Flu Hospitalizations in Youngest Kids Highest Ever, CDC Says

Troy Brown, RN

March 02, 2020

Hospitalization rates for infants and children younger than 5 years are the highest on record at this point in the season, "surpassing rates reported during the second wave of the 2009 H1N1 pandemic," according to the latest report from the Centers for Disease Control and Prevention (CDC).

Twenty flu-related pediatric deaths were reported during the week ending February 22 (week 8), bringing the total child deaths for this season to 125.

That's the highest number at this point in the season since pediatric pneumonia and influenza mortality became a nationally reportable event in 2004–2005, with the exception of the 2009–2010 pandemic.

Of the 125 pediatric deaths, 87 were linked to influenza B viruses. The lineage was determined for 18 of those viruses, which were identified as B/Victoria. Of 38 deaths from influenza A–associated viruses, 23 were subtyped; 22 were A(H1N1)pdm09 viruses, and one was an A(H3) influenza virus.

Still, the laboratory-confirmed hospitalization rate for the week is highest among adults aged 65 years or older, at 132.0 per 100,000 population.

The hospitalization rate for children aged 0 to 4 years is 80.1 per 100,000 population, compared with 45.5 at this point last season. The third-highest hospitalization rate is 69.1 per 100,000 population for adults aged 50 to 64 years.

Hospitalization rates among children and adolescents aged 5 to 17 years (20.6) and adults aged 18 to 49 years (28.6) are higher than in recent seasons, the CDC reports. Overall rates continue to be similar to those at this time during recent seasons.

There have been at least 32 million influenza illnesses, 310,000 flu-related hospitalizations, and 18,000 deaths from influenza, according to CDC estimates.

Mortality Low Overall

The percentage of deaths resulting from pneumonia and influenza has been lower overall, at 6.9% — below the epidemic threshold of 7.3% for week 7.

Outpatient visits for influenza-like illness (ILI) accounted for 5.5% of visits overall, down from 6.1% the week before but still above the national baseline of 2.4%.

"Outpatient ILI and clinical laboratory data remain elevated but decreased for the second week in a row. The percentage of specimens testing positive for both influenza A and influenza B viruses decreased," the CDC explains in the report.

The percentage of respiratory specimens that tested positive for influenza at clinical laboratories fell to 26.4% from 29.7% last week.

Influenza activity was high in New York City, Puerto Rico, and 43 states; moderate in five states (Delaware, Nevada, North Dakota, Ohio, and Oregon); low in the District of Columbia and Idaho; and minimal in the US Virgin Islands and Florida.

Geographically, influenza activity was widespread in Puerto Rico and 48 states, regional in Oregon, local in the District of Columbia and Hawaii, and sporadic in the US Virgin Islands. Guam did not report on influenza activity.

Nationally overall, numbers of influenza B/Victoria and A(H1N1)pdm09 viruses are approximately equal this season; however, influenza A(H1N1)pdm09 viruses have continued to rise in recent weeks.

According to interim estimates, the 2019–2020 influenza vaccine reduced physician visits for ILI by 45% overall and by 55% among children, as reported by Medscape Medical News.

The CDC continues to recommend antiviral medications for influenza. "Antiviral medications are an important adjunct to flu vaccine in the control of influenza. Almost all (>99%) of the influenza viruses tested this season are susceptible to the four FDA-approved influenza antiviral medications recommended for use in the US this season," the CDC explains in the report

FluView. Published online February 28, 2020. Full text

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