Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 13;72(41):1108-1114.
doi: 10.15585/mmwr.mm7241a2.

High Influenza Incidence and Disease Severity Among Children and Adolescents Aged <18 Years - United States, 2022-23 Season

Elizabeth B White, Alissa O'Halloran, Devi Sundaresan, Matthew Gilmer, Ryan Threlkel, Arielle Colón, Katie Tastad, Shua J Chai, Nisha B Alden, Kimberly Yousey-Hindes, Kyle P Openo, Patricia A Ryan, Sue Kim, Ruth Lynfield, Nancy Spina, Brenda L Tesini, Marc Martinez, Zachary Schmidt, Melissa Sutton, H Keipp Talbot, Mary Hill, Matthew Biggerstaff, Alicia Budd, Shikha Garg, Carrie Reed, A Danielle Iuliano, Catherine H Bozio

High Influenza Incidence and Disease Severity Among Children and Adolescents Aged <18 Years - United States, 2022-23 Season

Elizabeth B White et al. MMWR Morb Mortal Wkly Rep. .

Abstract

During the 2022-23 influenza season, early increases in influenza activity, co-circulation of influenza with other respiratory viruses, and high influenza-associated hospitalization rates, particularly among children and adolescents, were observed. This report describes the 2022-23 influenza season among children and adolescents aged <18 years, including the seasonal severity assessment; estimates of U.S. influenza-associated medical visits, hospitalizations, and deaths; and characteristics of influenza-associated hospitalizations. The 2022-23 influenza season had high severity among children and adolescents compared with thresholds based on previous seasons' influenza-associated outpatient visits, hospitalization rates, and deaths. Nationally, the incidences of influenza-associated outpatient visits and hospitalization for the 2022-23 season were similar for children aged <5 years and higher for children and adolescents aged 5-17 years compared with previous seasons. Peak influenza-associated outpatient and hospitalization activity occurred in late November and early December. Among children and adolescents hospitalized with influenza during the 2022-23 season in hospitals participating in the Influenza Hospitalization Surveillance Network, a lower proportion were vaccinated (18.3%) compared with previous seasons (35.8%-41.8%). Early influenza circulation, before many children and adolescents had been vaccinated, might have contributed to the high hospitalization rates during the 2022-23 season. Among symptomatic hospitalized patients, receipt of influenza antiviral treatment (64.9%) was lower than during pre-COVID-19 pandemic seasons (80.8%-87.1%). CDC recommends that all persons aged ≥6 months without contraindications should receive the annual influenza vaccine, ideally by the end of October.

PubMed Disclaimer

Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Sue Kim reports institutional support from the Michigan Department of Health & Human Services and the Council of State and Territorial Epidemiologists (CSTE). Ruth Lynfield is a member of CSTE and serves on the program committee for ID Week and is an associate editor for the American Academy of Pediatrics’ (AAP) Red Book (for which she donated the received fee to the Minnesota Department of Health) and is an executive officer of CSTE and the National Foundation for Infectious Diseases (NFID). She receives support for attending meetings of CSTE, NFID, the Infectious Diseases Society of America, and AAP. Kimberly Yousey-Hindes reports receipt of an honorarium for delivering an invited lecture at Western Connecticut State University in October 2020, and receipt of support for travel to the International Influenza Assessor Training by CSTE in January 2023. No other potential conflicts of interest were disclosed.

Figures

FIGURE 1
FIGURE 1
Percentage of outpatient visits for influenza-like illness (A), influenza-associated hospitalization rates (B), and percentage of all-cause deaths due to influenza (C) among children and adolescents aged <18 years — United States, 2022–23 influenza season Abbreviations: FluSurv-NET = Influenza Hospitalization Surveillance Network; ILI = influenza-like illness; ILINet = Outpatient Influenza-like Illness Surveillance Network; IT = intensity threshold; NCHS = National Center for Health Statistics. * In 2022–23, ITs for the percentage of outpatient visits for ILI were calculated using ILINet data from 2016–17 through 2021–22, excluding 2020–21. ITs for influenza-associated hospitalizations were calculated using FluSurv-NET data from 2006–07 through 2021–22, excluding 2011–12 and 2020–21. ITs for the percentage of deaths due to influenza were calculated using NCHS data from 2010–11 through 2021–22, excluding 2011–12 and 2020–21.
FIGURE 2
FIGURE 2
Influenza-associated medical visits (A and C) and influenza-associated hospitalizations (B and D) among children aged <5 years and children and adolescents aged 5–17 years — United States, 2016–17 through 2022–23 influenza seasons * With 95% credible intervals indicated by error bars. † Excluding 2020–21.
See this image and copyright information in PMC

References

    1. Daly P, Colón A, Merced-Morales A, et al. Influenza (flu): influenza activity in the United States during the 2022–23 season and composition of the 2023–24 influenza vaccine. Atlanta, GA: US Department of Health and Human Services, CDC; 2023. https://www.cdc.gov/flu/spotlights/2023-2024/22-23-summary-technical-rep...
    1. Thomas CM, White EB, Kojima N, et al. Early and increased influenza activity among children—Tennessee, 2022–23 influenza season. MMWR Morb Mortal Wkly Rep 2023;72:49–54. 10.15585/mmwr.mm7203a1 - DOI - PMC - PubMed
    1. CDC. Influenza (flu). How CDC classifies flu severity. Atlanta, GA: US Department of Health and Human Services, CDC; 2023. https://www.cdc.gov/flu/about/classifies-flu-severity.htm
    1. CDC. Influenza (flu). How CDC estimates the burden of seasonal influenza in the U.S. Atlanta, GA: US Department of Health and Human Services, CDC; 2023. https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm
    1. CDC. Influenza (flu). U.S. influenza surveillance: purpose and methods. Atlanta, GA: US Department of Health and Human Services, CDC; 2023. Accessed September 18, 2022. https://www.cdc.gov/flu/weekly/overview.htm

Substances