Organism, Causative Agent, or Etiologic Agent
Influenza (“the flu”) is a respiratory infection caused by the influenza virus. An influenza-associated pediatric death is a death in a child under 18 years of age resulting from a clinically compatible illness that is confirmed to be influenza by an appropriate laboratory or rapid diagnostic test.
Influenza viruses can be spread by large respiratory droplets generated when an infected person coughs or sneezes in close proximity to an uninfected person. Sometimes influenza viruses are spread when a person touches a surface with influenza viruses on it (e.g., a doorknob), and then touches his own nose or mouth. Although most influenza illnesses occur during the winter and early spring, it is possible to become ill with influenza at any time during the year. Adults who are ill with influenza are usually contagious for up to five days from the start of the illness; however, children may be contagious for a week or longer.
Symptoms can include fever, dry cough, sore throat, headache, body aches, fatigue, and nasal congestion. Among children, otitis media, nausea, vomiting, and diarrhea are common. Some infected persons are asymptomatic. Most people generally recover from illness in 5-7 days, but some people develop complications and may die from influenza.
The highest rates of influenza infection occur among children; however, the risks for serious health problems, hospitalizations, and deaths from influenza are higher among people 65 years of age or older, very young children, and people of any age who have medical conditions that place them at increased risk for complications from influenza.
Treatment & Prevention
Most people who develop influenza illness will recover on their own with bed rest and do not need medication. Antiviral medications can shorten the duration and severity of illness if given within the first 48 hours of the illness. These medications are usually prescribed to persons who have a severe illness or to those who are at higher risk for developing serious illness or complications due to influenza.
The best way to prevent influenza is to get an influenza vaccine each year as soon as the vaccine is available to the public. Other forms of prevention include the following:
- Hand washing and using alcohol-based hand sanitizers
- Covering your coughs and sneezes with a disposable tissue or your arm or sleeve
- Avoiding touching your eyes, nose, or mouth
- Avoiding close contact with persons who are ill
- Staying home when you are ill
- Taking antiviral medications for prevention of disease, if prescribed by your doctor (usually limited to high-risk individuals or health care workers exposed to an ill person).
School Exclusion Policy
Children with a fever should be kept out of school or childcare until they are fever free for 24 hours without the use of fever suppressing medications. Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare.
Recent Texas Trends
The official influenza reporting season for the United States begins in October and continues through May; in Texas, influenza surveillance continues year-round. In Texas, influenza activity usually peaks in January or February, although the peak of influenza has occurred as early as October. Except for influenza-associated pediatric deaths and novel influenza cases, individual cases of influenza are not reported.
Reporting of influenza-associated pediatric deaths began in Texas in 2007. In 2007, 2008, 2010, 2011, 2012 and 2013 the reported number of cases of influenza-associated pediatric mortality ranged from 7 to 17. During the 2009 pandemic year, 54 cases of influenza-associated pediatric mortality were reported. In 2007, the highest influenza-associated pediatric mortality rate in Texas occurred in children ages 15-17 years, followed closely by infants under 1 year of age. From 2008-2011, the highest influenza-associated pediatric mortality rate occurred in infants under 1 year of age. In 2012, the highest influenza-associated pediatric mortality rate occurred in children ages 10-14 years. For 2013, the highest influenza-associated pediatric mortality rate occurred in infants under 1 year of age, followed by children ages 15-17 years.