6 Alabama kids were on life support with flu

Nurses General Nursing

Published

These were otherwise healthy children who came down with a severe strain of seasonal flu. The original link to the local news is included but takes forever to load so that I decided to use a link from someone following this story at Flutrackers and will also include his follow up with the covering reporter. These kids are not the usual victims of seasonal flu which is one of the reasons why this is of concern:

FluTrackers - View Single Post - 6 Alabama children with flu on life support

FluTrackers - View Single Post - 6 Alabama children with flu on life support

Specializes in Maternal - Child Health.
http://www.flutrackers.com/forum/showpost.php?p=65142&postcount=1

http://www.flutrackers.com/forum/showpost.php?p=65143&postcount=2

This is tragic. This 11 year old had no prior existing conditions. She also had unusual symptoms. I am not sure that I would have recognized that this was a case of influenza. I would have been looking for respiratory symptoms, for the most part, but flu can manifest via the GI tract, neurologically, and in this case via the musculoskeletal system.

They are saying that this virus is an influenza A but, no information has been made available on the subtype, and no sequences released. Sequence information can predict virulence, ease of transmission, antiviral resistance, and other important data.

I live in Omaha, and have heard numerous news stories the past few days about this girl's death from the flu, but the above article is the first I've heard of other children hospitalized with similar muscular symptoms. What I haven't read is the mechanism by which these complications cause death. Does the muscle breakdown lead to acute renal failure? Do the respiratory muscles become paralyzed? Either of these possible scenarios would seem treatable (by dialysis or ventilator management), so I don't understand the rapid progression to death. Can anyone help me understand?

Also, the flu season has hit our area late, and seems to be particularly harsh on children. Very few cases of complications are being reported in the elderly, as would normally be expected, but schools are reporting particularly high absence rates due to flu-like symptoms.

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Specializes in CCU,ICU,ER retired.

I just watched the news about samonella tainted peanut butter, Peter Pan and Great value brands and they numbers on the lid are 2111.

These could very well be that cause because they present the same.

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Specializes in Maternal - Child Health.
I just watched the news about samonella tainted peanut butter, Peter Pan and Great value brands and they numbers on the lid are 2111.

These could very well be that cause because they present the same.

The salmonella cases have been confirmed by stool cultures, and influenza cases have been confirmed by viral cultures. I doubt that anyone ill enough to be hospitalized with either condition would be mistakenly mis-diagnosed with the other. Also, although some of the salmonella patients have required hospitalization, all have recovered. There have been no deaths linked to this salmonella outbreak.

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Specializes in Too many to list.

Jolie, no one is answering your question, and I can't really. I do not believe that this child died of renal failure. I would bet that it was multi organ failure with severe neurological involvement that would have made it pointless to continue with ECMO, dialysis and ventilation, all of which may have been tried. There seems to be a treatment protocol in place for these severe pediatric flu cases once they are identified as influenza. But, all of this is speculation on my part. Not that this is avian flu, but in avian flu cases most have died of multi organ failure, and I think that an overwhelming influenza infection would have the same result regardless of the type of influenza.

An astute reporter could probably find out the exact cause of death. I wonder if an autopsy was done, and if death certificates are considered to be part of the public record.

More cases are occurring in other states:

Seattle Cases:

http://seattletimes.nwsource.com/html/health/2003574721_flu16m.html

Kansas Case:

http://www.ksn.com/news/local/5888781.html

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Specializes in Too many to list.

The symptoms of severe muscle pain in pediatric flu cases is not unknown. How many clinicians would have recognized what disease this child had to initiate the appropriate tx early enough to save her? Sometimes, even with the right treatment, we can not save everyone. Of course, now they know to look for these cases.

http://www.flutrackers.com/forum/showpost.php?p=65371&postcount=16

Could dialysis save these two cases? Or is this a separate complication where ECMO would have been appropriate?

http://www.flutrackers.com/forum/showpost.php?p=65396&postcount=17

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Specializes in Too many to list.

According to this, at least one child had been vaccinated. Perhaps not soon enough? Fifteen cases hospitalized, that seems rather unusual.

http://www.flutrackers.com/forum/showpost.php?p=65442&postcount=19

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Specializes in Adolescent Psych, PICU.

I don't think this years vaccine is covering what strain is going around. I have had several nursing school friends (all of whom had been vax'ed back on Oct or Nov) get the flu here in the past month. We had our state epidemiologist come and talk to our class and he siad that kids are being hit particularly hard with this years flu, adults not as bad. Lots of kids out of school with the flu.

It has started to kinda worry me about my kids.

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Specializes in Maternal - Child Health.

Indigo girl,

Thanks for the information. The local press here in Omaha reported that the strain which caused the death of the 11 year-old girl from Lincoln was one of the 3 included in this year's vaccine. I have no idea what the vaccination rate is in our area among children, but flu-like symptoms are rampant in our schools now. Omaha is a relatively small city (pop. 400K), so having 15 children hospitalized with influenza does indeed sound significant. We're also in the midst of a long streak of bitterly cold weather (3 weeks of near and below zero temps.). That can't be helping any.

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Specializes in Too many to list.

I am including only cases that do not appear to have underlying health conditions. I did not realize that there is apparently very little tracking information prior to 2003 pediatric flu cases, but several of these articles mention this fact.

For Vancouver, I am using a link from curevents.com as the original does not seem to work:

http://www.curevents.com/vb/showpost.php?p=682108&postcount=19

Bellevue, Washington

http://www.komotv.com/news/5913586.html

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FluTrackers have not been regularly following pediatric flu deaths. I put this list together the other day of most of the recent pediatric deaths. Any comments?

Minnesota MN

Child 1, ( 8_) died (between Jan 18 - Feb 1),

Child 2, (17 months_), died (between Jan 18 - Feb 1)

Lucio Satar, ( 8M), died (1/30/2007?) St. Paul, MN, pneumonia, a complication he developed after coming down with the flu.

http://www.flutrackers.com/forum/showpost.php?p=62636&postcount=7

http://www.health.state.mn.us/news/pressrel/flu020807.html

Child (8_) died Mid February 2007, Duluth, MN (4th seasonal flu fatality)

http://www.flutrackers.com/forum/showpost.php?p=64878&postcount=1

Washington (WA)

Sarah J. Horner (7F) died 2/5/2007, Seattle WA - myocarditis, an inflammation of the heart caused by viral infections like the flu.

Marija E. Alumbaugh ( 8F), died 2/14/2007, Kent WA - myocarditis due to Influenza A

http://www.curevents.com/vb/showthread.php?t=69440

Nebraska (NE)

Ahn T. "Anna" Do (11F) died 2/10/2007, Omaha, Nebraska

Alabama (AL)

1 child died? December 2006?

New York (NY)

child (10M), Syracuse, NY died (1/9/2007?)

"Pediatric flu deaths are rare, with only 35 across the country last year. "

http://www.wgrz.com/news/news_article.aspx?storyid=43985

Kansas (KS)

Xena Anastasia Fogle, (11F) died 2/11/2007, Wichita, KS, Influenza A

http://www.ksn.com/news/local/5888781.html

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Specializes in Too many to list.

Thanks so much for the list Al. I am particularly interested in the school age cases because this is a group that do not normally die of influenza if there are no prior existing conditions. The other thing that bothers me are the unexpected symptoms. What parent would have known that this was influenza in Anna Doh's case? I know that flu can cause aches and pains but I would never have guessed muscle death. Now, of course, we know.

I just want to quote Monotreme from Pandemic Information Forum:

"We will have to wait for more information regarding the subtype of Flu A that is causing these cases to know for sure what is going on. One possibility is that there is a new strain that it is infecting relatively few people but which can cause severe disease when it infects children. The only way to determine if this is happening is to compare the sequences of the strains that caused severe disease with sequences from strains that caused only mild disease. Hopefully the CDC is doing this and we will get a report soon."

Do we know for sure that these cases are all influenza A? It does seem likely though.

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Specializes in LTC.

The mother of one of the kids in Omaha said her son had the B strain. He had the flu shot.

http://www.ketv.com/health/11052535/detail.html

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