2009년 영국에서 신종플루 대유행으로 70명의 어린이가 사망했다는 연구결과가 랜싯 최신호에 실렸다는 [가디언]지의 보도입니다.
어린이 치명율은 백만명 당 6명이었습니다. 영국 백인 어린이는 백만명 당 4명으로 떨어진 반면, 방글라데시 출신 어린이 치명율은 백만명 당 47명, 파키스탄 출신 어린이 치명률은 백만명 당 36명이었다고 합니다. 이러한 민족적 차이에 대해서는 규명되지 않았습니다.
========================
Flu pandemic in England killed 70 children in 2009, study shows
Study published in Lancet shows infants most at risk and unexplained preponderance of Bangladeshi and Pakistani victims during swine flu outbreak
Last year’s flu pandemic took the lives of 70 children in England, with babies less than a year old the worst affected, according to a new study published today.
The analysis, carried out by former chief medical officer Sir Liam Donaldson and Dr Nabihah Sachedina, his former clinical adviser at the department of health, also found that death rates among Bangladeshi and Pakistani children were higher than among other ethnic groups. The authors recommend that those children should have priority – along with children who already have underlying health problems – for future vaccinations.
The study, published online by the Lancet medical journal, looked at all reported child flu deaths in the nine months between June 2009 and March 2010. It was already clear during the pandemic that children were suffering disproportionately, but the final death toll has not previously been published.
Most of those who died had pre-existing health problems. Those with chronic neurological diseases such as cerebral palsy were especially vulnerable. But one in five were healthy before they caught the virus.
Sir Liam and his colleague felt the need for a full analysis of the impact on children. “Following the outset of the pandemic in England in April 2009, we initiated a confidential investigation into all resulting deaths. This investigation has provided a real-time and comprehensive system of national surveillance, which we have used to examine paediatric deaths in depth. We aimed to provide important evidence to strengthen clinical and public health policies for children during forthcoming influenza seasons and future pandemics,” they write.
The overall death rate in children was six per million population. Among white British children, this dropped to four per million, but the mortality rate rose substantially in Bangladeshi children (47 per million) and Pakistani children (36 per million).
The authors stress the seriousness of the impact of pandemic flu on children. “The occurrence of 70 deaths from pandemic influenza A H1N1 in children in one year in England is greater than the number of deaths in children every year from leukaemia, and this high childhood mortality was last seen for a single infectious disease (meningococcal disease) in 2001,” they say.
They cannot explain the reasons for the rise in deaths in certain ethnic groups, although they point out that flu outbreaks were concentrated in certain clusters such as London and the West Midlands, where there were high ethnic populations – although areas with low levels of such populations, in the East Midlands and Yorkshire, were also hit hard.
Most of the children who died appeared to have the normal breathing problems associated with flu, which means it is not possible to work out which are likely to have a worse outcome than others.
In an editorial on the Lancet site, two experts from Canada, Dr Robert Fowler of the University of Toronto and Dr Philippe Jouvet of the University of Montreal, say: “With the luxury of post-pandemic hindsight and with the findings of Sachedina and Donaldson, we now know that the 2009–10 H1N1 infection was associated with severe illness and death in greater numbers of children and young adults than previous influenza seasons with other influenza viruses. Any talk of over-reaction to 2009 H1N1 virus might lead to an underappreciation of the very real risks of influenza. The 2009 pandemic was not nearly as severe as feared, but might have been even less so with increased vaccination availability and uptake.”
