Little girl died in Padua attacked by 4 viruses. Do children need to be vaccinated?

4 viruses attacked a 4-year-old girl at the same time in the province of Padua, leaving her no escape. Beatrice Angela Gobbo died at just 4 years old on January 4th in the intensive care unit of Padua hospital. As Il Gazzettino reports, he did not suffer from any previous pathologies. A few days earlier, another dramatic episode struck a very young child: in the Cremona hospital, a 4-year-old boy died after having a fever and vomiting. News that leaves one dismayed and helpless, but on which it is useful to clarify so as not to raise alarms and help parents and families to obtain correct information.

What do we know about the little girl from Padua

Let’s start by explaining what happened to little Beatrice Angela. Father Giovanni speaks: “On December 30th I fell ill with the flu. We were supposed to have a New Year’s Eve dinner at our house with two other couples of friends with their children, who are our little girl’s best friends. Given my condition, one of the other mothers decided to organize the party at their house, where my wife and Beatrice Angela went. They were happy, they had fun, everything went well.”

The next day the little girl went with her friend to the cinema to see a film, “a cartoon that she loved”. Upon returning home, she continues her father, “she told me that she was tired. Shortly thereafter she experienced a slight fever. We thought it was just tiredness and a bit of an alteration. As the hours passed, the fever came and went, but it stabilized at 39 degrees. From the pediatric emergency room they told us that it was better for us to take her for a visit to the hospital. A few hours later, however, Beatrice Angela’s clinical picture has worsened. Suem 118 arrived with the medical car and they took her to the emergency hospital.”

It would be easy to make the connection between the father’s flu and the little girl’s virus. But doctors have made it clear that this is an idea that should be discarded. Within a couple of days, we read again in the Gazzettino, for little Beatrice Angela there occurred a series of complications: some viruses were found that affected her, then a cerebral hemorrhage occurred and on January 4th at 12.45 pm she was declared dead. None of the 4 viruses, the doctors said, could be related to seasonal flu.

The little girl’s condition was so compromised that the parents they couldn’t even donate their organs, a conscious choice of great social value that they would have liked to make. “We wanted to donate our baby’s organs – explained father Giovanni -, but we were told that the viruses that affected her had compromised her entire body, making our desire to donate in vain”.

What can happen to the body in case of multiple aggressive viruses

Beatrice Angela’s death was therefore not due to seasonal flu. The expert Liviana Da Dalt, until a few months ago director of the Department of Mother and Child Health in Padua, the only one in the Veneto, interviewed by the Gazzettino speaks of a very rare event. “I don’t know Beatrice Angela’s case – she explained – other than that it was a rapid death from a reasonably infectious cause, given that the fever at onset was dominant. But can this happen? The answer is that it is a rare event, as we are faced with a healthy subject, in an age group no longer fragile and susceptible to serious consequences after an infection, with the immune system having reached adequate maturity” .

So what could have happened? “A Sudden death is more frequent in very young childrenprecisely with a compromised immunological system, or with primary or secondary diseases, but it is unusual at this age. It occurs because the balance between the aggressiveness of the infecting agent and the immune response is broken and sepsis occurs, once defined as septicemia, both bacterial and viral, typical of this period”.

In short, the child’s immune response can create systemic inflammation, which affects all organs and which can lead, with an invasive and overwhelming mechanism, to multi-organ failure, with generalized inflammatory damage, which affects the function of the liver, heart, kidneys and blood, explains the expert again, in the latter case compromising the coagulative component. “What leads to death is the extent of the damage itself and where it occurs, because if it affects the cells of the central nervous system it cannot be cured with supportive therapies. If the heart doesn’t work, in fact, we resort to ECMO, extracorporeal oxygenation via a machine, if the kidney doesn’t undergo dialysis, but in the face of an intracranial cerebral hemorrhage nothing can be done.”

Antibiotics and antivirals are often not enoughconcludes Da Dalt “because what makes the situation irreversible is the anomalous inflammatory response of the young patient”.

How important it is to vaccinate even healthy children (and adults).

There is no telling whether or not this and other similar tragedies could have been avoided. However, what we who deal with information can try to do is talk more about protection, about strengthening the immune system, about good habits such as hand washing and the use of masks if you are contagious (they are still mandatory in some cases until 30 June 2024), and vaccination for example: how important it is to get vaccinated, even for healthy subjects.

Because this can help to better manage, for example, superinfections, if they arise (a few days ago, again in Veneto, two adults died from the H1N1 virus, better known as the “swine flu” virus). The first case of respiratory syncytial virus was also diagnosed in Italy in November.

We asked some pediatricians and the answer is always the same: “Few parents vaccinate their children against seasonal viruses“. Despite, we are told, an adequate information campaign by the Regions, which however is aimed at doctors, and not so much at the population. Or at least that’s the perception. Most families do not even think about the possibility of vaccinating their children if vaccines are not mandatory, such as those required at a very early age, taken in the first years of life.

For example, every year there is the possibility of vaccinating children, both very young and older, against seasonal flu, which as we know is always changing.

How the flu vaccine works for children

As the Istituto Superiore di Sanità clarifies, the flu vaccine is recommended for all subjects aged 6 months and older who have no contraindications to the vaccine, because it has been widely demonstrated over time, by a very large scientific literature, that the benefits infinitely outweigh the possible, very slight, side effects due to the vaccine, which in most cases are still skin redness, pain at the site of infection and general malaise or slight fever, all symptoms that resolve within a few hours.

The flu vaccine can be administered intramuscularly and inoculation into the deltoid muscle is recommended for all subjects over 2 years of age. In children up to 2 years of age and infants, the recommended site is the anterolateral aspect of the thigh. An alternative which can also be used in Italy – but which, as some paediatricians confirm, is rarely available (in Turin, for example, it is possible to have it) – is the so-called LAIV in the form of nasal spray: just one spray into both nostrils and the vaccine is done. Without pain or discomfort for the child.

A single dose of flu vaccine is sufficient for people of all ages over 10 years old. For children under 9 years of age who have never been vaccinated before, 2 doses of seasonal flu vaccine are recommended, to be administered at least 4 weeks apart.

However, the flu vaccine cannot be administered to infants under 6 months, due to the lack of controlled clinical studies demonstrating the safety of the vaccine in these age groups. In babies under 6 months of age, it is the vaccination of the mother and other family members who care about them to represent a possible alternative to protect them indirectly.

Which children should get the flu vaccine

Then there are children for whom vaccination is absolutely essential, because due to other pathologies from which they suffer they could more easily encounter complications in the case of a flu. They are children affected by these diseases:

  • chronic diseases affecting the respiratory system (including severe asthma, bronchopulmonary dysplasia, cystic fibrosis and
  • chronic obstructive pulmonary disease (COPD)
  • diseases of the cardiovascular system, including congenital and acquired heart diseases
  • diabetes mellitus and other metabolic diseases (including obese people with BMI >30)
  • chronic renal/adrenal insufficiency
  • diseases of the hematopoietic organs and hemoglobinopathies
  • tumors and undergoing chemotherapy treatment
  • congenital or acquired diseases resulting in deficient production of antibodies, immunosuppression induced by drugs or HIV
  • chronic inflammatory diseases and intestinal malabsorption syndromes
  • pathologies for which major surgical interventions are planned
  • pathologies associated with an increased risk of aspiration of respiratory secretions (e.g. neuromuscular diseases)
    chronic liver disease.