Tag: flu deaths

Why Do Kids Die With the Flu?

There is one question that few parents or pediatricians will ever likely be able to answer well. Why do kids die with the flu in this age of readily available flu vaccines?

Oh, I’m sure that everyone has heard dozens of reasons, from the idea that flu vaccines don’t work to parents just aren’t vaccinating their kids, but in reality, there is no good answer that fits all situations, except to know that the flu is deadly.

Why Do Kids Die With the Flu?

The biggest misconception that most people have about pediatric flu deaths is that all kids who die with the flu must have some underlying medical condition, like diabetes, asthma, immune system problems, or a heart condition.

That’s not true.

Around half of the kids who die with the flu have no underlying risk factors or medical conditions.

Around half of the kids who die with the flu have no underlying risk factors or medical conditions. They were otherwise healthy before they got sick with the flu.

But it is only younger kids that die with the flu, right?

Kids of all ages die with the flu, from infants and toddlers to teens.

Kids of all ages die with the flu, from infants and toddlers to teens.

And surprisingly, they often die quickly.

Most kids die within two or three days of getting their first flu symptoms.

Most kids die within two or three days of getting their first flu symptoms.

Many kids die with flu before they can even be admitted to the hospital for treatment.

That’s likely why many die before they can even be admitted to the hospital for treatment.

But they are all unvaccinated, right?

Tragically, no.

Among children who died from influenza during the 2010-11 flu season, few (23%) were vaccinated.
Among children who died from influenza during the 2010-11 flu season, few (23%) were vaccinated.

Although most are unvaccinated, some vaccinated kids do still die.

“This report summarizes the 115 cases of influenza-associated pediatric mortality reported to CDC that occurred from September 1, 2010, through August 31, 2011. Deaths occurred in 33 states. Nearly half of the deaths (46%) occurred in children aged <5 years. Of the children who died, 49% had no known Advisory Committee on Immunization Practices (ACIP)–defined* high-risk medical conditions, and 35% died at home or in the emergency department. Of the 74 children aged ≥6 months for whom vaccination data were available, 17 (23%) had been fully vaccinated.”

Influenza-Associated Pediatric Deaths — United States, September 2010–August 2011

Still, studies have shown that getting a flu vaccine can reduce a child’s risk of dying with the flu by half if they have an underlying high-risk medical condition and even more (65 percent) if they are otherwise healthy.

Ultimately, we need a better flu vaccine. Until we get it, the one we have is our best protection against the flu.

Flu vaccines are a safe way to reduce your risk of dying with the flu.
Flu vaccines are a safe way to reduce your risk of dying with the flu.

And since they are safe, there is no good reason to not get vaccinated and protected each year.

More on Pediatric Flu Deaths

Is This Year’s Flu Shot Only 9% Effective?

Why do some people think that this year’s flu shot is only 9% effective?

A statement or tweet from the CDC?

The CDC has not released any information on the effectiveness of this year's flu shot yet.
The CDC has not released any information on the effectiveness of this year’s flu shot yet.

Not exactly…

Is This Year’s Flu Shot Only 9% Effective?

As the 2019-20 flu season is just getting started, we don’t actually know how effective this year’s flu vaccine will be…

She was tweeting an old story about last year's flu vaccine and the 9% number was just about one strain in the vaccine. The adjusted overall vaccine effectiveness for the 2018-19 flu vaccine was actually 47%.
Greta Van Susteren was tweeting an old story about last year’s flu vaccine and the 9% number was just about one strain in the vaccine. The adjusted overall vaccine effectiveness for the 2018-19 flu vaccine was actually 47%.

Early estimates are typically posted in mid-February.

Will we get this year’s flu vaccine effectiveness estimates early because flu season started early?

As some predicted, the circulating H3N2 strains are of a different clade than the ones in the vaccine though…

Will it help that all circulating strains are antigenically similar to the flu virus strains in this year’s flu vaccine?

Or that we are seeing more flu B this year?

During the 2017-18 flu season, the flu vaccine worked much better against flu B strains.

We don’t typically talk about flu vaccine effectiveness against flu B strains because they aren’t a big part of our flu seasons, but in general, flu vaccines work well against flu B.

“In general, current flu vaccines tend to work better against influenza B and influenza A(H1N1) viruses and offer lower protection against influenza A(H3N2) viruses.”

Vaccine Effectiveness: How Well Do the Flu Vaccines Work?

In fact, they often work better against flu B than against other strains, so maybe it will turn out to be a good thing if we see more flu B than H3N2 this year…

The flu vaccine has many benefits besides preventing you from getting the flu.
The flu vaccine has many benefits besides preventing you from getting the flu.

But most importantly, we know that the flu vaccine has many benefits and few side effects, so even when it isn’t a perfect match it makes sense to get vaccinated and protected.

And know that until we get a better, universal flu vaccine, folks should know that talk about flu vaccine effectiveness is largely academic, as a yearly flu vaccine remains the best way to protect yourself from getting the flu and developing serious complications from the flu.

More on Flu Vaccine Effectiveness

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