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Children with pre-existing conditions more likely to die of H1N1 infection
Sachedina N. Lancet. 2010;doi:10.1016/S0140-6736(10)61195-6.
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Seventy children died during a 9-month period as a result of pandemic influenza A (H1N1) in England, according to a study conducted by the members of the UK Department of Health, making the childhood mortality rate six per million.
In the study, children with pre-existing conditions had the highest rate of mortality. Children from the country’s Bangladeshi and Pakistani communities experienced higher mortality than white British children. The mortality rate was highest for children aged younger than 1 year.
“Mortality from seasonal influenza in children is lower than that reported for pandemic influenza H1N1,” the researchers wrote in The Lancet. “Extrapolated data from population mortality estimates in England show a mortality rate from seasonal influenza of two per million for children aged less than 14 years.”
Deaths related to pandemic influenza A (H1N1) from June 26, 2009, to March 22 were identified using daily reporting systems and cross-checking. Deaths were validated by laboratory results or death certificates. The clinicians who treated the children provided detailed information about the children’s medical history and the children’s presentation with the H1N1 influenza.
For Bangladeshi children, the mortality rate was 47 deaths per million. For Pakistani children, the rate was 36 deaths per million. For white children, the rate was four deaths per million.
Of the children who died, 15 were previously healthy and 45 had severe pre-existing conditions. The mortality rate in children with chronic neurological disease was 1,536 per million. Deaths that occurred before inpatient admission were more likely to be children who were healthy or children who had mild pre-existing conditions.
“Vaccination priority should be for children at increased risk of severe illness or death from influenza,” the researchers wrote. “This group might include those with specified pre-existing disorders and those in some ethnic minority groups. Early pre-hospital supportive and therapeutic care is also important.”
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