ATLANTA — The nation's health agency
plans to closely watch flu complications among
children, who have swamped hospitals in some states and surprised
doctors with the severity of their illnesses.
A new concern is the
rise of a common drug-resistant staph infection that is complicating
efforts to treat children with the flu, an official with the
Centers for Disease Control and Prevention said
Monday.
Dr. Tim Uyeki,
epidemiologist with the influenza branch of CDC, said that some
children have died from the staph infections —
a phenomenon the CDC has not seen before.
Flu complications for
children have always been dire: pneumonia, kidney and heart failure,
possible brain damage.
"We've just never
seen them in the proportions we've seen them this year," said Dr.
Steve Schexnayder, chief of pediatric critical care at Arkansas
Children's Hospital in Little Rock.
From Texas to
California, children's hospitals have been swamped with sick children
— many of them desperately ill.
The waiting room at
Children's Hospital Central California in Madera was standing room
only during the Thanksgiving holiday, and hospital officials said
nearly every child tested positive for the flu.
Children's Medical
Center in Dallas has seen more than 500 kids with the flu since
October. One day last week, two dozen more appeared, most with enough
lung disease to be put on ventilators, said Dr. Jane Siegel.
"Because it seems to
be a strain that has not circulated in the U.S. before and is not
well-covered by the existing vaccine, we're seeing far more cases,"
said Dr. James Todd, director of epidemiology of Denver Children's
Hospital. "Just because you're seeing more cases, you're seeing more
complications."
Doctors say some
children are coming into hospitals with so much damage they are put on
heart-lung bypass machines just to stay alive.
Others face
additional problems: Nine-year-old Nick Collins at Arkansas Children's
Hospital needed four chest tubes to drain fluid from holes in his
lungs caused by bacterial pneumonia. Doctors are trying to prevent a
blood clot from killing him.
He also had
methicillin-resistant staphylococcus aureus (MRSA), a usually mild
infection which led to his severe pneumonia. Staph bacteria are
commonly found on the skin or in the nose and often go undetected.
Uyeki said the
children with staph-related flu likely picked up the bacteria before
they were hospitalized. In October CDC warned parents that many school
athletes had been found to carry MRSA.
These infections
don't normally cause pneumonia without the flu virus, said Dr.
Frederick Hayden, a flu expert and professor of internal medicine at
the University of Virginia.
But the flu virus can
impair the body's ability to fight the bacteria and expel it. The
bacteria, in turn, can produce enzymes that enhance the flu's ability
to infect cells, he said.
Nick, a healthy boy
until he got the flu in early November, is doing better, having been
removed from a ventilator on Friday. But he'll likely have to stay in
the hospital through the end of the year, his mother says.
"It's scary to find
that something as common as the flu can cause something this major
every year," said his mother, Kim Collins of Texarkana, Texas. "We sit
around for days in awe of the fact the flu has caused all of this."
Flu and its
complications are the sixth leading cause of death nationally among
children age 4 and younger, according to the CDC.
Anecdotally, this flu
season seems to be worse for children. But because the CDC doesn't
keep track of flu deaths, it's unclear how much worse. This year the
agency is planning to collect data on children who die from the flu,
those with MRSA, and those who develop brain damage, said Dr. Keiji
Fukuda, chief of epidemiology in the CDC's influenza branch.
In addition, some
connected with the CDC say there may be a push to add school-age
children to the list of those most strongly urged to get the flu shot
— the best protection against the virus. The current recommendation
for children covers those from 6 months to 2 years and those who have
certain chronic conditions.
"My own prediction is
what you'll continue to see is a broadening of the recommendation for
influenza immunization," said Dr. Greg Poland, a Mayo Clinic professor
and a member of the CDC advisory committee on immunization.
Pregnant women —
urged to get the flu shot if they are in their second or third
trimester — have also become a concern this year.
The CDC is looking
closely at some cases in which pregnant women have displayed high
pulse rates — which could be a symptom of a dangerous, and potentially
fatal, inflammation of the heart, said Dr. William Schaffner, a flu
expert with Vanderbilt University Medical Center. Texas in particular
has reported several such cases.