4-year-old obese boy almost died of flu

The baby was taken to the Ho Chi Minh City Hospital for Tropical Diseases for emergency treatment late last month with a rapid breathing rate of 50 breaths per minute, chest retraction, purple lips, low blood oxygen levels, and low blood pressure. The doctor placed an endotracheal tube, administered high-speed ventilation, administered anti-shock fluids, and added cardiovascular drugs to raise blood pressure to a safe level.

After an hour, the baby’s blood pressure increased but the blood oxygen level improved very slowly. Doctors determined that the baby had severe pneumonia that progressed rapidly to respiratory failure, causing acute respiratory distress syndrome (ARDS). The patient was given blood filtration to remove the inflammatory substances that led to this syndrome, intravenous antibiotics, and oral antiviral drugs for influenza.

The PCR test result of the sample was positive for influenza A/H1 (pdm 2009 strain). After a day of intensive treatment, the blood oxygen level was stable, the ventilator parameters were reduced as well as the dose of cardiovascular support drugs was reduced. A week later, the baby was awake, stopped using dialysis, stopped using the ventilator, and received physical therapy to restore movement and breathing before being discharged from the hospital.

The mother said that the baby had gained weight rapidly in the past 6 months, from 25 kg to 60 kg while being 120 cm tall, with a body mass index of more than 41 kg/m2. Obesity limited the baby’s mobility and made it difficult for him to sleep. The baby had not been vaccinated against the flu. Two other children in the family had coughs and fevers similar to this baby, but recovered on their own.

Obesity is one of the severe prognostic factors when contracting influenza. Obese patients with influenza can lead to pneumonia, rapidly progressing respiratory failure, requiring active and timely treatment. Therefore, flu prevention in obese children is very important. The World Health Organization (WHO) recommends that everyone should be vaccinated against influenza, especially at-risk groups such as children under 5 years old, obese people, malnourished people, asthma, congenital or acquired immunodeficiency (HIV/AIDS, long-term use of corticosteroids, undergoing cancer treatment…), pregnant women, people with chronic diseases, and the elderly over 65 years old.

Children from 6 months to under 9 years old are vaccinated according to a two-dose schedule, including the first injection as the first injection, the second injection at least 4 weeks after the first injection and a booster injection every year. Children from 9 years old and adults are vaccinated with a single injection and a booster injection every year.

According to the Department of Preventive Medicine, the 2009 pandemic influenza A/H1 strain is one of the seasonal influenza strains currently circulating. This strain is also known as swine flu because scientists initially thought it originated from pigs, unlike the A/H1N1 strain.

Influenza A/H1 broke out strongly in 2009 and spread very quickly. Currently, this flu is easily transmitted from person to person like other common seasonal flu strains. Not as dangerous as influenza A/H5N1, influenza A/H7N9, but people infected with influenza A/H1 or other seasonal flu viruses can suffer from secondary infections, pneumonia, severe cases of multiple organ failure, and death if accompanied by chronic diseases. The world records hundreds of thousands of deaths from influenza each year.

In May, a 3-year-old girl with pneumonia caused by influenza A/H1, with severe respiratory failure complications, was saved by ECMO intervention by doctors at the City Children’s Hospital.