Washington: During the H1N1 flu pandemic in 2009, healthy children became critically ill, developing severe pneumonia and respiratory failure, sometimes fatal. A nationwide investigation in the US has linked this to simultaneous infection with methicillin-resistant staphylococcus aureus (MRSA).
According to the investigation, led by Children`s Hospital Boston, MRSA elevated eightfold the risk for flu-related mortality among healthy children.
Almost all these co-infected children were rapidly treated with vancomycin, considered an apt treatment for MRSA. But they still died, which was especially alarming in view of the rising rates of MRSA among children, the journal Paediatrics reports.
"There`s more risk for MRSA to become invasive in the presence of flu or other viruses," says study leader Adrienne Randolph, Critical Care Medicine, Children`s Hospital Boston. "These deaths in co-infected children are a warning sign."
The researchers hope their findings will promote flu vaccination among all children aged six months and older -- no flu vaccine is currently available for children younger than six months, according to a statement.
"The 2009 H1N1 virus has not changed significantly to date," notes senior study investigator Tim Uyeki of the Influenza Division under the Centres for Disease Control and Prevention (CDC).
"Infections of children in the US with 2009 H1N1 virus are expected this season and need to be prevented and treated appropriately. Influenza vaccination protects against 2009 H1N1 illness," adds Uyeki.
The median age of such critically ill children was six years. Most had respiratory failure, two-thirds required mechanical ventilation, and some required extracorporeal membrane oxygenation (ECMO) for advanced cardiac and respiratory support.
Their disease progressed rapidly, and 75 children (nine percent) died, two-thirds of them within two weeks of ICU admission.
ECMO is a technique of providing both cardiac and respiratory support oxygen to patients whose heart and lungs are so severely diseased or damaged that they can no longer serve their function.
"Some children were quickly overwhelmed, and many died despite centres doing everything to save them," says Randolph.