A based on early data which was on cases infected when the sub-clade was less common during the earlier phase of the current season.

The 38 reported pediatric deaths suggest that the total for 2012-13 will rival the number of reported pediatric deaths in 2003-04.

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