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Why did healthy children fall critically ill in the 2009 H1N1 flu pandemic?
Date:11/6/2011

g their stay, but only 6 percent had received it prior to hospital admission. Randolph believes it's possible that earlier antiviral treatment might have saved some of these children, especially those who died of influenza without bacterial co-infection. (Influenza antiviral medications work best when given within the first two days of symptom onset.)

The study also found that most of the MRSA co-infected children who died had received vancomycin promptly at or before ICU admission. The researchers aren't sure why this antibiotic of choice didn't save these children perhaps it couldn't penetrate the lung, or perhaps the disease moved too rapidly.

Physicians seeing children with serious lower-respiratory-tract disease during flu season are urged to give early antiviral treatment (Tamiflu or zanamivir [Relenza]) and antibiotics covering MRSA and other flu-associated bacteria, even before suspected infections are confirmed in the lab, the researchers say.

But other approaches are urgently needed. "MRSA is hard to develop a vaccine against researchers have been trying since the 1960s and have been unsuccessful," says Randolph. "So the only way to prevent these severe complications is to get everyone vaccinated against the flu, and do more studies of MRSA colonization so we can prevent it in the community and in kids."

A growing threat

Recent studies point to a rise in the number of children carrying MRSA. A study in Pediatrics in 2010 found that the number of children hospitalized for MRSA infection increased from 2 in 1,000 admissions in 1999 to 21 in 1,000 admissions in 2008. This rise was attributed mostly to community-acquired cases not cases acquired in the hospital.

Many observers attribute the rise to increased use of antibiotics in both people and animals. "The more antibiotics we take, the more we colonize ourselves with antibiotic-resistant organisms such as MRSA," says Randolph.


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Contact: Keri Stedman
keri.stedman@childrens.harvard.edu
617-919-3110
Children's Hospital Boston
Source:Eurekalert

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