Linda Wadsworth of the University of Maryland, left, draws blood from Ethan Houley, 11, of Annapolis, Md., right, as Infectious Diseases Specialist Dr. Julia Hutter, second from left, and Gina Parsons of the University of Maryland, second from right, look on at Annapolis Pediatrics in Annapolis, Thursday, Aug. 27, 2009.Susan Walsh
The H1N1 pandemic virus is deadliest among school-age children, a departure from the seasonal flu, which is more often fatal to babies and toddlers, early indicators from U.S. health authorities show.
The findings Thursday from the U.S. Centers for Disease Control and Prevention come as health authorities brace for the start of the school year, fearing that classrooms will serve as incubators for the swine flu virus to spread rapidly.
Influenza deaths are generally rare in children. But the study of 36 lab-confirmed swine flu deaths in children suggest that those over the age of 5 are among the groups who are at the greatest risk of being severely infected by the new virus, and, as a result, should be first in line to be vaccinated.
More than 80 per cent of the pediatric deaths from H1N1 were among children between the ages of 5 and 18, the analysis found. In a normal flu season, half or more of the children who die are babies and toddlers.
Even more significantly, the agency found that children with underlying medical disabilities had a higher risk of being severely infected and succumbing to the virus. Almost two-thirds of U.S. children who died with swine flu had epilepsy, cerebral palsy or other neuro-developmental conditions. In a previous flu season, only a third of pediatric deaths had those conditions.
"Child deaths from influenza are really tragic," Thomas Frieden, director of the U.S. CDC, told reporters in a news briefing yesterday.
"If children have underlying conditions - and two-thirds of the children in this report had conditions such as muscular dystrophy and cerebral palsy - it's very important that they be treated promptly. And if a child is severely ill, if they're having trouble breathing, if their fever comes back after it went away, if they are having difficulty keeping fluids down, then it's very important to get treated promptly."
Dr. Frieden cautioned that it's too early to know whether there will be more pediatric deaths from the H1N1 virus than seasonal flu. Each year 50 to 100 American children die of seasonal flu, he said.
The virus, which first appeared in April, has caused relatively mild disease. But health authorities have noted that it has disproportionately affected younger people, unlike seasonal flu that mainly burdens the elderly. Officials believe that while young people have been exposed to other flu strains, they don't respond as well to H1N1 as older people who have been exposed to similar viruses in the past.
In Canada, there have been 227 pediatric cases of H1N1 - where the children have been admitted to hospital - including three deaths. David Butler-Jones, Canada's chief public health officer, said Thursday that more than half of those children and adolescents had underlying medical conditions, including asthma. The three children who died had severe underlying problems that put them at a much greater risk of disease and death, he said.
Canada has ordered 50 million doses of the H1N1 vaccine for all those who need and want it. Health authorities have indicated that a list of who should receive it first will be released in the middle of this month.
"Immunization in childhood, given the risks, is going to be an important part of the program," Dr. Butler-Jones said Thursday.
Caroline Alphonso