Six children in British Columbia have already died from influenza in an unusually severe flu season – more than reported in any other province and double the highest death toll of recent years.
In response, B.C. is trying to improve poor pediatric vaccination rates by expanding access to walk-in influenza clinics across the province this weekend. But health advocates say vaccinations alone are not enough.
More children are being admitted to hospitals across the country with influenza and other respiratory illnesses than at any other time in at least a decade, and governments are scrambling to restock children’s pain and fever medications after a surge in demand that began in August left drugstore shelves bare. The severity of the illnesses has put further pressure on a health care system already buckling under pandemic-related staffing issues.
On Thursday B.C. Provincial Health Officer Bonnie Henry confirmed the six pediatric influenza deaths.
“This is a very early and intense flu season,” she said in an interview. “We’ve had six children who have had a positive influenza test and have died.”
One of the children was under five, three were in the five-to-11 age group and two were teens, Dr. Henry said. She called the deaths “very unusual.”
By way of comparison, there were no influenza deaths among children last year and between one and three each year going back to 2015, according to the BC Coroners Service. Those figures represent cases in which influenza was identified as either the immediate, antecedent or underlying cause of death or as a significant condition.
According to FluWatch, Canada’s national influenza surveillance system, there have been 707 pediatric influenza-associated hospitalizations, 95 ICU admissions and fewer than five influenza-associated pediatric deaths between Aug. 28 and Nov. 26. However, only nine provinces and territories report to the system; B.C., Ontario, Nunavut and Quebec do not. And Saskatchewan’s hospitalizations only include those that require intensive medical care.
Dr. Henry said the early flu season has landed with an unusually high rate of severe illness and death among children, and public health officials are still trying to determine if the dominant flu strain itself is especially virulent or if infections are spreading more quickly through the population.
Late last week, pediatricians at BC Children’s Hospital sounded the alarm with Dr. Henry and the BC Centre for Disease Control, she said. She issued a warning to pediatricians and family physicians around the province on Dec. 2, asking them to watch for secondary infections such as pneumonia, blood infections and meningitis.
While more than half of British Columbians over the age of 65 have received their flu shots, only about 20 per cent of children aged six months to four years – a particularly high-risk group – have been vaccinated. It’s the same story for children aged 5 to 11, and only 15 per cent of teenagers have gotten the jab.
The government has directed parents to go to their local health authority websites for information on the walk-in influenza immunization clinics happening Friday through Sunday. Dr. Henry said she hopes B.C. can more than double the current pediatric vaccination rate by the end of the weekend.
“It is really important for children, especially for young children and children with any underlying illnesses, to get vaccinated right now,” so “we can make a difference in bending the curve that is still climbing here in B.C. for influenza,” she said.
Sanjiv Gandhi, a pediatric cardiothoracic surgeon and clinical professor at the University of British Columbia, said that while vaccinations are important, the province must use every measure at its disposal.
“This flu season is very abnormal in that the virulence of the influenza strain is significant and it’s affecting children who have already been impacted by previous COVID-19 infections. Even children who have not been formally diagnosed with COVID-19 have very likely been infected with the virus,” he said.
“There is increasing evidence that COVID causes immune dysregulation and impairs our ability to fight off other infections. So vaccinations, though incredibly important, are not the only strategy required. There should be more direct guidance for folks to avoid large gatherings and, certainly, there needs to be a mask mandate for indoor public places, schools, mass transit, things like that.”
The B.C. government has repeatedly called mask mandates a heavy-handed measure of last resort and said it is not looking to reinstate them.
“To not institute a simple, harmless, effective measure – that’s temporary – to help our kids in at least the short term is incomprehensible to me,” Dr. Gandhi said. “Government and public health apathy, in the face of dying children, makes no sense.”
Danielle Mei Cabana, 6, of Richmond, B.C., caught the flu around Remembrance Day, along with her sisters. But while her siblings recovered, Dani’s condition worsened.
Her father, Denis Cabana, said she was taken to BC Children’s Hospital, where the family learned she had developed myocarditis – an inflammation of the heart muscle – as a result of the flu. She was admitted to the ICU and put on a machine that circulates blood through an artificial lung to add oxygen and remove carbon dioxide.
On Nov. 26, a doctor “came to tell us that she had had a massive stroke and that she would not be coming back,” Mr. Cabana wrote in a post on social media. “We went back to the room where doctors unplugged the machine and we said our goodbyes.”