US Pediatric Deaths Raise Pandemic Concerns
Recombinomics Commentary 02:07
September 4, 2009

Arizona (six cases), California (three), Connecticut (one), Florida (one) , Illinois (two), Massachusetts (one), Minnesota (two), New Jersey (three), New York (four), New York City (four), Oregon (one), Rhode Island (one), Texas (two), Utah (three), and Wisconsin (two).

The above list of locations of the 36 pediatric deaths in the United States described in tomorrows MMWR highlight the differences between these earlier cases and those12 who have died in the past 2 weeks, which were largely in the south where school began in early August.  Many of the earlier cases had severe underlying conditions, but the number of infections in children during that time period was relatively low because the levels of H1N1 began to rise near the end of the school year.  Although there were reports of outbreaks in summer camps, the number of cases have exploded among students returning to school for the current season.

These outbreaks were most dramatic in the south (see map) and schools with absentee rates above 10% were common.  Moreover, several school districts (see map) have closed when rates rose to 20-40%.  Additional schools remaned open, and now similar rates are being seen further north, like the 44% of 6th graders at a school in suburban Pittsburgh (see map).

The student fatalities are at public schools and there is no indication of underlying conditions.  One student began feeling ill on Friday, played soccer of Saturday, and died on Monday.  This short interval between disease onset and death has been described for several students.

Thus, these cases make tomorrow's report obsolete prior to publication.  A similar analysis of students dying during the current school year should be underway. 

Results from that report are eagerly anticipated.

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