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4-Year-Old May Lose Vision After Battling Flu

photo of jade delucia

This story was updated Jan. 13, 2020, with updates on Jade's condition and on Jan. 10 with news that Jade returned home. 

Jan. 9, 2020 -- Jade DeLucia, 4, of Iowa is home after a bout of the flu landed her in the intensive care unit fighting for her life and her eyesight.

Amanda Phillips, Jade's mother, says they are hoping for the best and trying to settle in at home since Jade was discharged on Jan. 9. "She's doing great with walking, eating and talking, but is still blind," Phillips said Monday in an interview with WebMD. 

Doctors say Jade developed a very rare complication of the flu. "What we think is happening is [a condition called] acute necrotizing encephalopathy, is a reaction after the flu infection, an inflammatory process that can lead to blindness, " says Alex Bassuk, MD, PhD, division director of pediatric neurology for the University of Iowa Stead Family Children's Hospital in Iowa City, one of the first doctors to care for Jade. She was flown to the hospital Dec. 24 after being diagnosed with the flu, according to Jennifer Brown, PhD, a spokesperson for the Iowa City hospital.

"That is a rare process that occurs and often it occurs after influenza," Bassuk says. "But it is a very rare occurrence even with influenza."         

Inflammation from the encephalopathy can lead to blindness, Bassuk says. The last case he saw was in 2003, he said, and he has been in training since 1999. "She was treated with different kinds of antinflammatories — such as steroids and intravenous immunoglobulin. Now we will just have to wait. I do expect some recovery."

One of Jade's doctors, Theresa Czech, MD, told CNN it could take 3 to 6 months before they know if Jade's vision loss is permanent. 

The girl's grandmother, Courtney Frey, told a local television station that the infection made the girl's brain swell. On the family Facebook page to help support Jade's fight, there was mention of eyesight problems. CNN reported that Jade had been diagnosed with acute necrotizing encephalopathy, which is usually caused by a viral infection. 

The process of recovery has been slow but steady, her team says. ''Jade continued to improve gradually and her strength and ability to respond to commands are improving consistently. However, her vision is affected, probably at the level of brain, and she needs more diagnostic tests. She will get regular follow up visits with the neurology and ophthalmology teams as an outpatient," said Aditya Badheka, MD, medical director of the Pediatric Intensive Care Unit at the hospital.

Jade's mother, Amanda Phillips, talked about what happened ahead of her discharge on the Fundraiser for Jade Facebook page . 

"We’re doing one final test here soon to see if her brain will react to her eyes," Phillips wrote. "If her brain does respond then there is hope for her eyesight returning. If it doesn’t then we'll be taking home the bravest, strongest, kindest, blind girl I will every meet."

 

Aaron Glatt, MD, chair of medicine at Mount Sinai South Nassau and a professor of medicine at the Icahn School of Medicine at Mount Sinai, says the flu can cause problems in the nervous system. He did not treat Jade.

"Fortunately it isn't very common, but it is not unheard of,” Glatt says. “Breathing problems can lead to problems in the brain," with the lack of oxygen affecting how well the brain works.

The flu virus can also affect the eyes, experts say.

This year's flu season is shaping up as a bad one, according to the CDC. For the week ending Dec. 28, seasonal flu activity in the U.S. is high, the CDC says, and continues to increase.

Influenza B/Victoria viruses are most common now nationally, and that is unusual for this time of year, the CDC says. Next most common are influenza A (H1N1) strains.

Five new child deaths blamed on the flu were reported during the 2019-2020 season the week of Dec. 28. The total for the season is 27 child deaths, as of Dec. 28.

Children younger than 5 years old, and in particular those younger than 2, are at high risk of getting serious flu-related problems, the CDC says. The flu vaccine is recommended each year for children 6 months and older.

Complications include pneumonia, dehydration, brain problems, sinus problems, and ear infections. Since 2010, hospitalizations for children under 5 have ranged each year from 7,000 to 26,000, the CDC says.

Deaths from the flu are relatively rare in children. Since 2004-2005, the number of deaths reported annually has ranged from 37 to 187; but the CDC says the deaths may be underreported. For instance, during the 2017-2018 season, the number may have been closer to 600.

WebMD Health News Reviewed by Michael W. Smith, MD on January 09, 2020

Sources

CDC: “FluView,” Dec. 28, 2019, “Children & Influenza (Flu).”

Aaron Glatt, MD, chair of medicine, Mount Sinai South Nassau; professor of medicine, Icahn School of Medicine at Mount Sinai, New York.

Jennifer Brown, PhD, spokesperson, University of Iowa Health Care.

Facebook: Fundraiser for Jade, Jan. 9, 2020.

Local 21 News: “4-year-old fighting for life, suffered brain damage after getting the flu.”

GoFundMe: Jade's Hospital Fund.

CNN.com, "Flu leaves a 4-year-old girl blind in Iowa."

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