On February 5, 2007, Public Health received a report of an elementary school child who died at home following a flu-like illness. Influenza antigen testing at the Public Health Laboratory was positive for influenza A and the King County Medical Examiner’s Office determined the cause of death to be myocarditis due to influenza virus infection. Currently in King County, levels of influenza activity are increasing with children and adults becoming ill at levels that are typical for recent flu seasons. Influenza surveillance does not show other evidence of unusually severe illness in children, and the household members of this case have not had severe illness. Public Health requests healthcare providers report unusual clinical manifestations of influenza and all influenza deaths in children to Public Health at 206-296-4774.

Influenza causes serious illness resulting in hospitalization or death most frequently in adults 65 years of age and older, persons with underlying medical conditions, and children less than 2 years of age. However, influenza can cause severe disease and death even in healthy children and adults. In 2003 in the U.S., 153 influenza deaths in children were reported to the CDC (none from King County) compared to an estimated 92 deaths per year during the 1990’s (and compared with almost 33,000 deaths per year for adults over 64 years of age). National reporting of influenza deaths in children began in 2004-5 and therefore it is difficult to compare figures from season–to-season as some states may not be reporting completely yet. Last season in the U.S., there were a total of 41 reports of influenza-associated deaths in children. This season, the CDC has received 7 reports of pediatric influenza deaths in the U.S. through late January. These numbers likely underestimate the true extent of the problem.

Public Health recommends the following steps to protect healthcare workers and patients from influenza:

• Post visual alerts instructing patients and persons who accompany them to inform health-care personnel if they have symptoms of respiratory infection.
• Provide tissues or masks to patients and visitors who are coughing or sneezing.
• Ensure that supplies for hand washing are available where sinks are located; provide dispensers of alcohol-based hand rubs in other locations.
• Have coughing persons to sit at least 3 feet away from others, if possible.
• Use standard and droplet precautions (at a minimum) when evaluating persons with cough illnesses.
• Stay home from work if you are ill.
• Flu vaccine is currently available in the community and is recommended for anyone who wishes to reduce their risk of getting influenza, and is particularly recommended for: Healthcare workers, children 6-59 months of age, pregnant women, adults over 50 years of age, and children and adults with certain chronic medical conditions, such as heart disease, lung disease (including asthma), kidney disease, diabetes, weakened immune systems, neuromuscular dysfunction, and others conditions. Flu vaccine is also recommended for household and close contacts of the above mentioned people.
• Antiviral drugs can be used to treat influenza if administered early, and to prevent the spread of influenza within households and institutions. For additional information on use of antiviral drugs, see: www.cdc.gov/flu/professionals/treatment

• Complete information on flu activity in King County
• Public Health clinic sites and hours
• All healthcare providers are requested to enroll in Public Health’s Information Alert Network. If you have not registered or need help registering, please send an email to: phskc_cdepi@kingcounty.gov. Include the words "SUBSCRIBE IAN" in the subject line. In the body of your message, include your name, profession, and license number. If you do not have access to email, please call 206-296-4774 for assistance.