Why Do Some People Die From the Flu?

Most people—young and old—who get sick recover. Find out what makes a person more at risk for serious flu complications.

Certain influenza seasons, typically occurring during the fall and winter months, exhibit varying levels of severity. For instance, the 2018-2019 flu season demonstrated less intensity compared to the preceding year. Nonetheless, a notable degree of widespread flu activity persists annually throughout the United States. The potential risks associated with the flu largely hinge upon the efficacy of the yearly vaccine.

Tragically, fatalities do occur, affecting both adults and children who, despite appearing healthy, succumb to the flu, sometimes shortly after symptom onset. These occurrences have been documented by both families and healthcare authorities. Notably, within the context of San Diego, eight flu-related deaths encompassed individuals with no preexisting medical conditions, including a 32-year-old male.

Recently, a distressing incident transpired when Michael Messenger, aged 12, passed away mere days following a negative outcome on a rapid flu test conducted at an urgent care center. In another case, Katharine Gallagher, aged 27, tragically lost her life five days after leaving work early due to flu-like symptoms, which later escalated into severe acute bronchial pneumonia. These accounts paint a disconcerting picture.

However, it is imperative to assess the genuine likelihood of succumbing to the flu and the mechanisms underlying such outcomes. To glean insights into these questions, Health magazine interviewed Dr. Pat Salber, an erstwhile emergency room physician stationed in San Francisco and the originator of the blog “The Doctor Weighs In.”

What Are the Chances of Dying From the Flu?

The impact of the flu in terms of illness, hospitalization, and fatalities varies from year to year due to a range of factors. These include the predominant strain of the virus and the effectiveness of the annual vaccine. Within this dynamic context, the Centers for Disease Control and Prevention (CDC) approximates that annual flu-related deaths span from 12,000 to 56,000.

When placed in perspective, this figure remains relatively modest, especially when considering the potential magnitude of flu cases within a given year, which can surge up to 60.8 million cases according to CDC data. Dr. Pat Salber underscores that despite these numbers, in certain pandemic scenarios where millions are affected, fatalities remain comparatively rare.

How Does Someone Die From the Flu?

In certain instances, individuals grappling with the flu may encounter secondary infections, such as pneumonia—a condition characterized by inflammation of the lung’s air sacs. This can escalate into a critical state, possibly leading to organ failure and eventual mortality, as highlighted by Dr. Salber. The complexity of the flu’s impact extends to the potential development of sepsis, a perilous immune system response triggered by the presence of bacteria in the bloodstream.

Complications stemming from the flu can also result in fatalities among those already burdened by compromised immune systems due to preexisting illnesses. Dr. Salber elucidates this, emphasizing that conditions like diabetes, asthma, and chronic lung diseases can be exacerbated by a flu infection. For instance, if an individual with diabetes experiences mild renal failure and subsequently contracts the flu, inadequate hydration can worsen renal function, coupled with a diminished ability to combat the flu virus due to a weakened immune response. This can initiate a dangerous downward spiral.

However, even individuals in good health are not immune to the threat of flu-related mortality, a fact underscored by media accounts of children succumbing to the virus. Dr. Salber postulates that seemingly healthy young children might encounter a scenario where their own immune responses become overpowering. In certain cases, these heightened immune reactions might lead to the accumulation of infection-fighting proteins in the bloodstream, culminating in damage to vital organs. For instance, excessive immune activity in the lungs could severely impede breathing, a symptom not typically associated with the flu.

Who Is Most at Risk of Dying?

The segments of the population most susceptible to severe flu-related complications, such as hospitalization and mortality, are the elderly and young children. The vulnerability of older adults can be attributed to their often compromised immune systems due to underlying health issues. Furthermore, they are more predisposed to contracting secondary infections, as elucidated by Dr. Salber. Conversely, children might be more prone to an overwhelming immune response due to their potential lack of prior exposure to particularly aggressive flu strains.

To exemplify, in recent times, the H3N2 strain was responsible for a significant portion of influenza cases. Dr. Salber underscores that since H3N2 had not been prevalent for several years, children born after its previous prominence might lack pre-existing antibodies, potentially facilitating a more rapid spread of the virus.

It is important to recognize the variability of individual immune responses to the flu, as each person’s defense mechanisms are distinct. Despite considerable advancements in our understanding of the flu, a multitude of uncertainties remain, as acknowledged by Dr. Salber.

How Can Someone With the Flu Stay Safe?

Now is not the time to adopt a heroic stance. Dr. Salber emphasizes the importance of maintaining a cautious approach and promptly seeking medical assistance when needed. This is particularly crucial if you find yourself grappling with severe symptoms, possibly unlike anything you’ve experienced before, such as pronounced shortness of breath.

Dr. Salber elaborates on the typical progression of illnesses, highlighting that they often commence with mild symptoms, worsen temporarily, and then gradually improve. However, if your condition continues to deteriorate, it’s unwise to delay seeking medical attention. In such cases, a healthcare professional might opt for antiviral interventions like Tamiflu or Relenza, or address potential secondary bacterial infections through antibiotics. Adhering to age-old advice, ensuring adequate rest, and maintaining hydration are paramount strategies that enhance your body’s capacity to effectively combat the flu, thereby facilitating a swifter and safer recovery.

What’s the Best Way To Avoid the Flu in the First Place?

Securing a flu shot remains the foremost strategy for safeguarding oneself against the flu, even if the flu season is well underway. While its effectiveness isn’t absolute, Dr. Salber underlines that it still offers a level of protection. While not foolproof, it significantly contributes to reducing risks and is a step better than forgoing vaccination. Its significance is even more pronounced in safeguarding the most vulnerable members of our society. Dr. Salber emphasizes that while healthier individuals might consider “toughing it out,” the potential repercussions on the more susceptible, like elderly relatives, can be severe. Thus, the purpose of getting vaccinated extends beyond personal safety to that of protecting cherished family members and loved ones.

Additionally, practicing regular hand hygiene by washing hands thoroughly is vital. Moreover, it’s entirely acceptable to opt for a polite decline when it comes to germ-laden handshakes. This decision could potentially save lives, either your own or someone else’s, underscoring the importance of such seemingly small gestures in preventing the flu’s spread.