Another Flu Concern: Staph Infections

In case yesterdayâs post didnât convince you to get a flu shot,  you should check out Maryn McKenna at Superbug's report on the growing problem of deadly staphylococcus infections hitting flu sufferers. She highlights the sad case of Robert Sweitzer, a 39-year-old man who was healthy until he came down with the flu â and then died of MRSA pneumonia while waiting in the emergency room. (MRSA, or methicillin-resistant staphylococcus aureus, is a particularly troublesome strain of staph, because it's resistant to the antibiotics generally used to treat it.)

In October, McKenna wrote a CIDRAP article about the role of bacterial infections in child deaths from flu, which are on the rise. Over the last three flu seasons, co-infections were involved in an increasing percentage of childrenâs flu-related deaths: 6% in the 2004-5 season, 15% in 2005-6, and 34% in 2007-8. The number of child flu deaths is still relatively low (166 over three flu seasons), but the trend is alarming. Almost all of that increase was due to S. aureus. Hereâs what McKenna writes about prevention (emphasis added):

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.

Many of the children who died hadnât been vaccinated:

A 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.

The bottom line is that people in generally good health can die very quickly from the combination of influenza and a staph infection. McKenna reports that 45% of the children whose deaths were studied died within 72 hours of their first symptoms, and it appears that Robert Sweitzer died just 24 hours after waking up feeling ill.

Superbug has links to several past posts about infections and influenza, if you want to read more about the problem. And then, if you havenât already, you should really go and get a flu shot.