Austin Booth didn’t feel great, but well enough to play in a high school varsity basketball game and even made it to school the next day. When he started coughing up blood, his mother knew to take him to the emergency room.
It was too late. Six days later, Austin, who had been perfectly healthy, had died from something as mundane as the flu.
“He went from being a healthy, vibrant 17-year-old boy to being gone in less than a week,” his mother, Regina Booth, said in a telephone interview.
Austin’s case is not unusual, according to a new Centers for Disease Control and Prevention study released Thursday. In fact, 43 percent American children who died from flu were perfectly healthy beforehand, CDC researchers found. While conditions such as cerebral palsy and asthma can make flu especially dangerous for a child, there’s no way to tell which children will become seriously ill or even die from seasonal flu, the researchers warn.
Worse, the healthier kids died faster – an average of four days, versus seven days for kids who had high-risk conditions.
Austin died in January 2011, at the height of influenza season in the United States. Like most American kids his age, he had not been vaccinated against the flu. Given how unpredictable flu can be and how fast it can kill, says the CDC’s Dr. Karen Wong, vaccination is the best protection for kids and adults alike.
“Because the study did find a lot of otherwise healthy kids who did have influenza-associated deaths and because we know deaths can happen fast, prevention is best, and the best prevention is the vaccine,” said Wong, who led the study.
The study’s findings, presented at a meeting of infectious disease specialists in San Diego, seem counterintuitive, and Wong says there is no clear explanation. “It is a very dangerous disease,” she said.
There are two theories about why healthier kids might succumb more quickly. One is that the parents of kids with asthma, Down syndrome or other health problems are already very vigilant and highly familiar with the health care system, and they seek treatment the moment their children start to sniffle. There’s an antiviral drug called Tamiflu that can help prevent the worst effects of influenza if patients get it within a day or two of being infected.
The other theory is that for some reason the immune system goes into overdrive in some healthy children. “The doctors called it a perfect storm,” said Regina Booth, Austin's mother.
She and the doctors did everything by the book. “He was one of those kids that everybody liked instantly,” Booth said. The family had moved to the Colorado mountain town of Rifle less than a year before from the Dallas area, and they let Austin choose which school district they would settle in.
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He was an honors student who played every sport he could. “He played varsity football and varsity baseball and basketball,” Booth, 42, said. The oldest of five children, he tried never to miss school.
“It was very, very rare that he would be sick or stay home for anything,” she said.
“When he got sick still the first day, he didn’t feel good. We knew it was flu season. A couple of other kids on the basketball team had come down with flu so we knew that was going on.”
But Austin didn’t want to miss school, which would have meant missing that night’s game. “He played in the varsity basketball game that night and did really good,” Booth said.
“He was strong, healthy. We assumed he had an awesome immune system, so we didn’t worry.” He even felt well enough to go to school the next day, although the basketball coach sent Austin home from practice when he didn’t seem up to it.
Booth kept him home the next day. “By about 10 a.m. that Thursday he had coughed up some blood,” she said. She rushed him to the emergency room, and they airlifted him to the nearest big hospital in Grand Junction, Colo. But even then it didn’t seem dire.
“When my husband and I got there, the doctor there was saying, ‘maybe it’s not as bad as I thought,’ and that gave us hope,” Booth said.
Doctors used sedatives to put Austin into a medical coma and dosed him with “I don’t know how many antibiotics,” Booth said. A ventilator was helping him breathe. It turned out he had both influenza B and an infection with a “superbug” called methicillin resistant Staphylococcus aureus, or MRSA.
“But it was more than he could do. His organs started to shut down.” Austin died on Monday, Jan. 17, 2011.
A doctor who reviewed Austin’s record said there was nothing the medical team didn’t try.
“If I would have taken him to the doctor sooner they would have said he has the flu and sent him home,” Booth says. “Nothing would have changed. The only thing I look back at now — I wish we would have gotten the flu shot that year.”
Booth has joined Families Fighting Flu and helps distribute posters that feature Austin's picture and encourage people to be vaccinated.
Although the CDC says everyone over the age of six months should get a flu shot, most still don’t. Flu kills anywhere between 3,000 people a year to 49,000 people a year, but only 51.5 percent of children aged 6 months to 17 years were vaccinated last year. Just under 75 percent of babies aged up to 2 were vaccinated. A third of kids in Austin’s age group, 13 to 17, got vaccinated.
“I was one of those people who didn’t think they needed it,” Booth says. “I was one of those people who thought if you get the shot, you are going to get sick.”
These common beliefs, as well as a lack of motivation, keep people from getting vaccinated, even though flu kills anywhere between 3,000 and 49,000 Americans every year.
Wong’s team looked at all the children who died of flu between 2004 and 2012. “Of the 781 with a known medical history, 333 (43 percent) had no high-risk conditions; of children with high-risk conditions, 57 percent had neurologic disorders, 45 percent had asthma or other pulmonary disease, and 22 percent had genetic or chromosomal disorders,” they reported.
As for Booth, she’s expecting a baby in December. “The kids are excited,” she said. Her four other children, aged 16, 12, 7 and 3, all get vaccinated against the flu every year now.