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Spike In Adolescent Seasonal Flu Deaths
Recombinomics Commentary 17:00
December 28, 2012

Two influenza-associated pediatric deaths were reported to CDC during week 50. One was associated with an influenza A (H3) virus and one was associated with an influenza A virus for which the subtype was not determined. These deaths occurred during the weeks ending November 17 (week 46) and December 1 (week 48). This brings the total number of influenza-associated pediatric deaths reported during the 2012-2013 season to 8.

The above comments from the week 50 CDC FluView described the two most recent reported pediatric deaths.  These deaths are now reportable and are also included on the reportable disease page of the weekly MMWR which includes the location of the cases.  The two cases cited above were from New Jersey.  Four of the six prior cases were reported in the two preceding weeks (Texas in week 49 and one each from South Carolina, Florida, and Indiana in week 48).  The two earlier cases were from Texas (week 46) and Tennessee (week 41).  The reporting of 8 cases in the first 10 weeks of the new flu season is close to the average rate.

However, recent media and state lab reports cite 8 additional fatal cases which have not been reported in FluView or MMWR.  One was reported in the week 48 South Carolina report (which cited two deaths but only one was reported in FluView).  Another was an influenza A case (6F) in Maine reported in week 49.  Texas reported an influenza B fatality (9 y o) in week 50.  Recent media reports cited a death in Washington (Pierce county, <12 y o), as well as 2 deaths in Colorado (influenza B in cases under 3 y o in Denver and Jefferson counties) and 2 deaths Michigan (6 months and 13 y o cases of influenza B and H3).

This spike in adolescent cases raises concerns that the dramatic spread of H3N2 in recent weeks in northern states will lead to a dramatic increase in deaths, which rival the rate during the 2003/2004 season when the Fujian strain (A/Fujian/411/2002) caused an alarmingly high level of adolescent deaths, which led to required reporting of such cases. 

In addition to the increase in adolescent deaths, the pneumonia and influenza (P&I) death rate was well above the epidemic threshold, which is also expected for the 2012/2013 season due in part to the earlier appearance of H3N2 low reactors.

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