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US Adolescent Seasonal Flu Deaths Increase To 20
Recombinomics Commentary 12:00
December 29, 2012

Eight influenza-associated pediatric deaths were reported to CDC during week 51. Three were associated with influenza B viruses, 3 were associated with influenza A (H3) viruses, and 2 were associated with influenza A viruses for which the subtype was not determined. All 8 deaths occurred during week 50 (week ending December 15, 2012). This brings the total number of influenza-associated pediatric deaths reported during the 2012-2013 season to 16.

The above description from the CDC’s week 51 FluView reports 8 new pediatric deaths linked to seasonal flu, which brings the reported US total of fatal pediatric cases to 16 for the 2012/2013 season, which is the highest weekly tally since the peak if the 2010/2011 season.  However, media and state lab reports indicated the number of deaths exceeded the 16 reported in FluView.

As seen above, the FluView description of the fatal cases provides serotype information, but does include location.  Since pediatric flu deaths are now reportable in the US, the CDC also tallies pediatric flu deaths on the reportable disease page of the weekly MMWR, which closely parallels FluView data.  However, the week 51 MMWR will not be released until 2013 due to the holiday, so the state assignment of the 8 cases cited above is unclear.

However, the week 51 FluView reports 3 fatal influenza B cases in week 50, while state lab reports cite 4 influenza B cases not previously listed in FluView.  Moreover, three additional cases reported prior to week 50 have not been listed in FluView, indicating there are at least 20 pediatric deaths (19 lab confirmed and one, 17F, cited in an Ohio obituary).  Moreover, in the absence of the week 51 MMWR, it is unclear if all 8 of the cases cited in the week 51 FluView are included in the tally of the 20 cases, listed below.

This updated list includes three cases from Texas and two cases from five additional states (Colorado, Florida, Michigan, New Jersey, and South Carolina).  The remain seven cases are from Indiana, Maine, New York, Ohio, Tennessee, Washington, and Wisconsin.

The large number of pediatric fatalities parallels the dramatic recent rise in cases in northern states, signaling an increase in weekly totals in early 2013.  This rise is largely due to the emergence of A/Victoria/361/2011, which has evolved away from prior H3N2 isolates, and includes changes that have also accelerated the evolution away from the current vaccine, which uses the above sequence as the H3N2 target.

MMWR    Cases     Location
51                    8       Unassigned
50                    2       NJ
49                    1       TX
48                    3       IN FL SC
46                    1       TX
41                    1       TN

Cases not listed/assigned in FluView / MMWR
51                    3       FL NY WI
50                    6       CO(2) MI(2) TX WA
49                    1       ME
48                    2       OH SC

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