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Study says doctors miss flu in children

Infections not diagnosed for 4 in 5 preschoolers

NEW YORK -- Doctors fail to diagnose the flu in the vast majority of young children, depriving them of medicines that could shorten their illness and keep them from spreading it to others, a study suggests.

Flu infections were missed in 4 out of 5 preschoolers who were treated for flu symptoms at a doctor's office or emergency room and in about three-quarters of those who were hospitalized, researchers report.

``Many of the children did not have a test performed and few of the children were sent home with a specific diagnosis of influenza," said Dr. Katherine A. Poehling, of Vanderbilt University Medical Center in Nashville , who led the government-funded study.

If more doctors used a rapid flu test, more cases of flu could be detected and steps taken to prevent its spread, the researchers suggested. About a third of the children would have been candidates for medicines like Tamiflu, which work better to ease symptoms when given early, they said.

Their study is published in today's New England Journal of Medicine. Two of the researchers report receiving grant support and consulting fees from spray flu-vaccine maker MedImmune Inc.

Poehling and her research colleagues in Nashville, Rochester, N.Y., and Cincinnati are part of a surveillance network sponsored by the Centers for Disease Control and Prevention.

Doctors aren't required to report cases of the flu, so the researchers set out to determine how many children younger than 5 actually get the flu. They will eventually use their findings to see how well flu shots work.

Over four years, the researchers did their own lab tests on young children who went to the doctor or were hospitalized with flu-like symptoms such as cough, runny nose, and fever. Doctors didn't have the results but could have done their own test. A rapid test takes less than 30 minutes.

The study found that only 28 percent of hospitalized flu cases and 17 percent of those who went to the doctor or emergency room were diagnosed with flu. The rest of the preschoolers received diagnoses varying from asthma to pneumonia to a viral illness.

The researchers determined that the annual hospitalization rate for young children with the flu was about 1 per 1,000, with most of them younger than 2. But they calculated there were 56 visits per 1,000 children in a mild flu season and 122 visits in a moderate season.

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