Influenza and Children with Neurologic Disorders

Influenza virus. CDC/Doug Jordan, MA The Centers for Disease Control and Prevention (CDC) has published a study in the journal Pediatrics on the effects of influenza in children with neurologic disorders.[1] The study compared clinical outcomes during and after influenza, like hospitalization and death, between children with and without neurologic disorders. For the this study, researchers looked at the medical records of reported pediatric deaths between April 15 and September 30 of 2009, during the H1N1 influenza pandemic. Of the 336 pediatric deaths associated with influenza that were reviewed in the study, 227 (68%) “had at least 1 underlying condition that conferred an increased risk of complications of influenza.” Of those 227, 164 (64%) had a neurologic disorder.

It has long been known that people of any age with a neurologic condition are more likely to suffer severe consequences from a respiratory disease. For example, people with cerebral palsy -- or similar conditions -- may have difficulty coughing out lung irritants, breathing deeply, or otherwise clearing their lungs.[2] People with a severe neurologic condition are more likely to be institutionalized, thus being exposed to other residents or patients with infectious diseases.[3] Even if the neurologic disorder is not one that prevents normal body functions, the person with the disorder may not be able to understand and follow good hygiene practices like washing their hands when necessary.

In their press release, CDC investigators also point out that “seventy-five percent of children with a neurologic condition who died from 2009 H1N1 influenza-related infection also had an additional high risk condition that increased their risk for influenza complications, such as a pulmonary disorder, metabolic disorder, heart disease or a chromosomal abnormality.” Also, only 23% of children in the study who had neurologic disorders had received the seasonal influenza vaccine. Only 3% had received the recommended dose of 2009 H1N1 vaccine.

These findings underscore the need for influenza immunization in all children and especially in children with conditions that put them at high risk for severe complications and people taking care of them. In some cases, the underlying medical condition in high-risk children makes the influenza vaccine contraindicated. So it is imperative that children who cannot be immunized are protected from influenza by herd immunity.

In order to increase awareness in the public of the need to immunize and prevent influenza, CDC, the American Academy of Pediatrics, Families Fighting Flu, and Family Voices have partnered to inform the public on the risks of influenza. Depending on the severity of the influenza season, CDC reports that between 3,000 and 49,000 people die from influenza or its complications.[4]

Influenza vaccine in the United States is currently recommended for everyone older than six months.[5] There are two types of influenza vaccine, an injectable vaccine that contains dead influenza viruses and a nasal spray vaccine that contains live-attenuated viruses. Your healthcare provider is the best person to discuss the benefits of influenza immunization with you.

Further Reading

CDC Online Newsroom - Press Release - Children with neurologic disorders...

CDC - Seasonal Influenza (Flu) - Children, the Flu, and the Flu Vaccine

Influenza (Flu)


[1] "Neurologic Disorders Among Pediatric Deaths Associated with the ..." 2012. 29 Aug. 2012 <http://pediatrics.aappublications.org/content/early/2012/08/24/peds.2011-3343.abstract?sid=6d0248fe-576c-4469-87ef-3ce4e7cd3d07>

[2] "Cerebral Palsy: An Overview - January 1, 2006 - American Family ..." 2009. 29 Aug. 2012 <http://www.aafp.org/afp/2006/0101/p91.html>

[3] "Hospital-Acquired and Institution-Acquired Pneumonia: Pneumonia ..." 2011. 29 Aug. 2012 <http://www.merckmanuals.com/home/lung_and_airway_disorders/pneumonia/hospital-acquired_and_institution-acquired_pneumonia.html

[4] "Seasonal flu-related deaths - Centers for Disease Control and ..." 2009. 29 Aug. 2012 <http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm>

[5] "CDC - Seasonal Influenza (Flu) - Who Should Get Vaccinated ..." 2011. 29 Aug. 2012 <http://www.cdc.gov/flu/protect/whoshouldvax.htm>

Comments (2)Posted in:

Comments

@PutinReloaded:

Thank you for your comment. The actual paper -- not the abstract -- clarifies this thus:

"Neurologic disorders in children comprise a heterogeneous group of disorders, including neuromuscular disorders, epilepsy, cerebral palsy, and hydrocephalus. Some of these children have associated medical conditions such as heart, lung, or other organ system disorders and many have impaired motor and intellectual function."

As you can see, "intellectual disability" is associated with or a result of the neurologic disorder, and is not a neurologic disorder onto itself. It is analogous to saying that sneezing is associated with or a result of a cold and not a disease onto itself.

Further down in the paper, we are given the definition of a neurologic disorder for this study:

"Neurologic disorders were classified into 3 groups: neurodevelopmental disorders, epilepsy, and neuromuscular disorders. Neurodevelopmental disorders included cerebral palsy, moderate to severe developmental delay, and hydrocephalus with ventriculoperitoneal shunt. Neuromuscular disorders included muscular dystrophy, spinal muscular atrophy, and mitochondrial disorders."

Again, nothing in there about intellectual disability. The results section makes it even more clear that there was no "bundling" of intellectual disability with neurologic disorders:

"Of the 146 children with neurologic disorders, 28 distinct disorders were reported. Among the 3 major categories, neurodevelopmental disorders were most common (94%)followed by epilepsy (51%) and neuromuscular disorders (6%) (Table 1). Seventy-one (49%) had neurologic diagnoses in .1 category. Among the 137 children with any neurodevelopmental disorder, 41 (30%) had both an intellectual disability and cerebral palsy"

As you can see, intellectual disability is presented as a byproduct of the neurologic disorders and not as a disorder itself.

Because of copyright considerations, I am unable to post the entire paper at this time. You may be able to get a copy of it from your school or local public library.

The paper: http://pediatrics.aappublications.org/content/early/2012/08/24/peds.2011-3343.abstract?sid=fb710982-7ac6-40aa-b666-ee37b0a1fe80

This study is a magnificent example of manipulation and framing.

"Intellectual disability" is a psychological profile not traceable to a neurological disorder. However, the authors have bundled it together with true neurological disorders, such as palsy and
epilepsy, confounding the statistics of all three.

Also, much more significant risk factors such as pulmonary disorders are present in the dead (48%).

The authors use this to frame deaths by pulmonary, palsy and epilepsy complications onto the "intellectually disable", falsely portraying them as a risk group.

The "intellectually disable" represent a significant chunk of the population (about 2%), and their misrepresentation as a risk group can expand the market of unnecessary flu vaccines by a succulent 2%.

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