At Least 30 Children Have Died From This Season’s Flu. Some of Them Were Perfectly Healthy

Thirty children have died from confirmed influenza-related causes so far this flu season, according to the Centers for Disease Control and Prevention’s (CDC’s) most recent weekly report, released last Friday. The total includes deaths between Oct. 16 and Jan. 13.

CDC Director Brenda Fitzgerald has described the 2017-2018 flu season as “very active,” and has said that much of the country is experiencing “widespread and intense flu activity.” During a Jan. 12 press update, Fitzgerald said that influenza A, H3N2, has been the most common strain of flu virus reported this year. “These viruses are often linked to more severe illness, especially among children and people age 65 and older,” she said.

Most children who get the flu do recover. But thousands are hospitalized every year, and some die from complications. The number of children killed by influenza-related causes per season has ranged over the last decade from a low of 37 (in 2011-2012) to a high of 288 (in 2009-2010).

The current flu season is, so far, on track to be deadlier for children than the previous two. During last year’s flu season, 110 children died from the flu between November 2016 and September 2017, with 17 pediatric deaths reported through the second week of January last year. During the 2015-2016 flu season, 92 children died from the flu, with 10 child deaths by this point in the season.

But there have also been worse seasons in recent years: Compared to the 30 deaths so far in 2017-2018, there were 255 child deaths reported by the same week in 2010. The 2014-2015 flu season was also particularly dangerous, with a total of 148 pediatric deaths, 97 of which were reported by this time in 2015.

Preliminary data suggests that this year’s flu season has reached its peak and is starting to decline, although experts say it’s too soon to know for sure. “If you assume we’re about halfway through the season, and you multiplied the 30 cases so far by two, that’s a relatively average year for pediatric deaths,” says Dr. Roberta DeBiasi, chief of pediatric infectious diseases at Children’s National Health System in Washington, D.C. “Having said that, we don’t want people to think this year is not dangerous — because each and every year, children do die.”

Young people with chronic illnesses and compromised immune systems are at increased risk for serious complications of the flu. But about 40% of children who die from influenza every year have no preexisting conditions, DeBiasi says. “You really can’t reassure yourself that your child, who seems to be perfectly healthy, is not going to be a victim of the severe flu,” she says.

That was the case with 10-year-old Connecticut boy Nico Mallozzi, who died on Jan. 14 from sepsis resulting from pneumonia. “Ten years of health,” Nico’s mother told TIME last week. “He was like an ox.”

Several otherwise healthy adults have died of flu-like illnesses in the last month, as well. Kyle Baughman, a 21-year-old aspiring personal trainer from Pennsylvania, died in late December of flu-related organ failure, according to his family.

Flu-related hospitalization rates have increased this month, as well, and a large percentage of those admitted have been children. On Jan. 12, Dr. Dan Jernigan, director of the CDC’s influenza’s division, said that hospitalizations for children under 5 had “almost doubled in the last week.” A total of 8,990 confirmed flu-related hospitalizations have been reported to the CDC since Oct. 1, with the highest rates among adults 65 and up, followed by adults 50 to 64 and children under 5. About 58% of children hospitalized for the flu had at least one underlying medical condition, such as asthma, a neurological disorder, obesity or cardiovascular disease.

Ten of the 30 pediatric deaths confirmed so far this flu season were reported during the week ending Jan. 13, although several of them occurred in November and December. Since October, 21 pediatric deaths have been attributed to Influenza A (including H1N1 and H3N2) and nine deaths have been attributed to Influenza B.

DeBiasi says that, like other hospitals around the country, Children’s National Health System has been hard-hit this year with flu cases. About 40% of children admitted this season have been sick enough that they need treatment in the hospital’s intensive-care unit, she says, often because they require respiratory assistance.

She stresses that parents should take symptoms of the flu seriously and get sick children to a doctor right away — especially if they have a pre-existing condition or they’re under the age of 5. Signs of flu in children can include a high fever, chills, body aches, extreme tiredness, cough and sore throat. Nausea, vomiting and diarrhea are also common in children with the flu, unlike adults. Doctors may not screen for the flu virus, she says, as the laboratory test isn’t always accurate; rather, they can make a probable diagnosis — and prescribe treatment — based on a physical exam.

“If the flu is going around and you suspect your child has a respiratory illness and a fever, it’s more important to get treatment with an anti-viral than it is to get tested,” she says. Two antiviral medications, oseltamivir (brand name Tamiflu) and zanamivir (brand name Relenza) are approved for children.

The most important thing parents can do to protect their children, says DeBiasi, is to make sure they get vaccinated every flu season. “It’s not perfect and it’s not 100% effective, but it’s the best thing we have,” she says, “and the flu vaccine is one of the safest, most vetted and most studied vaccinations there is.”

“It’s really hard for me to see parents who didn’t vaccinate and now their child is in the ICU with the flu,” DeBiasi adds. “We don’t know if the vaccine would have prevented it, but it’s likely it would have at least ameliorated that child’s symptoms.” It’s like wearing your seatbelt, she says: “You may still get an injury in a crash and you may even die, but it will certainly help reduce the chances that something terrible is going to happen.”