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At least 42 children, more than half of them under 5, have died of influenza-related causes in what a top health official is now calling an ''epidemic'' flu season.
Julie Gerberding, director of the Centers for Disease Control and Prevention, said Friday that the deaths are being investigated, and at least 40% occurred in children who had underlying health problems that would place them at high risk for flu complications.
Federal health officials ''continue to pull out all the stops to combat the influenza epidemic,'' she said.
Working out of its emergency operations center in Atlanta, the CDC is surveying infection-control experts across the country to assess supplies of anti-viral medications and has sent its experts to help state health authorities investigate influenza deaths and allocate dwindling vaccine supplies to areas that need them the most.
On Friday, the CDC posted consumer information on its Web site, www.cdc.gov, including advice on how to distinguish between colds and flu.
Gerberding said investigators don't know yet how many of the children who died had been vaccinated. Children under 9 getting flu vaccine for the first time need two doses. Flu vaccine is recommended for children 6 months and older who are chronically ill.
Most of the estimated 36,000 people who die of influenza each year are elderly. Young children are hospitalized for flu as often as older people, but it's not known how many die. Mathematical models put the number at about 92, Gerberding said. States do not report individual flu deaths.
No states have been spared flu cases this year, and in 36 states flu is widespread.
''The season is not over,'' Gerberding said, though ''we may be seeing some leveling off'' in states hit early in the season. The number of deaths caused by pneumonia and influenza is just under a statistically determined ''epidemic threshold.'' But, she said, from a practical standpoint, ''it's safe to call it an epidemic.''
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