Preschoolers on Front Lines of Flu Defense
Sun | Health & Fitness
By Shari Roan, Los Angeles Times — Oct 14th, 2005
Any parent knows that when a preschooler gets the flu, it won't be long before the rest of the family is bedridden too. Three- and 4-year-olds are infamous for their runny noses and spewing coughs, not to mention their indifference to tissues and hand-washing.
Now, however, experts think this beloved age group is doing more than infecting their families. A new study suggests that 3- and 4-year-olds may be powerful drivers of annual influenza outbreaks.
The findings could lead to changes in the U.S. strategy on flu vaccination.
The study, from Children's Hospital Boston, showed that preschool-age children are the first to show up each year in emergency rooms and clinics with flu, a pattern that typically begins in late September. Babies younger than 2 tend to arrive with symptoms a week or two later, while older children begin to arrive in October. Adults don't generally show up until November.
Moreover, preschoolers may foreshadow the severity of any given influenza season. As the number of babies and preschoolers with the flu increased in the study, so too did flu-related deaths in the elderly.
Preschoolers are thought to be robust flu-spreaders because of their poor hygiene, close contact with other children and because they shed the virus — remain infectious — longer than other age groups.
"It's well known that preschoolers introduce flu into households. But what was not previously described is that children are leading off the epidemic," says Dr. Kenneth Mandl, an attending emergency room physician at Children's Hospital Boston and coauthor of the study. "Not only do preschoolers come in first, they can be used as sentinels, giving a three-week window into the future. That's a very important surveillance and early warning function."
Priority Shifts
The study, published in the Oct. 1 issue of the American Journal of Epidemiology, used a computerized biosurveillance system to collect data from five healthcare settings in the Boston area from 2000 through 2004.
The findings are expected to rekindle interest among public health officials in expanding flu vaccine recommendations to 3- and 4-year-olds. Under the current plan, the government recommends flu vaccine for people at high risk for developing complications or dying, such as the elderly, infants and chronically ill individuals.
Last year, the CDC began recommending vaccines for babies ages 6 to 23 months because studies show children younger than 2 have hospitalization rates second only to people age 65 and older.
But it may end up being just as important to prevent flu in the group most likely to spread it — preschoolers, says John Brownstein, lead author of the study and a researcher in the Children's Hospital Informatics Program. "This would provide a different approach to vaccination," he says. "This would be more of a public health approach to vaccinate people on the front lines who may spread it to other people."
Not at higher risk
Three- and 4-year-olds are not at higher risk for flu complications. But, he says, vaccinating them would mean they infect fewer people.
The Advisory Committee on Immunization Practices for the federal Centers for Disease Control and Prevention is considering expanding flu vaccine recommendations to preschoolers, says Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine and a member of the advisory committee. But the agency may be reluctant to act now, only one year after a major snafu in the supply line caused a severe national vaccine shortage.
"Everyone is leery of making expanded recommendations because the vaccine supply has, from time to time, been insecure," Schaffner said. "But if the vaccine supplies remain firm, people should expect to see recommendations expanded further, with preschoolers and school-age children the next target."
Flu vaccine supplies are expected to be adequate for the 2005-2006 season, according to federal health officials.
Adding preschoolers to the flu vaccine recommendation plan would also require discussions about logistics and cost, says Dr. Margaret Rennels, a professor of pediatrics at the University of Maryland and a vaccine expert.
"In general, influenza is a very safe vaccine," Rennels says. "The main concern would be economic. You would have a lot more people coming in for the vaccine on a seasonal basis."
Kids getting vaccine may require two shots
Sep 22nd, 2004
DEAR ABBY: Last year, you kindly published a letter from Dr. Deborah Wexler of the Immunization Action Coalition highlighting the importance of influenza immunization. Thanks in part to your efforts, record numbers of people were vaccinated early in the 2003-2004 season. Your letter ... [Read More...]
CDC: Too many who need flu shots not getting them
WASHINGTON -- Of the Americans who most need a flu shot, fewer than half actually get one, federal health officials warned Thursday as they called for special attention to babies, toddlers and the elderly as vaccinations begin next month. A record 100 million doses ... [Read More...]
DEAR ABBY | jeanne phillips Ex-Beau's Dinner Invitation Is Not to Woman's Taste
Dear Abby, My former fiance has recently begun calling and asking me to meet him for dinner at a fancy restaurant. Our relationship ended badly, and I have neither spoken to him nor seen him for almost two years. He will not explain ... [Read More...]
Sick It Up, Don't Suck It Up
As the flu season approaches, common sense about how deal with it or what you do when you have it is often lost. Some people overreact, excited by news of exotic flus—such as SARS or avian flu—or reports of vaccine shortages. ... [Read More...]
Flu shots aren't as effective for elderly as believed, study says
Vaccinating the elderly against influenza is not as effective as researchers had previously believed, government researchers reported Monday. Although previous studies have suggested that flu shots reduce mortality among the elderly by 50 percent to 80 percent, a new study of three decades of mortality ... [Read More...]