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New Report Finds Critical Gaps in Planning Efforts to Protect, Treat Children in Flu Pandemic

By Jennifer Nuzzo, October 19, 2007

Trust for America’s Health (TFAH) and the American Academy of Pediatrics (AAP) issued a press release1 on October 17, 2007 announcing a new report titled Pandemic Influenza: Warning, Children At-Risk.2 According to the press release, although “children and teens between the ages of 0-19 account for nearly 46 percent of all H5N1 ‘bird’ flu deaths,” there are critical gaps in U.S. pandemic influenza planning efforts for treating and caring for children.1

The report examines the “strategic approaches for containing the spread of a pandemic in children and adolescents, which include limiting social interaction, developing potential medical interventions such as vaccines and anti-viral medication, the use of masks and respirators, and educating children, families, and communities on what to do and how to do it.”2

Some of the “key gaps” in pandemic planning for children and teens identified in the report include:

1. Insufficient antivirals (only 100,000 courses of pediatric formulation) for children in the Strategic National Stockpile.
2. No licensed drugs effective against H5N1 that are approved for use in children <1 year old.
3. N95 respirators, which have been recommended by the CDC for use by the public in “certain circumstances during a pandemic outbreak…are not currently produced in children’s sizes.”
4. In the event that schools are closed during a pandemic, there are no plans in place to provide meals to the 30 million children who rely on the National School Lunch Program.1

To address these gaps, TFAH and AAP recommend the following “specific actions to ensure that health and welfare of the nation’s children are protected in the event of a flu pandemic”1:

• Pandemic planning efforts at all levels of government should include pediatric medical care providers.
• HHS should study the efficacy of influenza vaccine in young children, “support the development of additional flu vaccine products, and conduct more studies of antiviral agents for infants.”
• HHS “should immediately convene an independent task force to study and make specific recommendations about the use of surgical masks, N95 respirators, and other personal protective equipment by children.”
• HHS should conduct studies on “the feasibility of prolonged school and childcare center closures,” including a more precise assessment of the potential adverse outcomes and how to mitigate them.
• The Strategic National Stockpile (SNS) should be expanded to include “sufficient pediatric does of antiviral medications to ensure treatment of 25 percent of the nation’s children and adolescents.”
• HHS should develop guidelines for state and local planners for “evaluating hospital surge capacity (i.e., equipment, personnel, etc.) for children.”
• Schools should provide students with “grade-appropriate heath education about communicable diseases and methods to interrupt disease spread (cover cough, wash hands, etc.).”
• “Educators and school administrators should be encouraged to get an annual influenza vaccine” and should remind families of public health vaccine recommendations. CDC and state/local health departments should “encourage and support seasonal flu vaccination clinics in school settings to maximize flu vaccine coverage rates.”
• “Educators and public health officials should consider the potential psychological ramifications on the student populations before, during, and after a pandemic” and should make available mental health professionals “to help students cope with illness and loss of family, fellow students, and friends.”
• “Educators and public health officials should plan for ‘influenza free’ daycare centers (with availability of point-of-care rapid testing for symptomatic children’ to allow working parents…to continue to go to work.”2

In the press release about the report, AAP Committee on Infectious Disease Member John S. Bradley, MD, FAACP, highlighted the importance of addressing the pediatric component of pandemic influenza planning: “Children tend to be major vectors. They are inherently more at-risk for contagious respiratory diseases because they have limited pre-existing immunity, often spend lots of time in groups, and tend to share germs easily….Right now, we are behind the curve in finding ways to limit the spread of a pandemic in children even though they are among those most at-risk.”1

References

1. Report finds major gaps exist in U.S. pediatric pandemic preparations [press release]. Washington, DC: Trust for America’s Health, American Academy of Pediatrics; October 17, 2007. http://healthyamericans.org/newsroom/releases/release101707.pdf. Accessed October 18, 2007.
2. Pandemic Influenza: Warning, Children At-Risk. Washington, DC: Trust for America’s Health, American Academy of Pediatrics; October 2007. http://healthyamericans.org/reports/fluchildren/KidsPandemicFlu.pdf. Accessed October 18, 2007.