‘This is March 2020 for kids,’ warns B.C.-based family physician

B.C. recorded at least five influenza-related deaths in children in November, a marked increase from previous years, triggering warnings from doctors across Canada about the severity of this year’s influenza season.

The B.C. Coroners Service confirmed five deaths, but Wednesday afternoon, the BC Centre for Disease Control (BCCDC) said it is aware of six influenza-associated deaths among children and youth.

Numbers between agencies can vary based on how deaths are tracked and reported. For example, the cause of death in an influenza-related case could also be categorized as a death from strep throat or a bacterial infection.

The B.C. Coroners Service said the data reflects investigations where influenza was identified as “either the immediate, antecedent or underlying cause of death or as a significant condition,” and said none of the deaths were recorded in infants younger than one.

Historical data provided by the B.C. Coroners Service showed the deaths represent a departure from previous flu seasons prior to the COVID-19 pandemic. Between 2015 and 2019, B.C. recorded two to three influenza-related deaths in people aged 18 or younger every year. In 2020, the province recorded one death, while none were recorded in 2021.

Dr. Anna Wolak, a family physician in Vancouver, said “children dying at a higher rate than what we are used to seeing in a typical flu season.”

“That is the hardest part of this at the moment. This is March 2020 for kids. We’re seeing hospitals under strain. We’re seeing cases rising,

“The influenza season started weeks earlier than it normally does and is rising at a significant rate — the curve is almost vertical.”

Estimates of the number of annual flu deaths in Canada vary depending on the severity of the flu season, but doctors, including Wolak, have warned this year appears to be particularly severe. Children, especially young children, are at a higher risk of severe outcomes. Seniors are also at greater risk of complications.

The BCCDC said in a statement, “Early findings indicate some of the children experienced secondary bacterial infections contributing to severe illness, which can be a complication of influenza. ”

“It is important to know that death associated with influenza in previously healthy children continues to be rare.”

It said children with chronic medical conditions are most at risk of severe outcomes and recommended all children aged six months and older receive a vaccination against influenza.

‘Dramatic increase’ in influenza A

The warnings from doctors and the BCCDC come as wait times at emergency rooms across the province have continued to climb. Over the weekend, the estimated wait time to see a doctor at B.C. Children’s Hospital was reported to be over 10 hours.

Health Minister Adrian Dix said he couldn’t comment on the individual cases but said he believed at least two of the cases involved teenagers.

“This is absolutely devastating for everyone in the health-care system and obviously and most importantly for the families involved,” he said.

“It shows the significant dangers the flu can have for many children. It can be relatively mild [but] for some it can be fundamentally difficult, for those who are in critical care and those who pass away.”

On Monday, health officials in B.C. urged parents to have children vaccinated, citing a “dramatic increase” in cases of influenza A, a strain which can cause severe illness in children. According to data collected by B.C. Vaccine Operations, only 20 per cent of children under five have been vaccinated.

Pediatric influenza cases on the rise across Canada

While the deaths in B.C. are higher than those in the rest of the country, doctors across Canada have voiced similar concerns about a startling number of pediatric cases.

In Alberta, two children have died of influenza since the start of the flu season. Kids up to the age of 19 account for nearly one-third of the province’s flu-related ICU admissions, according to provincial data.

Ontario recorded one child death from influenza in late November.

Paul Roumeliotis, a pediatrician and the medical officer of health for Ontario’s Eastern Health Unit, said Ontario is also experiencing an “unprecedented amount of children, particularly under 17 years of age, going into the emergency room and actually being admitted to hospital.”

Jesse Papenburg, a pediatric infectious-disease specialist at Montreal Children’s Hospital said the spike in cases is also been seen in Quebec. He said that early in the influenza season, younger children tend to get infected first before spreading it to other parts of the population, including the elderly.

“I think principally we’re seeing more severe cases because of the volume. We’re also noticing an increase in the amount of secondary bacterial infections that we’re seeing,” said Papenburg.

“It seems that we’re seeing more of these bacterial infections on top of kids who have influenza or other respiratory viruses.”

The annual FluWatch report showed that in the 2018-2019 influenza season indicated that nationally, 10 child deaths were recorded, all of them associated with influenza A.