6 area children with flu on life support
Number, severity of early cases alarm officials
Friday, December 22, 2006
LISA OSBURN
News staff writer The Birmingham News
Six children are on life support at Children’s Hospital fighting severe cases of Influenza, hospital officials said.
The severity of the cases, many developing in the past two weeks, has raised concerns in Birmingham’s pediatric medical community, said Dr. David Kimberlin, who specializes in pediatric infectious diseases at UAB.
"It is not the volume and not even the time of year that is jumping out at us," he said. "It is more that, for a number of otherwise healthy children, they are ending up on life support from the flu. The number of times that is occurring – it seems out of the ordinary, at least for now."
Influenza has hit Birmingham area children hard and early this year, with at least 10 reports of critically ill children, said Raenetta Ellison, influenza surveillance coordinator for the Jefferson County Health Department.
This is a "normal" flu, not the dreaded H5N1. But it is illustrative of what a flu can do, even to healthy people. We are so used to thinking of flu as just a normal thing that most people get at least once a year, we rarely stop to think that it can be a dangerous and life-threatening illness.
Normally, cases of that number and severity are not reported until late January, February and March, she said.
"I would like to know more so we can better understand what we are comparing this against," Kimberlin said. Outside of data that would better track the number of pediatric flu cases, "we are left with clinical impression. And this seems to be a particularly bad year, at least for some normal children who are getting the flu," he said.
Kimberlin, who is an associate professor of pediatrics at UAB, mentioned the 2003-04 flu season, when 153 influenza-associated deaths in children younger than 18 were reported by state health departments across the country. At that time, doctors determined that they did not know enough about how many children get sick during a flu season. Although studies and other types of surveys have been established since then, more time is needed to better compare one year with another, he said.
While the Birmingham and Jefferson and Shelby county school systems are not reporting a spike in sick students overall, there have been isolated cases of the flu hitting individual schools or classrooms, said Cindy Warner, spokeswoman for Shelby County schools.
Alabama elevated its weekly influenza report to the "widespread outbreak" category this week, compared with the "regional outbreak" category last week, said Katina James, an epidemiologist with the Alabama Department of Public Health.
Since influenza is not a reportable disease, there are no numbers available for flu cases, she said. Her office had no other reports of severe cases like those seen in Jefferson County.
"Alabama had influenza activity earlier than most other states this year," Kimberlin said. "Right now, we and Florida and perhaps Georgia are really experiencing the largest outbreak of influenza in the country. We have a lot of children in the hospital with influenza, and that includes some very sick children in ICU."
While the article doesn’t identify the strain of flu these children are suffering, there seems to be a particularly nasty strain B this year, not matched in this years influenza vaccine. The B strain is hitting children hard because they have not previously had this strain, its last, widespread appearance was in the late eighties. Of course, that’s assuming that this is the flu these particular children have.
The level of life support varies among the six patients, all of whom have respiratory failure, Kimberlin said. In some cases, in addition to a ventilator, additional support is needed, such as a heart and lung bypass machine.
This paragraph, second from the last, in the article is particularly worrisome. Advanced life support is a finite resource. If more patients present than the hospitals are capable of handling the children will find themselves having to be outsourced to other hospitals, in areas where the flu hasn’t hit yet.
While most of the younger flu patients are not that severely ill, emergency rooms and doctor’s offices are staying packed with sick children, he said.
The good news is that while this is a "nasty" flu bug, the vast majority of the children are not critically ill. But I offer this article as a gentle hint that even a "normal" flu can be a deadly disease, and it is a pale, anemic relative to a novel pandemic strain of H5N1′s caliber.
