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Flu Vaccinations for Children May Slow Spread of Disease

Posted on: Thursday, 29 September 2005, 06:00 CDT

By Steve Sternberg

A new study suggests that preschoolers get flu first and may spread the disease to older children and grown-ups.

Doctors say it may bolster a push to expand vaccinations to this age group as part of a broader shift in the USA's flu strategy. Not only that, they say, it provides a new justification for an emergency room surveillance system first proposed to detect bioterrorism.

The findings emerged from a surveillance program in Massachusetts that tracked respiratory illness in 400,000 people in four hospital emergency rooms, a managed-care organization and several thousand community doctors who participate in a federal flu-alert network.

"The most prominent finding is that preschool-age kids, particularly 3- and 4-year-olds, come into emergency departments first," says study co-author Kenneth Mandl of Children's Hospital in Boston. "Not only are they coming in first, but the pattern of their visits seems to be related to later illness in (those) around them."

Usually, subsequent cases turn up about a month later in older children who come in contact with the preschoolers. "Our results suggest that younger children may initiate spread to these older children," says the study in the Oct. 1 American Journal of Epidemiology.

"It's this group we know to be spending their days in incubators of infection: preschool and day care," Mandl says.

He says it's unlikely that the study findings reflect parents who are simply nervous about children with sniffles because they tracked visits to emergency rooms and not pediatrician's offices.

William Schaffner of Vanderbilt University, a member of the federal Advisory Committee on Immunization Practices, called the study "provocative."

He says it could bolster a proposal on the panel's agenda to expand vaccinations to this age group to prevent flu from spreading rather than just vaccinating people at high risk of fatal complications. He called it a "community-wide approach" designed to "impede the spread of the virus, so it can't circulate as freely."

The government, based on past advice from the committee, now recommends flu shots for people older than 50, those with chronic diseases, children 6 months to 2 years old, and, if there's enough vaccine, anyone else.

About 150 million people fall into high-risk groups; vaccine makers will produce about 80 million doses of vaccine this year, more than will probably be used.

The researchers note that the study's results also are among the first to demonstrate the peacetime value of a surveillance system involving a sampling of emergency rooms that has been proposed for bioterrorism defense.

(c) Copyright 2005 USA TODAY, a division of Gannett Co. Inc.

Source: USA TODAY

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