March 2, 2009 -- In Maryland, a 13-year-old boy dies after a brief but violent battle with what doctors believe is influenza. A week later, a school in Virginia shuts down for a day when nearly 200 of its students are absent due to sickness.
The headlines make it impossible to deny that we are in the middle of the flu season. And infectious disease experts say that similar stories could be in store for the weeks to come.
The flu season, during which the disease is most rampant, is generally thought to run from November through April. According to estimates from the U.S. Centers for Disease Control and Prevention, the influenza virus sends more than 200,000 Americans to the hospital every year. And each year, more than 36,000 people die from the flu and its complications.
Most vulnerable are the elderly, infants and those with conditions that cause their immune systems to be compromised. But even young, healthy individuals can die from a severe infection.
Such was the case with 13-year-old Ian Willis of Frederick, Md. Ian's father, Robert Willis, said that on Feb. 13, Ian woke up and said he was not feeling well.
Ian's mother, Michelle Willis, took the boy's temperature, but after finding that he did not have a fever she let him go to school. Later that afternoon, Ian said he still felt under the weather; yet after downing a foot-long Subway sandwich, he spent the evening playing video games with friends.
On Saturday, he began having a fever. And on Sunday, his condition got worse.
"We noticed a change in his color," Willis said, adding that the boy appeared to be having trouble breathing. Willis rushed his son to Frederick Memorial Hospital, where doctors determined that the boy was going into respiratory distress.
In a sequence of events that Willis now describes as a "rollercoaster," doctors at Frederick Memorial administered life-saving treatment before transferring Ian to Children's Hospital in Washington, D.C., where more treatments were needed.
On Feb. 19, Ian passed away.
"We've tried to rehash this in our minds," Willis said. "We've seen the posters in the doctor's office -- 'If you have these symptoms, you have the flu. Get fluids and rest.'
"By the time we noticed he had trouble breathing, it was less than four to five hours before he was in critical condition in the hospital."
Ian is not the only casualty of the flu season thus far. According to the weekly flu report by the CDC, his death was just one of eight flu-associated deaths among children reported so far in the week ending Feb. 21.
Often, there are other infections that accompany the flu, making it even more deadly -- infections like the superbug MRSA, for example. But Dr. William Schaffner, chair of the Department of Preventive Medicine at the Vanderbilt University School of Medicine in Nashville, Tenn., said that in all too many cases, influenza alone is enough.
"Fortunately, this is rare, but it is incredibly tragic," Schaffner said. "These are often healthy children -- not necessarily children with underlying medical conditions. Within 24 hours or less, they are often ill enough to be admitted to the intensive care unit.
"This is not the common cold; it's a really bad [virus]."
Classes Out for Influenza
A state away, in Virginia, one private school is dealing with its own influenza catastrophe. Peter Bender, principal of the upper school at Walsingham Academy in Williamsburg, Va., said he and other administrators were forced to shut down the school on Friday when more than a quarter of the student body was absent Thursday with flu-like symptoms.
"We started noticing absences this past Monday -- maybe 60 or 62 students were out," Bender said. "The lower school principal told me that she had 30 out."
With each day, the number of illness-related absences grew. By Thursday, 118 out of 314 upper school pupils and 80 out of about 440 lower school pupils children were absent with symptoms consistent with either a respiratory infection or gastrointestinal illness.
Bender said that it was at that point the administrators decided to close down the school on Friday -- to the praise of the students' parents.
Bender, who has 35 years of experience working in various school systems, said he has never seen a wave of illness-induced absence of this magnitude.
He noted that state health officials have not yet determined the exact cause for the illnesses. Currently, he said, the health department is offering the families of sick children screening kits to detect norovirus -- a type of bug that causes gastrointestinal illness.
Schaffner said that it is difficult to determine the exact nature of the illness without knowing more about the individual cases. But he said that the influenza virus is a likely suspect, given the symptoms described.
"You would think that the influenza virus is the more likely cause this time of year," he said.
Schaffner added that while norovirus is generally more associated with intestinal symptoms, influenza can also bring about gastrointestinal effects such as diarrhea in younger children.
"It would be extremely unusual to have two prominent viruses in one institution simultaneously," he said. "That would be very, very odd."
Beating Flu to the Punch
In the aftermath of the infections at Walsingham Academy, workers are scrubbing down the school -- a step that Schaffner said will not likely help if an influenza bug is to blame, but which Bender said he welcomes.
"My No. 1 concern is the health of the students," he said. "This extra day is intended to give everyone a rest and the opportunity to clean the buildings."
For Willis, the week to come will be one in which he struggles to cope with his loss.
"It's like I'm waiting to wake up from a nightmare," Willis said.
Since his son's death, he has talked openly to the media about his experience. Talking about it, he hopes, will help him deal with his grief -- and alert other families to the danger of the flu.
"If it helps one family avoid going through what we're going through, then it's worth it," he said.