Influenza-Associated Pediatric Deaths in the United States, 2010-2016

Pediatrics. 2018 Apr;141(4):e20172918. doi: 10.1542/peds.2017-2918. Epub 2018 Feb 12.

Abstract

Background: Influenza-associated pediatric deaths became a notifiable condition in the United States in 2004.

Methods: We analyzed deaths in children aged <18 years with laboratory-confirmed influenza virus infection reported to the Centers for Disease Control and Prevention during the 2010-2011 to 2015-2016 influenza seasons. Data were collected with a standard case report form that included demographics, medical conditions, and clinical diagnoses.

Results: Overall, 675 deaths were reported. The median age was 6 years (interquartile range: 2-12). The average annual incidence was 0.15 per 100 000 children (95% confidence interval: 0.14-0.16) and was highest among children aged <6 months (incidence: 0.66; 95% confidence interval: 0.53-0.82), followed by children aged 6-23 months (incidence: 0.33; 95% confidence interval: 0.27-0.39). Only 31% (n = 149 of 477) of children aged ≥6 months had received any influenza vaccination. Overall, 65% (n = 410 of 628) of children died within 7 days after symptom onset. Half of the children (n = 327 of 654) had no preexisting medical conditions. Compared with children with preexisting medical conditions, children with none were younger (median: 5 vs 8 years old), less vaccinated (27% vs 36%), more likely to die before hospital admission (77% vs 48%), and had a shorter illness duration (4 vs 7 days; P < .05 for all).

Conclusions: Each year, influenza-associated pediatric deaths are reported. Young children have the highest death rates, especially infants aged <6 months. Increasing vaccination among children, pregnant women, and caregivers of infants may reduce influenza-associated pediatric deaths.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Influenza A virus* / isolation & purification
  • Influenza B virus* / isolation & purification
  • Influenza Vaccines / administration & dosage*
  • Influenza, Human / diagnosis
  • Influenza, Human / mortality*
  • Influenza, Human / prevention & control*
  • Mortality / trends*
  • United States / epidemiology

Substances

  • Influenza Vaccines