Cerebral Palsy and H1N1

[psych_2]

<p>I’ve been seeing a bunch of reports that people with CP are at higher risk of complications and death from the swine flu. While I could understand this in very severe CP, which frequently interfers with swallowing/breathin, it seems to be much broader in this case… anyone know why? I have moderate CP and have never been told that I was “high risk” w/ regards to the seasonal flu.</p>

[my_0.02]

<p>The concern seems to stem from the observation that children with neurodeveopmental conditions are overrepresented among the 36 pediatric deaths associated with 2009 pandemic influenza A. The CDC report does not provide sufficient information to explain this finding.</p>

<p>

Thirty-six pediatric deaths associated with 2009 pandemic influenza A (H1N1) infection were reported from 15 state and local health authorities† through August 8 (Table 1).§ Illness onsets occurred during May 9–July 20, and deaths occurred during May 15–July 28. Six deaths occurred in May, 25 deaths in June, and five deaths in July. Median age of the patients was 9 years (range: 2 months–17 years); 50% were male, 42% were non-Hispanic white, and 33% were Hispanic (Table 2). Seven (19%) of the 36 children were aged <5 years (five were aged <2 years), and 24 (67%) had at least one high-risk medical condition, including three children aged <5 years. Among the 24 children with high-risk medical conditions, 22 (92%) had neurodevelopmental conditions (e.g., developmental delay or cerebral palsy). Of these 22 children, 13 (59%) had more than one neurodevelopmental diagnosis, and nine (41%) had neurodevelopmental and chronic pulmonary conditions. Eight (22%) of the 36 children were aged ≥5 years with no reported high-risk conditions. Two of these eight children were reported as obese; however, height and weight measurements were not reported.

See [Surveillance</a> for Pediatric Deaths Associated with 2009 Pandemic Influenza A (H1N1) Virus Infection — United States, April–August 2009](<a href=“http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5834a1.htm]Surveillance”>Surveillance for Pediatric Deaths Associated with 2009 Pandemic Influenza A (H1N1) Virus Infection --- United States, April--August 2009)</p>

<p>This observation had been noted in prior influenza associated deaths.

Certain children are at higher risk for complications from influenza infection. An investigation of 153 seasonal influenza-associated deaths among children during the 2003-2004 season found that 33% of the children had an underlying condition recognized to increase the risk of influenza-related complications, and 20% had other chronic conditions; 47% had previously been healthy. Chronic neurologic or neuromuscular conditions were present in one third.

[CDC</a> H1N1 Flu | Interim Guidance for Clinicians on the Prevention and Treatment of Swine-Origin Influenza Virus Infection in Young Children](<a href=“http://www.cdc.gov/h1n1flu/childrentreatment.htm]CDC”>http://www.cdc.gov/h1n1flu/childrentreatment.htm)</p>

<p>A 1998 report observed very high influenza infection rates at two homes for children with CP.

In July, an outbreak of influenza occurred in two residential homes for children with cerebral palsy; the residences are served by the same staff. On July 10, a 7-year-old resident of one home developed fever and cough. During the following 2 weeks, in both residences combined influenza-like illness (defined as fever accompanied by cough and or sore throat) developed in 20 (91%) of 22 children and 10 (18%) of 56 staff members. Eleven (55%) children were hospitalized; four had pneumonia, including one child who was in the hospital intensive-care unit for 5 days. The average length of hospitalization was 6 days (range: 2-13 days). All ill persons have recovered. Nasopharyngeal swabs were collected from three of the ill children, and all yielded influenza A virus. On analysis at CDC, the three viral isolates were similar antigenically to A/Sydney/05/97(H3N2), the strain that predominated during the 1997-98 influenza season and is included in the 1998-99 influenza vaccine.

[Influenza</a> A – Florida and Tennessee, July-August 1998, and Virologic Surveillance of Influenza, May-August 1998](<a href=“http://www.cdc.gov/mmwr/preview/mmwrhtml/00054832.htm]Influenza”>Influenza A -- Florida and Tennessee, July-August 1998, and Virologic Surveillance of Influenza, May-August 1998)</p>

[psych_2]

<p>^
Interesting. The high rates of institutional deaths make sense, as those most of kids probably have severe CP, but the other rates seem odd and somewhat alarming. I wonder why none of my doctors ever mentioned CP being a high risk condition to my parents or me.</p>

[intparent]

<p>This is completely non-scientific, but I am sitting on the couch, surrounded by piles of tissues and suffering through the third day of H1N1 (oink). And this is a VERY phlegmy illness - - like the worst cold you ever had, but the phlegm is particularly liquid/runny. I don’t know how most people AVOID getting pneumonia, you would have to aspirate some of this stuff into your lungs (gotta breath sometime…). D2 did get pneumonia (and she has no underlying conditions). So if your CP in any way at all compromises your breathing or lung capacity (even a little bit), I can how this might increase your risk of complications. If you can get the vaccine as soon as it is available, I say go for it. And keep washing your hands like crazy in the meantime.</p>

[psych_2]

<p>Hope you feel better soon… that sounds awful!</p>

[albers]

<p>My son is a high school senior with mild CP and he seems to have H1N1 right now. The doctor put him on Tamiflu right away, because that’s supposed to keep the virus from multiplying and making him sicker. It also prevents it from going into a secondary bacterial infection, which caused some of the bad complications. It seems to be helping. If you get any symptoms of H1N1 get on Tamiflu within 24-48 hours. Good luck!</p>