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Children with neurologic disorders face higher risk for flu-related death
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A disproportionate number of children with neurologic disorders died of influenza-related complications during the 2009 H1N1 pandemic, according to study results published in Pediatrics. The study was conducted by scientists with the CDC, which is joining the American Academy of Pediatrics, Families Fighting Flu and Family Voices to address the importance of influenza vaccination and treatment in children.
“We’ve known for some time that certain neurologic conditions can put children at high risk for serious complications from influenza,” Lyn Finelli, DrPH, chief of the surveillance and outbreak response team in the CDC’s Influenza Division, said in a press release. “However, the high percentage of pediatric deaths associated with neurologic disorders that occurred during the 2009 H1N1 pandemic was a somber reminder of the harm that flu can cause to children with neurologic and neurodevelopmental disorders.”
The Pediatrics study used data reported to the CDC from state and local health departments. The 2009 pandemic claimed more than five times the median number of pediatric deaths than what was reported in the previous five influenza seasons. Of the 336 children with information available on underlying medical conditions who died of causes related to the 2009 H1N1, 227 (68%) had at least one underlying heath condition. Of those, 146 (64%) had a neurologic disorder. The most common of these disorders were cerebral palsy, intellectual disability and epilepsy.
According to the press release, of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23%) received the seasonal influenza vaccine and two (3%) were fully vaccinated for 2009 H1N1.
Compared with children who had no underlying medical conditions, children with neurologic disorders were older (P=.02), had a longer duration of illness from onset to death (P<.01) and were more likely to die in the hospital vs. at home or in the ED (P<.01).
Pneumonia (70%) and acute respiratory distress syndrome (40%) were the most commonly reported complications among children with neurologic disorders. Among those children with a neurologic disorder who died of 2009 H1N1-related infection, 75% also had comorbid high-risk conditions, including pulmonary disorder (48%), metabolic disorder (16%), cardiac disease or congenital heart defect (16%), and chromosomal abnormality (12%).
“Flu is particularly dangerous for people who may have trouble with muscle function, lung function or difficulty coughing, swallowing or clearing fluids from their airways,” said study researcher Georgina Peacock, MD, MPH, a medical officer and developmental-behavioral pediatrician at the CDC’s National Center on Birth Defects and Developmental Disabilities. “These problems are sometimes experienced by children with neurologic disorders.”
According to CDC Director Thomas R. Frieden, MD, MPH, the CDC is coordinating its message with other organizations to promote awareness of influenza prevention and treatment.
“Partnering with the American Academy of Pediatrics, influenza advocacy groups and family led-organizations can help prevent influenza in children at highest risk,” he said.
The CDC recommends that those aged 6 months and older get annual influenza vaccinations. Antiviral drugs are a second line of defense.
Disclosure: The researchers report no relevant financial disclosures.
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