Tag: flu deaths

Can Vaccines Cause Rhabdomyolysis?

The urine is dark because of myoglobinuria secondary to muscle break down. Hemoglobinuria, from blood, is the other thing that makes urine dark.
The urine is dark because of myoglobinuria secondary to muscle break down. Hemoglobinuria, from blood, is the other thing that makes urine dark. Photo Kumar et al (CC BY-NC-SA 3.0 US).

You have probably never heard of rhabdomyolysis.

Children with rhabdomyolysis have severe muscle pain, muscle weakness, and dark urine.

It is classically caused by exercising too much (really overdoing it or exercising a lot more or a lot longer than you typically do) and damaging your muscles, leading to a breakdown of muscle cells and the release of creatine kinase, which in addition to muscle symptoms, can lead to kidney failure.

In addition to exercise, rhabdomyolysis can be caused by seizures, drugs, toxins, insect stings, snake bites, metabolic disorders, infections (viral myositis), and trauma.

“The most common causes of pediatric rhabdomyolysis were viral myositis (38%), trauma (26%), and connective tissue disease (5%).”

Mannix et al on Acute Pediatric Rhabdomyolysis: Causes and Rates of Renal Failure

Keep in mind that rhabdomyolysis is rare. You won’t confuse the aches and pains that most kids get, and which often get blamed on growing pains, with rhabdomyolysis. Although younger kids don’t always have dark urine when they have rhabdo, the pain and weakness is severe. Seek immediate medical attention if you think that your child might have rhabdomyolysis.

Can Vaccines Cause Rhabdomyolysis?

It is well known that rhabdomyolysis can be caused by infections.

“Rhabdomyolysis has been reported to be associated with a variety of viral infections, including influenza, [15,16] Coxsackie virus, human immunodeficiency virus (HIV), echovirus and cytomegalovirus [17]. In our series, the definite viral infection was identified in 5 patients (influenza type B in 4, Coxsackie A10 in 1)”

Chen et al on Clinical spectrum of rhabdomyolysis presented to pediatric emergency department

So if a natural influenza virus infection can cause rhabdomyolysis, does that mean that the flu vaccine can too? What about other vaccines?

Not necessarily, but there are a few case reports that associate vaccines with rhabdomyolysis.

“Influenza A infection has been described as a major viral cause of infection-induced rhabdomyolysis, but to date, only one reported case was described as having been induced by influenza vaccine.”

Callado et al on Rhabdomyolysis secondary to influenza A H1N1 vaccine resulting in acute kidney injury.

In several of the reports, patients already had chronic medical problems for which they were being treated. Still, no signal was found to suggest that the flu vaccine is a problem for these patients.

It is important to note that reports of post-vaccination rhabdomyolysis in healthy people are even rarer.

So while it is could be possible that vaccines are rarely associated with rhabdomyolysis, we know that many infections, including many vaccine-preventable diseases, are a more common cause.

Don’t skip or delay a vaccine because you might have heard that vaccines cause rhabdomyolysis.

Vaccines are safe, with few risks, and are obviously necessary.

More on Vaccines and Rhabdomyolysis

Has the CDC Decided to Extended Flu Season Indefinitely?

As most people know, flu season traditionally goes from about December to March, with a peak in February.

That’s really just the peak times of flu activity though.

“While seasonal influenza (flu) viruses are detected year-round in the United States, flu viruses are most common during the fall and winter. The exact timing and duration of flu seasons can vary, but influenza activity often begins to increase in October. Most of the time flu activity peaks between December and February, although activity can last as late as May.”

The Flu Season

Sometimes flu season starts earlier or goes later and technically, you can get the flu during any month of the year.

Has the CDC Decided to Extended Flu Season Indefinitely?

Does that mean it’s true, that flu season has been extended indefinitely?

Of course not!

It's not too late to get a flu shot! That part is true.
It’s not too late to get a flu shot! That part is true.

Surprisingly, local media in Las Vegas did actually run a story this story, with that quote.

And the CDC?

The last Situation Update: Summary of Weekly FluView Report, from March 21, says that “overall influenza activity decreased since last week, but remains relatively high for this time of year.”

“CDC expects flu activity to remain elevated for a number of weeks.”

Situation Update: Summary of Weekly FluView Report

So flu season isn’t over yet.

But that hardly means that it is never going to end!

Flu season has peaked and is starting to wind down.

But since you might expect flu activity through April and May, as we see in most years, it isn’t too late to get a flu vaccine.

“Vaccination can still be beneficial as long as flu viruses are circulating. If you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.”

Misconceptions about Seasonal Flu and Flu Vaccines

That is the standard advice that is given every year. It is never too late to get a flu vaccine if you are unvaccinated and want to get protected while there is still flu activity in your area.

What about the idea of twice a year flu vaccines?

“In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for some children, only one dose of flu vaccine is recommended each season.”

Misconceptions about Seasonal Flu and Flu Vaccines

And yes, there have been fewer flu deaths this year, but that’s compared to one of the worst flu seasons on record!

Compared to this time last year though, there are more pediatric flu deaths in Clark County, Nevada.

It’s a good reminder that flu season isn’t over, although thankfully it won’t go on indefinitely, but still, it’s not too late to get a flu shot and get protected for the rest of this year’s flu season.

More on the Myth that Flu Season has been Extended Indefinitely

Have Normal Childhood Diseases Become More Deadly?

Weren’t measles and chicken pox once a rite of passage for kids?

Yes, in the pre-vaccine era, almost all kids got measles, chicken pox, and other now vaccine-preventable diseases in early childhood.

It was considered a rite of passage.

That she doesn't understand survivorship bias doesn't mean that you shouldn't vaccinate your kids.
That she doesn’t understand survivorship bias doesn’t mean that you shouldn’t vaccinate your kids.

But these diseases were never benign.

They were considered a rite of passage only because we all had to endure them. They weren’t something anyone looked forward to.

Benign diseases don't kill kids.
Benign diseases don’t kill kids.

After all, you don’t typically die from a benign disease.

Have Normal Childhood Diseases Become More Deadly?

But what about the idea that folks never used to worry about these diseases, at least not until vaccines were developed? Or that we only fear diseases that are vaccine-preventable?

It’s easy to say that no one worried about measles in the pre-vaccine era when you are just trying to scare folks away from getting vaccinated.

That’s one of the more ridiculous arguments anti-vaccine folks make.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951 and made headlines in the New York Times. That’s not surprising, as there were 683 measles deaths in the United States that year.

And also one of the easiest to refute.

When was the last time that you saw a headline warning about congenital rubella syndrome?
When was the last time that you saw a headline warning about congenital rubella syndrome?

These diseases that are now vaccine-preventable routinely made headlines in the pre-vaccine era.

Even the schools were closed in San Antonio when polio came to Texas in 1946.
Even the schools were closed in San Antonio when polio came to Texas in 1946.

And it was surviving these diseases that was considered a rite of passage, at least for those who were fortunate enough to survive.

So no, childhood diseases have not become deadlier.

They have always been serious and life-threatening!

Of course, not everyone died who got them, but they were rarely a walk in the park. Remember, even a mild case of measles includes a high fever for 4 to 7 days. That’s why folks often end up seeking medical attention multiple times, even if they don’t end up having any complications and don’t need to get admitted to the hospital

Lassie got shot, but ended up saving the day, getting help for Timmy, after they ran out of gas taking a short cut rushing home.
The Lassie episode about measles, in 1958, was called ‘The Crisis.” There were 552 measles deaths in the United States that year.

But what about the Brady Bunch measles episode, Is There a Doctor in the House? Is that really why you think vaccine-preventable diseases are mild?

In 1969, when that episode first aired, there were 25,826 reported cases and 41 deaths from measles in the United States.

Why don’t we see that many deaths now?

That’s easy.

We don’t see as much measles now. Most folks are vaccinated and protected.

If more people skip or delay their vaccines though, we will see more and more outbreaks, with greater chances that people will die.

Believe it or not, we still don’t have cures for measles, chicken pox, congenital rubella syndrome, and hepatitis B, etc. So while these diseases haven’t become any more deadly, they haven’t become any less deadly either, even with all of the advances of modern medicine.

More on Childhood Diseases as a Rite of Passage

Is H1N1 Flu Back This Year?

You remember H1N1 flu, right?

Is it back this year?

Is H1N1 Flu Back This Year?

While H1N1 seems to be the most frequently identified influenza virus type this year, in reality, since causing the “swine flu” pandemic in 2009, this strain of flu virus never really went away.

It instead became a seasonal flu virus strains.

So it is back again this year, but just like it was back during the 2013-14 and 2015-16 flu seasons.

Is that good news or bad news?

In general, it’s good news, as “flu vaccines provide better protection against influenza B or influenza A (H1N1) viruses than against influenza A (H3N2) viruses.”

“The 2009 H1N1 influenza virus (referred to as “swine flu” early on) was first detected in people in the United States in April 2009. This virus was originally referred to as “swine flu” because laboratory testing showed that its gene segments were similar to influenza viruses that were most recently identified in and known to circulate among pigs. CDC believes that this virus resulted from reassortment, a process through which two or more influenza viruses can swap genetic information by infecting a single human or animal host. When reassortment does occur, the virus that emerges will have some gene segments from each of the infecting parent viruses and may have different characteristics than either of the parental viruses, just as children may exhibit unique characteristics that are like both of their parents. In this case, the reassortment appears most likely to have occurred between influenza viruses circulating in North American pig herds and among Eurasian pig herds. Reassortment of influenza viruses can result in abrupt, major changes in influenza viruses, also known as “antigenic shift.” When shift happens, most people have little or no protection against the new influenza virus that results.”

Origin of 2009 H1N1 Flu (Swine Flu): Questions and Answers

The only reason we were so concerned about this strain of H1N1 in 2009 was because it was new.

Still, even in a good year, it is important to remember that a lot of people die with the flu, including a lot of kids. And most of them are unvaccinated.

So while it might be interesting to talk about which flu virus strain is going around, just remember that your best protection against that strain is a yearly flu vaccine.

More on H1N1 Flu