Bacterial coinfections boosting child flu deaths

first_imgOct 7, 2008 (CIDRAP News) – The number of children who have died from a combination of influenza infection and bacterial pneumonia—in many cases due to the superbug methicillin-resistant Staphylococcus aureus (MRSA)—has risen sharply over the past few years, federal epidemiologists say in a new report that urges flu shots as a preventative.Overall, the researchers say, child deaths from influenza are relatively uncommon. There were 166 between autumn 2004 and spring 2007, according to a new national reporting system, only a few more than the 153 that occurred in the harsh 2003-04 flu season and prompted the reporting system’s founding. But child deaths from flu are rising, and serious complications from bacterial infections such as MRSA are playing a much larger role.Staph infection is difficult to prevent: The bacterium lives on the skin and in the nostrils and causes disease unpredictably. But “you can’t have this overwhelming catastrophic complication without also having the flu, so if you can prevent the flu, you can prevent the coinfection,” Lyn Finelli, DrPH, chief of influenza surveillance at the Centers for Disease Control and Prevention (CDC), said in an interview.Finelli is lead author of the report in the October issue of Pediatrics, which is co-authored by flu and MRSA researchers from two CDC divisions. The article analyzes reports of child deaths from flu filed by 39 states and two local health departments since the CDC made child death from flu a nationally reportable illness in 2004.Issue emerged 4 years agoThe rate at which children die because of flu is thinly researched; it emerged as an important health issue only after the 153 deaths in the 2003-04 season were tallied. Up to that point, modeling based on flu surveillance reports and death-certificate data had estimated that 28 to 92 children younger than 5 died of flu each year in the United States.The new surveillance system, which the authors acknowledge does not yet report all deaths, found 47 child deaths from flu in the 2004-05 season, 46 in 2005-06, and 73 in 2006-07, all relatively mild flu seasons. (Preliminary reports from 2007-08, not included in the paper, have identified 86 deaths.) The deaths were very rapid: 45% of the children died within 72 hours of their first symptoms and 75% died within a week, while 43% died either at home or in an emergency room.Bacterial infection superimposed on flu was not the only cause of death; children also died from seizures, encephalitis, and shock. But it played an important role: Coinfections were involved in 6%, 15%, and 34% in the three successive seasons, a fivefold increase. Almost all of that increase was due to S aureus: There were one staph infection in 2004-05, 3 in 2005-06, and 22 in 2006-07, and 64% of the staph infections were drug-resistant.(Oddly, very little illness was attributed to Streptococcus pneumoniae [pneumococcus] historically the No. 1 cause of pneumonia in children—a finding that may reflect the influence of new pneumococcal vaccines.)Staph pneumonia is not a new phenomenon; from 3% to 10% of pneumonias that begin outside hospitals have been attributed to staph, but those pneumonias tend to occur in the elderly and immune-impaired. And the severity of simultaneous staph and flu infections has been documented after each influenza pandemic, in which large numbers of deaths were attributed to bacterial pneumonia.But the staph pneumonias recorded by the new reporting system represent an apparently new development, because they occurred in previously healthy children infected with a seasonal flu virus that presumably does less damage to the lungs and immune response than a novel pandemic one. And they appear to be occurring at the same time as a rapid rise in MRSA colonization in the United States, which doubled between 2001 and 2004.Most victims weren’t vaccinatedA troubling aspect of the report is that most of the children who died had not been vaccinated against flu, which would have protected them from primary viral onslaughts such as encephalopathy, as well as from the lethal synergy of flu and bacterial infection. Ninety of the 166 had an underlying condition such as asthma or a seizure disorder, but only 18 of them had received even one of the two flu shots recommended for young children.But, on the other hand, flu-shot recommendations for young children have changed over the past few years; 76 of the children were in age-groups not specifically recommended to receive flu shots in the years they died.This flu season, for the first time, federal guidelines call for all children and teens up to 18 to receive flu shots. But motivating parents to get children vaccinated is proving challenging. A recent CDC report said that only about 21% of children 6 to 23 months old were fully vaccinated in the 2006-07 flu season, 2 years after guidelines recommended they be immunized, and a smaller study this year found only 16.5% of 2- to 5-year-olds were fully vaccinated.Given low levels of vaccine protection, physicians should consider giving influenza antiviral drugs when children are hospitalized with flu, because the drugs have been shown to reduce complications, the article says. And given how rapidly the reported deaths occurred, vancomycin or another antibiotic of last resort should be considered if MRSA is suspected and until it can be ruled out by lab tests.Finelli L, Fiore A, Dhara R, et al. Influenza-associated pediatric mortality in the United States: increase of Staphylococcus aureus coinfection. Pediatrics 2008;122:805-11 [Abstract]See also: Reports on the following topics:Estimates of children’s mortality from flu:Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003;289:179-86 [Abstract]Influence of pneumococcal vaccines:Whitney CG, Farley MM, Hadler J, et al. Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med 2003;348:1737-46 [Abstract]Incidence of community-acquired staph pneumonia:Fine MJ, Smith MA, Carson CA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA 1996;275:134-41 [Abstract]Bacterial pneumonia and pandemic flu:Schwarzmann SW, Adler JL, Sullivan RJ, Jr., et al. Bacterial pneumonia during the Hong Kong influenza epidemic of 1968-1969. Arch Intern Med 1971;127:1037-411957:Louria DB, Blumenfeld HL, Ellis JT, et al. Studies on influenza in the pandemic of 1957-1958. II. Pulmonary complications of influenza. J Clin Invest 1959;38:213-65 [Full text]1918:Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis 2008;198:962-70 [Full text]MRSA colonization statistics:Gorwitz RJ, Kruszon-Moran D, McAllister SK, et al. Changes in the prevalence of nasal colonization with Staphylococcus aureus in the United States, 2001-2004. J Infect Dis 2008;197:1226-34 [Full text]Flu immunization coverage in children:Sep 26 CIDRAP News story “Flu shots for small children slow to catch on”last_img read more

Shooting: India’s Elavenil claims her maiden World Cup gold medal

first_img Written By WE RECOMMEND SUBSCRIBE TO US FOLLOW US Last Updated: 30th August, 2019 15:10 IST Shooting: India’s Elavenil Claims Her Maiden World Cup Gold Medal The fast-rising Elavenil Valarivan claimed her maiden senior World Cup gold medal.The 20-year-old shot 251.7 in the finals leading India to extend its dominance The fast-rising Elavenil Valarivan claimed her maiden senior World Cup gold medal, finishing on top in the women’s 10m air rifle competition but fancied teammates Anjum Moudgil and Apurvi Chandela ended outside the medal bracket at the ISSF Rifle/Pistol Stage event here. In her debut year at the senior level, the 20-year-old Elavenil shot 251.7 in the finals to help India extend their new-found dominance in the event, leaving behind Seonaid Mcintosh of Britain, who won silver with an effort of 250.6 on Wednesday. India has now won three out of the four World Cup gold medals in the women’s 10m air this year.CWG 2022 | Shooter Heena Sidhu And National Rifle Association Back IOA’s Call To Boycott Event Over Non-inclusion Of ShootingElavenil is a junior World Cup gold-medallist besides being an Asian champion. Chinese Taipei’s Ying-Shin Lin won bronze as well as one of the two Tokyo 2020 quota places on offer. The second quota was won by Iran. India is already assured of a quota in this event. Gujarat’s Elavenil had earlier pipped her senior Anjum in qualification, with an impressive 629.4 to the world No.2s 629.1 as they took the fourth and fifth spots through to the eight-woman final. World number one and finals world record holder Apurvi failed to qualify for the finals, finishing 11th with a score of 627.7. READ: Assam Rifles Team Aces It At World Police And Fire Games, Bags Five Gold Medals In ChinaSuch has been India’s supremacy that Mehuli Ghosh, shooting in the non-competition Minimum Qualification Score (MQS) section, shot a 629.1, which could have earned her a final spot as well. Anjum led the finals field after the first five shots. Seonaid began as the Indian finished and the eight finalists bunched closely at the top. The Briton then attempted to pull ahead after 10 shots as Anjum had a poor second series to go down to fifth by the 12th shot. However, Elavenil, who was shooting brilliantly, went ahead of Seonaid. American Mary Tucker was the first to be eliminated in eighth place after the 12th shot.CWG 2022 | Indian Olympic Association Mulls Boycott After Non Inclusion Of Shooting In Commonwealth Games 2022Korea’s Kim, then went out in seventh after the 14th shot at which stage there were three athletes, including Elavenil and Seonaid, who were jointly in the lead with a score of 147.1. Anjum maintained her fourth place at that stage. Anjum finished fifth losing to Romania’s Laura-Georgeta Coman. The Indian shot a 10.1 to Coman’s 10.4 to go out in fifth. Meanwhile, Elavenil was dishing out a master-class with a series of high 10s, which saw her maintain a 1.4 points lead with four shots of the 24-shot final to go. Seonaid and Elavenil battled till the end, but it was the Indian who prevailed for a milestone win.READ: Tokyo 2020 Paratriathlon Test Shortened Due To Bad Water QualityIn the Women’s 25m Pistol, Annu Raj Singh, making a comeback to the India squad, shot a solid 292 in the precision stage to set herself in 12th spot ahead of the Rapid Fire round on Thursday, preceding the final.  Compatriot Chinky Yadav shot 290 to lie in 17thplace while Abhidnya Ashok Patil shot 286 to be further back in 43rdspot. In the men’s 50m Rifle 3 Positions competition, there was a qualification world record in the first elimination round itself as Austria’s Jan Lochbihler shot 1188 to set the new mark. India’s Sanjeev Rajput shot 1170 in the first elimination round to sail through with a 14thspot finish. He will now shoot the qualifying round on Thursday for a shot in the finals. So will Parul Kumar, who finished 10th in his elimination round with a score of 1169. Chain Singh shot 1163 in the same round along with Sanjeev to end in 27th position. Thursday has as many as three finals on the schedule beginning with the men’s 50m Rifle 3 Positions, followed by the women’s 25m Pistol and the men’s 10m Air Pistol being the concluding final of the day. READ: Cannot Interfere But Will Explore Diplomatic Channels To Get Shooting Back In CWG: Sports Minister Kiren Rijiju LIVE TV Video Player is loading.Play VideoPlayMuteCurrent Time 0:00Loaded: 0%Duration 0:00Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -0:00 Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedSubtitlessubtitles settings, opens subtitles settings dialogsubtitles off, selectedAudio TrackQuality LevelsFullscreenThis is a modal window. This video is restricted from playing on your current domain Error Code: PLAYER_ERR_DOMAIN_RESTRICTED Session ID: 2020-09-09:3f283a19872edd7b60e110b7 Player Element ID: video_player_5f585ca8b3fde OK Close Modal DialogBeginning of dialog window. Escape will cancel and close the window.TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal DialogEnd of dialog window.Close Modal DialogThis is a modal window. This modal can be closed by pressing the Escape key or activating the close button.Close Modal DialogThis is a modal window. This modal can be closed by pressing the Escape key or activating the close button.PlayMuteCurrent Time 0:00/Duration 0:00Loaded: 0%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -0:00 Playback Rate1xFullscreen WATCH US LIVEcenter_img 1 year ago After Texas, second mass shooting in US’s Ohio leaves nine dead 1 year ago El Paso shooting | Pressure mounting on 8chan online forum website to go offline, What is 8chan, Everything you need to know First Published: 29th August, 2019 11:29 IST Press Trust Of India 1 year ago Norway mosque shooting: Man open fires on Al-Noor Centre, gunman arrested COMMENT 1 year ago Mass shooting in United States leaves multiple dead; Donald Trump says its ‘terrible’ 1 year ago Toofan: Farhan Akhtar marks ‘calm before the storm’ as filming beginslast_img read more