Four children have died of the flu in Colorado since last week in what U.S. health officials said Wednesday could foretell a severe flu season for the country.
The children were 21 months old, 2, 8 and 15, and their deaths startled some health officials because they happened so close together and so early in the season. Last year, Colorado had four child deaths over the course of the flu season, which normally peaks in January and February and runs through April.
Even before the deaths, there were signs that this could be an especially bad flu season. Some parts of the country -- particularly Colorado, Texas and Nevada -- have been hit hard a month earlier than usual.
Also, the flu strain that doctors are seeing is the H3N2 Fujian, part of a class of flu viruses that caused severe outbreaks in the United States in the 1990s.
"Doctors across the city are saying they've never seen a flu season like this," said Dr. Ned Calonge, chief medical officer for the Colorado Department of Public Health in Denver. He said nearly 4,000 cases of flu in adults and children had been reported in Colorado so far this fall.
The four youngsters are the only flu deaths so far in Colorado. However, flu-stricken children in both Texas and Colorado are being kept alive on ventilators in hospitals. And some schools in both states have seen high absentee rates or have closed to stop the spread of the flu.
The Colorado cases have prompted concern among parents who are rushing their children to the clinic for shots. Arvada Pediatric Associates has already given 862 shots in the last month, said administrator John Gordon. That contrasts with 745 shots given in the entire fourth quarter of 2002.
"I don't know if it's in my head, but she's been sick, and after watching the news, I realized she had some of the same symptoms," said Dennis Shing, who became worried about his 5-year-old daughter, Emma, after seeing news reports about the four children. "It's kind of scary."
The parents of one of the flu victims, 8-year-old Joseph Williams, went on TV with their story Tuesday night in hopes other parents would take sick children to the doctor.
"It happened so quick and so sudden," Scott Williams said. "He was fine. He wasn't even that sick."
"He just flat-lined and he looked at me," Carrieann Williams said. "Nobody could believe it happened."
Health experts said it would take time to determine whether this flu season will be especially dangerous for children.
"This is something that we are studying and are certainly concerned about," said Dr. Scott Harper, infectious-diseases physician for the Centers for Disease Control and Prevention. "But it's likely this is something that's been going on for years and we just have not recognized it before."
The deaths in Colorado are "a little bit out of the ordinary," said Dr. William Schaffner, chairman of Vanderbilt Medical Center's department of preventive medicine in Nashville. "I think it's a manifestation of this H3N2 strain, which causes more serious disease."
The deaths underscore an often-overlooked fact: Flu can be deadly in children.
Each year, an estimated 36,000 Americans -- mainly the elderly -- die from the flu. Health officials do not know how many children die, because states do not require doctors to report influenza cases.
"In general, people look as influenza as a benign illness like a common cold when in fact it's a serious illness," Harper said. The flu can cause pneumonia and other respiratory problems, heart failure and heart muscle inflammation in infants.
Last month, a CDC advisory panel recommended that children 6 months to 23 months old receive flu shots, since this age group has as great a risk of hospitalization from the flu as the elderly.
The Fujian strain -- which originated in Fujian province, China -- was not known when this year's flu vaccine was developed, so this year's formula does not exactly match the flu virus now circulating. But the vaccine will still help prevent the flu and its complications, Schaffner said.
Health experts continue to recommend that people get their flu shots, particularly infants and the elderly.