Teenagers Battle Back From Life-Threatening Cases of the Flu

When Collin Longo started to feel sick early last February, he didn’t think much of it. He and his mother, Carolyn, figured it was a cold or a touch of the flu, typical ailments that millions of Americans experience every winter.

But instead of being sick for a couple of days, Longo, now 17 and a Pleasantville High School junior at the time, was getting sicker, suffering from shortness of breath and experiencing an unusual pain in his side. His mother brought him to Northern Westchester Hospital on Thursday, Feb. 7, and while doctors discovered that Collin had Type 1 diabetes, that would be the least of his troubles.

His condition deteriorated so rapidly that before the end of that weekend, Collin was fighting for his life at Maria Fareri Children’s Hospital.

“As soon as they found out he had Type 1 diabetes, they said he needs to go to Maria Fareri because they’re equipped to deal with it,” Carolyn Longo recalled. “That was Thursday and then by Sunday, he had pneumonia and sepsis and they were talking about putting him on life support.”

The life-threatening episode wasn’t a result of the diabetes but the effects of the flu, which had quickly ravaged Collin. He had acute respiratory distress, which forced doctors to intubate him for about a month and put him in a medically-induced coma. Collin eventually needed a tracheotomy.

The difference heading into last winter, Carolyn believes, was that her son hadn’t gotten a flu shot. Like many families, they were busy and the only one in their family who ended up getting the shot was her husband, a dentist, who is obligated to do so every year.

This year, as soon as Pleasantville Pharmacy receives its supply of the shot, most likely by sometime next month, Collin will be among the first in line.

“It’s not fool-proof,” Carolyn Longo said.” There’s plenty of people who get the shot who still get the flu, but there’s a difference between getting the flu and getting a life-threatening case of the flu.”

Dr. Sheila Nolan, section chief of pediatric infectious diseases at Maria Fareri Children’s Hospital, said while these episodes for otherwise healthy teenagers are uncommon, it does happen. The pediatric mortality rate typically claims 100 to 200 children a year in the United States.

However, it’s not the flu but the complications it triggers that usually causes the most damage, Nolan said. The development of a bacterial infection on top of the viral infection is the most dangerous.

“The flu itself can cause a very severe pneumonia and you can end up on a respirator and needing ventilatory support and life-sustaining intervention,” Nolan said. “Most kids will get through the flu, it’s just if they have other complications that can actually affect areas, like the brain. There’s some significant variability to the different problems it causes.”

However, what happened to Longo wasn’t an isolated case locally. Last Dec. 13, Rebecca Berak, an eighth-grade honors student in the Wappingers School District, came home from school feeling sick, said her mother, Kathie.

Then overnight, a fever set in, which began climbing throughout the next day, and a cough developed, Kathie Berak said. She took her daughter to the doctor, where she tested positive for the flu. Rebecca was given Tamiflu and prednisone, but her fever spiked to 106, and when she began coughing up blood, Berak rushed her to Vassar Hospital.

Shortly after her arrival, medical staff told Berak what she refused to believe: that Rebecca was going to die.

“She was a perfectly healthy kid. She was fine. This isn’t happening. Don’t be here talking to me,” remembered telling the doctors, “help her.”

In a snowstorm, Rebecca was transferred to Westchester Medical Center. She had lost so much blood – she would require four units to replenish – and her vital signs were so bad that she needed to be resuscitated on her trip to Valhalla.

Once admitted to Maria Fareri Children’s Hospital, Rebecca had to be intubated. Doctors found that part of a lung was damaged, which is where the blood was coming from. Following a long intubation period, she would also need a tracheotomy.

Similar to Collin’s situation, Berak said that a busy schedule had conspired to prevent Rebecca from getting her flu shot earlier in the season. In previous years, she had felt mildly sick following the shot, so she and her mother agreed Rebecca would get it on a Friday heading into a weekend where she didn’t have anything scheduled. She was scheduled to receive it on Dec. 14.

Road to Recovery

Collin was transferred from the Pediatric Intensive Care Unit (PICU) to Blythedale Children’s Hospital for rehabilitation on Mar. 22. He remembers virtually nothing of the roughly six weeks in the PICU, only his ambulance ride from Northern Westchester Hospital to Maria Fareri – and some very odd dreams.

At Blyethdale, there would be physical therapy, occupational therapy, speech therapy and music therapy. He needed to learn to not just reuse his muscles again and walk, but how to swallow solid food and water. He felt as though he was constantly thirsty.

While Collin has been slender, standing at about 5-foot-8, he had dropped to 108 pounds.

“One of the worst things, obviously, is I was awake for two months I couldn’t eat or drink,” he said. “But I was thinking because my mouth was so dry, at the most you could have two ice chips or a swab of water.”

After the time in the PICU, one of Collin’s vocal cords was paralyzed, but doctors told his mother that the other one has been compensating. He was discharged from Blyethdale on June 4.

“We’re going to check in a year and see what happens,” Carolyn Longo said.
“He has to have a little procedure done where he had the traech. It’s like a little indentation. They’ll do a little something for that.”

Next week, Collin will be starting his senior year at Pleasantville High School, something he’s been looking forward to for months, even though he feels he has more strength to gain.

“At least now, I have a college essay topic,” said Collin, who is considering a career in film and theater.

For Rebecca Berak, her mother said she is also recovering but has permanent damage to a part of a lung. It’s similar to what someone who has cystic fibrosis experiences but the damage has been isolated in one area and it is not expected to affect her life expectancy, she said.

Similar to Collin, Rebecca needed extensive rehabilitation at Blythedale after being discharged from Maria Fareri in late January. She was able to go home in April. This summer, Rebecca studied and completed all of her Regents exams and is now set to begin her freshman year at Roy C. Ketcham High School.

She has also been slowly building up strength by swimming in the family’s pool, although she currently has nowhere near the stamina she previously had. Rebecca, who was about 110 pounds before her illness, lost close to 30 pounds, her mother said. She must wear a special vest that helps her lungs and must also use a cough assist.

“She’s so excited about starting high school,” Kathie Berak said. “I’m a nervous wreck, to be honest with you, not because of the high school part, just putting her back with all the germs and everything.”

Flu Shots

Carolyn Longo said that despite all that’s known about the effectiveness of flu shots, the simple task of getting the shot doesn’t register with some people.

“It’s no joke,” she said. “Look, you can’t force people to get the flu shot, but I don’t care. Put a picture of him on that bed. This is what could happen. There was nothing wrong with him. He was fine.”

Nolan, the pediatric infectious disease specialist at Maria Fareri, said nearly everyone above the age of six months should get the flu shot, except in some rare cases where a medical condition warrants it. Shipments should start arriving in doctors’ offices and pharmacies sometime in September and everyone should be inoculated before the holidays, she said.

While Nolan said it is still too early to predict the severity of the 2019-20 flu season, you don’t have to have a repeat of the 2009 flu pandemic to have serious health consequences. Last year, turned out to be an average flu season.

Since the flu virus mutates every year, it’s impossible to develop a shot where its recipients are guaranteed not to get sick, but the effects will be far less severe than if someone doesn’t receive the vaccine.

“It doesn’t necessarily mean that it will prevent you from getting sick with the flu, but it significantly reduces the rates of complications, and most notably, you’re much less likely to have lower respiratory track disease and more significant illness,” Nolan said.