The Flu's Hidden Threat: Why a Rare Complication Reminds Us to Stay Vigilant


Olivia Yanxi Li was a vibrant four-year-old, a perfect blend of typical childhood joys and remarkable abilities. She loved gymnastics, playing dress-up as Elsa, and watching "Peppa Pig." She was also bilingual, switching effortlessly between her native Mandarin and English. Just five weeks after celebrating her fourth birthday on December 18th, Olivia suddenly fell unconscious—a rare and devastating consequence of a flu infection.

She had contracted acute necrotizing encephalopathy (ANE), a severe neurological condition that can be triggered by viruses like influenza or COVID-19. While extremely rare, with only 41 cases found in a recent U.S. study of two flu seasons, ANE is terrifyingly fast and often fatal, even in previously healthy children. All but one of the children who died in the study were unvaccinated.

This study serves as a stark reminder that the flu is not always a mild illness. The last U.S. flu season saw an estimated 27,000 deaths, including 266 children, marking the highest number of pediatric flu-related deaths since the 2009 swine flu pandemic. While the new study doesn’t directly prove vaccination prevents ANE, other research supports this conclusion. A preliminary analysis of the 266 flu-related child deaths over the past two seasons found that only 20 percent were fully vaccinated. In response, the CDC is now initiating formal surveillance for flu-associated encephalopathy, or brain damage.

Olivia, too, was unvaccinated, a decision her mother, Ting Wang, now deeply regrets. The initial stages of her illness were not cause for alarm. On January 21st, she went home from school with a 101-degree fever and a positive test for influenza A. Neither Tamiflu nor fever-reducing medications seemed to help. Three days later, her parents, both Google engineers, took her to urgent care with a temperature of 104 degrees, but a doctor dismissed their concerns and sent them home. Her parents believe that if the fever had been taken more seriously at that point, the outcome could have been different.

That night, Olivia's fever spiked to a dangerously high 106.8 degrees. She began to vomit and seemed unusually sleepy—a shocking change for a child her mother described as "energetic no matter what." At the hospital the next morning, Olivia remained unresponsive. Brain scans revealed widespread swelling and damage, including to her brainstem and thalamus. The neurologist delivered a heartbreaking prognosis: Olivia would likely remain in a vegetative state, dependent on a ventilator for life.

Dr. Andrew Silverman, a pediatric neurologist at Stanford Lucile Packard Children’s Hospital and a lead author of the ANE study, emphasized that while influenza is primarily a respiratory illness, it can also affect the brain. "If a child with the flu becomes confused, stops responding, or has seizures, that’s an emergency," he warned. The study he co-authored, which reviewed cases from 76 academic hospitals, found that most deaths occurred within the first week of illness in children with a median age of 2. While nearly two-thirds of survivors suffered moderate neurological disabilities, a surprising number were able to return to school, indicating that recovery is possible.

Despite the initial lack of progress, Olivia was discharged to a rehab unit and then sent home after just two weeks, as no other rehab facility would accept her, and insurance denied her parents' request for an in-home nurse. Frustrated by the lack of options and seeking new hope, Olivia's parents found a supportive community on the Chinese social media app WeChat. Following advice from the group, they decided to take Olivia to China in late March. With the help of family, they secured an escorted flight and spent months in Chinese hospitals. Olivia underwent various treatments, including acupuncture and hyperbaric therapy, and slowly began to make small improvements, such as swallowing water.

Upon returning to California in mid-July, Olivia had shown some progress, but not as much as her parents had hoped. She can now swallow some soft foods but still requires a feeding tube. Dystonia has left her unable to walk or speak, and she communicates mainly through grunts and screams. The most painful reality for her mother is that Olivia does not recognize her parents. Still, Ms. Wang remains hopeful. “We also feel lucky that she’s still with us, and we can still touch her and kiss her,” she said. “And there is still hope that she recovers with some level of skills and memories.”

Post a Comment

0 Comments