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Doctors report upticks in severe brain dysfunction among kids with flu

CDC, encephalitis, encephalopathy, flu, health, kids, MMWR, neurological / /

Doctors around the US have anecdotally reported an uptick of children critically ill with the flu developing severe, life-threatening neurological complications, which can be marked by seizures, delirium, hallucinations, decreased consciousness, lethargy, personality changes, and abnormalities in brain imaging.

It’s long been known that the seasonal flu can cause such devastating complications in some children, many with no underlying medical conditions. But doctors have begun to suspect that this year’s flu season—the most severe in over 15 years—has taken a yet darker turn for children. On February 14, for instance, health officials in Massachusetts released an advisory for clinicians to be on alert for neurological complications in pediatric flu patients after detecting a “possible increase.”

With the anecdata coming in, the Centers for Disease Control and Prevention analyzed all the data it has on neurological complications from flu this year and seasons dating back to 2010. Unfortunately, existing surveillance systems for flu do not capture neurological complications in pediatric cases overall—but they do capture such detailed clinical data when a child dies of flu.

An analysis of that data, published today in the CDC’s Morbidity and Mortality Weekly Report, can’t definitively say that this year is out of the norm. For one thing, the flu season is not yet over. But the data so far does suggest it may be one of the more severe seasons in the last 15 years.

Specifically, the CDC received reports of a severe neurological complication called influenza-associated acute necrotizing encephalopathy (ANE). ANE is a severe form of the more general category of influenza-associated encephalopathy or encephalitis (IAE), meaning brain dysfunction or inflammation from the flu.

When a child dies of the flu, clinicians are required to fill out a standardized case report form from the CDC, which collects a large variety of data, including complications. Encephalopathy or encephalitis are included as a checkbox on the form.

Between 2010 and February 8, 2025, 1,840 children died of the flu. Of those, 166 had IAE checked off as a complication. IAE was most prevalent in children aged 2 to 4 but affected children in all age groups under 18. More than half of the cases (54 percent) had no underlying medical conditions, and most (80 percent) were unvaccinated against the flu.

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COVID shots protect kids from long COVID—and don’t cause sudden death

COVID-19, health, kids, long COVID, Science, sudden cardiac arrest, sudden cardiac death / /

Benefits and a non-existent risk

Using an adjusted odds ratio, the researchers found that vaccination reduced the likelihood of developing long COVID with one or more symptoms by 57 percent, and reduced the likelihood of developing long COVID with two or more symptoms by 73 percent. Vaccination prior to infection was also linked to a 75 percent reduction in risk of developing long COVID that impacted day-to-day functioning. The authors note that the estimates of protection are likely underestimates because the calculations do not account for the fact that vaccination prevented some children from getting infected in the first place.

“Our findings suggest that children should stay up to date with current COVID-19 vaccination recommendations as vaccination not only protects against severe COVID-19 illness but also protects against [long Covid],” the authors conclude.

In a second short report in JAMA Network Open, researchers helped dispel concern that the vaccines could cause sudden cardiac arrest or sudden cardiac death in young athletes. This is an unproven claim that was fueled by anti-vaccine advocates amid the pandemic, including the new US Health Secretary and long-time anti-vaccine advocate Robert F. Kennedy Jr.

While previous analyses have failed to find a link between COVID-19 vaccines and sudden cardiac deaths, the new study took a broader approach. The study, led by researchers at the University of Washington, looked at whether the number of sudden cardiac arrests (SCA) and sudden cardiac deaths (SCD) among young athletes changed at all during the pandemic (2020–2022) compared with prior years (2017–2019). The researchers drew records from the National Center for Catastrophic Sports Injury Research. They also collected medical records and autopsy reports on cases among competitive athletes from the youth, middle school, high school, club, college, or professional levels who experienced sudden cardiac arrest or death at any time.

In all, there were 387 cases, with no statistically significant difference in the number of cases in the years prior to the pandemic (203) compared with those during the pandemic (184).

“This cohort study found no increase in SCA/SCD in young competitive athletes in the US during the COVID-19 pandemic, suggesting that reports asserting otherwise were overestimating the cardiovascular risk of COVID-19 infection, vaccination, and myocarditis,” the authors conclude.

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Splash pads really are fountains of fecal material; CDC reports 10K illnesses

CDC, cyrptosporidium, gastrointestinal diseases, health, Infectious disease, kids, public health, Science, splash pads / /

Once infectious material gets into the water, disinfection systems that aren’t working properly or are inadequate can allow pathogens to gush from every nozzle. Splash pads aren’t unique in having to handle sick children in poopy swim diapers—but they are unique in how they are regulated. That is, in some places, they’re not regulated at all. Splash pads are designed to not have standing water, therefore reducing the risk of young children drowning. But, because they lack standing water, they are sometimes deemed exempt from local health regulations. Before 2000, only 13 states regulated splash pads. Though many states have since added regulations, some did so only after splash pad-linked outbreaks were reported.

Downpour of disease

The primary method for keeping recreational water free of infectious viruses and bacteria is chlorinating it. However, maintaining germ-killing chlorine concentration is especially difficult for splash pads because the jets and sprays aerosolize chlorine, lowering the concentration.

Still, in most splash-pad linked outbreaks, standard chlorine concentrations aren’t enough anyway. The most common pathogen to cause an outbreak at splash pads is the parasite Cryptosporidium, aka Crypto. The parasite’s hardy spores, called oocysts, are extremely tolerant of chlorine, surviving in water with the standard chlorine concentration (1 ppm free chlorine) for over seven days. (Other germs die in minutes.) In splash pads that might not even have that standard chlorine concentration, Crypto flourishes and can cause massive outbreaks.

In 2023, the CDC recommended new health codes that call for “secondary disinfection” methods to keep Crypto at bay, including disinfection systems using ozone or ultraviolet light. Another possible solution is to have “single-pass” splash pads that don’t recirculate water.

In all, to keep splash pads from being geysers of gastrointestinal parasites and pathogens, various changes have to happen, the CDC experts say.

“Prevention of waterborne disease outbreaks at splash pads requires changes in user behavior; recreational venue code updates; and improved venue design, construction, operation, and management of facilities,” they conclude. But it should all start with keeping kids from sitting on jets and drinking the water.

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