The Centers for Disease Control and Prevention (CDC) last week reported two more pediatric flu deaths for the 2023-24 season, which matched the previous record high of 199 fatalities in kids during the 2019-20 flu season.

In a statement, the CDC provided a breakdown of flu vaccination status among the group. Of 158 children who were eligible to receive the vaccine and had known vaccination status, 131 (83%) were not fully vaccinated.

Half were in previously healthy kids

Among the fatal cases, 73 were younger than 5 years old and 126 were ages 5 to 17. Roughly half involved influenza A. Of those with known subtypes, 43 had H1N1 and 16 had H3N2. Three children died from coinfections involving both influenza A and influenza B. 

Of 189 kids with health status information, 93 (49%) had at least one underlying medical condition.

The CDC also noted a drop in flu vaccine uptake in kids for the 2023-24 season, with coverage 2.2 percentage points lower than the previous season and 8.5 percentage points lower than the prepandemic period. It also warned that vaccination disparities, such as urbanicity, race, and ethnicity, are worsening.

The CDC said any number of children’s flu deaths is a deeply tragic reminder that flu can cause severe illness and deaths, with the risk highest in those with certain underlying health conditions. The group has recommended annual flu vaccination for everyone 6 months and older and that children ages 6 months to 8 years old who have never received two flu shots before need two doses given 4 weeks apart. 

The World Health Organization (WHO) yesterday released new guidance to help countries address key gender disparities in the prevention, diagnosis, and treatment of drug-resistant infections.

The document provides a summary of the evidence on antimicrobial resistance (AMR) and gender and proposes recommendations for policymakers to consider when they develop, revise, implement, and monitor their national AMR action plans. 

"Gender influences people's exposure to infections, what they do to prevent infections and whether they seek timely care or try to treat themselves," Anand Balachandran, Unit Head for National Action Plans and Monitoring and Evaluation in WHO's AMR division, said in a press release. "Yet the majority of national action plans on AMR do not mention sex or gender."

More antibiotic exposure for women, girls

Among the key findings of the report are that lack of clean water and safe sanitation in the community and health facilities puts women and girls at increased risk of exposure to drug-resistant infections because of their menstrual hygiene needs, more frequent contact with the healthcare system, and their responsibility for household water provision. Women are also at heightened risk of an AMR infection because they represent 70% of the global workforce. 

On the other side, male-dominated professions such as animal husbandry, industrial farming, and slaughterhouse work can expose men to antibiotics and drug-resistant pathogens, while men's roles as primary income earners can contribute to their delaying diagnosis and treatment of resistant infections. 

Gender influences people's exposure to infections, what they do to prevent infections and whether they seek timely care or try to treat themselves.

Meanwhile, stigma and negative experiences with the healthcare system can deter both men and women from seeking diagnosis and treatment of sexually transmitted and urinary tract infections. 

The WHO also found that women are 27% more likely to receive antibiotics throughout their lifetime than men, female doctors take a more conservative approach to antibiotic prescribing than their male counterparts, and antibiotic recommendations made by male pharmacists are more likely to be accepted than those made by female pharmacists.

The guidance includes 20 recommendations aimed at identifying and addressing gender-specific vulnerabilities, embedding gender analysis into AMR research, incorporating policies that strive for gender equality into national AMR action plans, and promoting equitable access to antibiotics.

• China has reported another human case involving H9N2 avian influenza, its sixth of the year, according to the latest weekly avian influenza update from Hong Kong’s Centre for Health Protection. The patient is a 3-year-old girl from Guangdong province in the southern part of the country. Her symptoms began on August 12. No details were available about her condition or how she contracted the virus. H9N2 is a low-pathogenic virus in poultry in many countries, including China. Many of the earlier illnesses involved contact with poultry or poultry environments. The illnesses are often mild and often involve children. 
• The Florida Department of Health (Florida Health) recently issued a mosquito-borne illness advisory for Palm Beach County following the confirmation of a locally acquired dengue infection. The state typically reports sporadic local cases, and the latest case marks the first of the year from Palm Beach County. In its surveillance update last week, Florida Health reported 31 local cases from six counties this year, of which 21 were from Miami-Dade County. Other affected counties include Hillsborough, Manatee, Monroe, Orange, and Pasco.
• The National Institutes of Health has established a pandemic preparedness research network with a goal of developing vaccines and monoclonal antibodies, and the group recently announced award recipients to make up the Research and Development of Vaccines and Monoclonal Antibodies for Pandemic Preparedness (ReVAMPP) network. The group will focus on five virus families:  Bunyavirales, Flaviviridae, Flaviviridae, Picornaviridae, and Togaviridae. The Research Triangle Institute in Durham, NC, will coordinate the network, which also includes projects at Albert Einstein College of Medicine, the University of California, Irvine, the University of Texas Medical Branch, the University of Washington, Vanderbilt University Medical Center, and Washington University, St. Louis.