Influenza-Associated Deaths Pediatric (Age <18 Years)

Reportable by Providers

About this Reportable Disease

Infectious agent:  Influenza virus

Description of illness: “Classic” influenza disease is characterized by the abrupt onset of fever, myalgia, sore throat, nonproductive cough, and headache. The fever is usually 101°–102°F. Additional symptoms may include runny nose, headache, substernal chest burning, and eye pain and sensitivity to light; a minority of patients may have gastrointestinal symptoms.

Influenza is primarily transmitted from person to person via large respiratory droplets from infected person’s cough or sneeze which then settle on the mucosal surfaces of the upper respiratory tracts of susceptible persons who are near (<= 3 feet) infected persons. Transmission may also occur through contact with surfaces contaminated with influenza virus and then touching the eyes, nose or mouth.

Interactive Disease Data


Laboratory Reporting for this Disease

Arboviral Panel (IgG and IgM Antibody Assay)

TEST NAME

 Arboviral Panel
DISEASE(S)/DISORDER(S)
  • Eastern Equine Encephalitis
  • Western Equine Encephalitis
  • St. Louis Encephalitis
  • California Encephalitis (LaCrosse)
ALTERNATIVE NAME(S) None
METHODOLOGY
  • Focus Diagnostics' Arbovirus IFA IgM
  • Focus Diagnostics' Arborvirus IFA IgG
SPECIAL INSTRUCTIONS Send acute sample at time of collection; do not wait for convalescent sample to be drawn.
ORDERING INFORMATION

Lab Web Portal

PTBMIS:

Test Order Code: ARBOVRS

Test Order Description:  Arbovirus Panel

Specimen Requirements

Patient Preparation

Paired Serum Samples:

-   Acute: drawn at illness onset

                   and

-   Convalescent: drawn 7 to 14 days later

Note: Send acute sample at time of collection; do not wait for convalescent sample to be drawn.
Specimen Collection
  • Asepticallly collect whole blood in Red Top tube (no anticoaglulant).
Specimen Labeling
  • Specimen must be labeled with at least two unique patient identifiers and match accompanying test order.
Specimen Processing
  • Allow sample to clot at room temperature prior to centrifugation.
  • Aseptically transfer serum to a sterile, plastic, screw-capped vial.
Specimen Storage and Preservation
  • Store serum at 2 - 8°C.
  • If shipping is to be delayed for longer than five  (5) days, the specimen should be frozen at  (-20)°C or colder.
Specimen Transportation
  • Ship specimen at 2 - 8°C.  If specimen has been frozen,  ship on Dry Ice. 
  • Specimen must be placed in an individual biohazard bag with absorbent material and should be shipped to the laboratory on  the day of collection. 
  • All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180). 
Specimen Acceptability and Rejection
  • The following submissions will not be tested:

-  Specimens not properly identified with the patient's name and date of birth and                   matching the submission form.

-  Convalescent serum that is collected sooner than seven (7) days from the collection           date of the acute sample.
Testing Location
  • Knoxville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

 

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • Influenza-associated pediatric mortality is a nationally notifiable condition (since 2004) and is monitored through CDC’s Influenza-Associated Pediatric Mortality Surveillance System; case definition includes death in a person aged <18 years with influenza-confirmed illness and no complete recovery between illness and death.
  • In Tennessee, Influenza-Associated Deaths: Pediatric (Age <18 Years) is a reportable condition; TDH describes classic influenza symptoms and supports timely reporting for surveillance and response.
  • Clinical management is influenza-guideline based: ensure appropriate diagnostic testing, prompt initiation of antivirals when indicated (especially for severe/progressive disease and high-risk children), and aggressive supportive care for complications (e.g., pneumonia, encephalopathy, myocarditis).
  • Surveillance outputs are published in CDC FluView; counts are provisional during the season and can increase as reports are received and finalized.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What Is It

An influenza-associated pediatric death is a death in a person younger than 18 years that occurs after an influenza-compatible illness and is confirmed by influenza testing, with no period of complete recovery between the illness and death.

Why It Matters

Seasonal influenza can cause severe complications in children, even in children who were previously healthy. Tracking pediatric flu deaths helps public health identify trends, understand risk factors, and guide prevention efforts during influenza seasons.

Signs and Symptoms

“Classic” influenza often starts suddenly and can include fever, muscle aches, sore throat, cough, and headache. Emergency warning signs in children can include trouble breathing, bluish lips/face, chest pain, severe dehydration, seizures, or symptoms that improve then return with worse fever/cough.

How It Spreads

Influenza spreads mainly through respiratory droplets when people with flu cough, sneeze, or talk, and by touching surfaces contaminated with influenza virus and then touching the mouth, nose, or eyes. Children can spread influenza to others, including before they feel very sick.

Prevention and What Families Can Do

Annual flu vaccination is the best way to reduce the risk of severe influenza outcomes. Early medical care is important for children with severe symptoms or who are at higher risk for complications; prompt antiviral treatment may be recommended by clinicians for some children.

This Page Last Updated: March 25, 2026 at 8:53 PM