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Media Myth On Pediatric Flu Deaths
Recombinomics Commentary 11:45
January 17, 2013

Roughly 100 children die in an average flu season, and it's not yet clear the nation will reach that total.
The deaths this year have included a 6-year-old girl in Maine, a 15-year Michigan student who loved robotics, and 6-foot-4 Texas high school senior Max Schwolert, who grew sick in Wisconsin while visiting his grandparents for the holidays.

The above comments create significant confusion on the pediatric death toll in an “average flu season”.  Prior to the 2004-05 season, pediatric deaths were not reportable.  The 2003-04 season was dominated by the Fujian strain of H3N2 (A/Fujian/411/2002) and an unusually large number of pediatric (children under 18 years of age) were noted (153).  However, since pediatric deaths were not reportable and only a small fraction of flu deaths are lab confirmed, the US required lab confirmation and reporting of pediatric deaths.  Although many of the pediatric deaths due to flu are still not reported because they are not tested, the numbers since the 2003-04 provide a method for comparing pediatric  deaths each season, and the number of such deaths is usually well below 100.

The 2009 H1N1pdm09 pandemic significantly affected the number of pediatric deaths.  The 2009-10 season was most affected and there were 282 pediatric deaths.  The effect of H1N1pdm09 on the following season also produced an unusually high total of 122.  Last season had much lower levels of H1N1pdm09, and the number fell to 34, and other than the two season strongly affected by pandemic H1N1pdm09, no season has topped the 100 mark for pediatric deaths.  The highest number has been 88 in the 2007-08 season, which was a moderate to severe season, and the number for this season will almost certainly top the 2007-08 levels.

The CDC has reported 20 pediatric deaths through week 1 (the current flu season technically goes to the start of next year’s season which begins at week 40, but most cases and reporting is centered on the first 20 weeks of the current calendar year).  However, the current CDC significantly lag the pediatric cases which have already been confirmed and described in state lab or media reports. 

Below is an updated list of cases which are likely to be eventually reported by the CDC.  The prior list of 41 has been pared down to 38.  The Ohio case (17F) from Ohio has been removed because it is unlikely that the case will be tested, even though her obituary stated that she died from flu complications.  The Nebraska case (10M) has been removed because initial test were negative for influenza A and B.  Finally, one of the Texas cases listed in week 2 was removed because the case (17M) had already been counted in the week 1 report from Texas. 

The list has also been update to include identification of cases that have already been cited in state lab reports.  Only one of the 38 cases has not been lab confirmed.  That Ohio case (4M) is undergoing testing.  The autopsy was consistent with death due to a viral infection, and the patient went to sleep with flu-like symptoms (headache and sore throat).  Thus, the total number of cases listed below is 38, including 37 which are lab confirmed and 34 which have been cited in state lab reports. 

Thus, the confirmed cases have already exceeded the 34 reported last season and are likely to top the to highest total since 2003-04, when the two seasons heavily impacted by the 2009 pandemic (2009-10 and 2010-11) are excluded.

FluView pediatric cases
Wk   #    Location

01    2    KS TX
52    2    MI NY
51    8    AR FL ME MI(2) TX WA WI
50    2    NJ
49    1    TX
48    3    IN FL SC
46    1    TX
41    1    TN

Pediatric deaths not in FluView
02    8    MA* NY TX* OH* OH+ CO(2) DE
01    7    MI MN NE NY PA* SC TX
52    1    IN
50    2    CO

*  = Lab confirmed but not in state updates
+ = Under investigation

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