title: Influenza-associated pediatric deaths in the United States, 2004-2012.
abstract: BACKGROUND
  Influenza-associated deaths in children occur annually. We describe the epidemiology of influenza-associated pediatric deaths from the 2004-2005 through the 2011-2012 influenza seasons.
  
  
  METHODS
  Deaths in children <18 years of age with laboratory-confirmed influenza virus infection were reported to the Centers for Disease Control and Prevention by using a standard case report form to collect data on demographic characteristics, medical conditions, clinical course, and laboratory results. Characteristics of children with no high-risk medical conditions were compared with those of children with high-risk medical conditions.
  
  
  RESULTS
  From October 2004 through September 2012, 830 pediatric influenza-associated deaths were reported. The median age was 7 years (interquartile range: 1-12 years). Thirty-five percent of children died before hospital admission. Of 794 children with a known medical history, 43% had no high-risk medical conditions, 33% had neurologic disorders, and 12% had genetic or chromosomal disorders. Children without high-risk medical conditions were more likely to die before hospital admission (relative risk: 1.9; 95% confidence interval: 1.6-2.4) and within 3 days of symptom onset (relative risk: 1.6; 95% confidence interval: 1.3-2.0) than those with high-risk medical conditions.
  
  
  CONCLUSIONS
  Influenza can be fatal in children with and without high-risk medical conditions. These findings highlight the importance of recommendations that all children should receive annual influenza vaccination to prevent influenza, and children who are hospitalized, who have severe illness, or who are at high risk of complications (age <2 years or with medical conditions) should receive antiviral treatment as early as possible.
authors.affiliation: 1600 Clifton Rd NE, MS E-03, Atlanta, GA 30329. vij4@cdc.gov.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Wong
authors.forename: Seema
authors.initials: S
authors.lastname: Jain
authors.forename: Lenee
authors.initials: L
authors.lastname: Blanton
authors.forename: Rosaline
authors.initials: R
authors.lastname: Dhara
authors.forename: Lynnette
authors.initials: L
authors.lastname: Brammer
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Lyn
authors.initials: L
authors.lastname: Finelli
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D009026:Mortality / Q000639:trends*; D011159:Population Surveillance / Q000379:methods; D014481:United States / Q000453:epidemiology
keywords: influenza; mortality; pediatric; surveillance