To explain what happened to Emma Vitulli other tests will be needed because the pathology is so rare that it is present in scientific literature in only a hundred cases in the world.

The rest is only pain, a drama that upsets a family and which led to the death of a ten-year-old girl from Treviso for the rare complications of an influenza virus.

29/01/20 Silea. Emma Vitulli – Picture: Paolo Balanza
The fever

The most likely hypothesis for USL 2 doctors is that it was an acute necrotizing encephalopathy: the disease starts from the infection and progresses very quickly, attacks the nervous system, compromises the vital centers and leaves no way out. Saturday afternoon Emma, ​​who lived with her parents and two older brothers in Silea (Treviso), began to have a fever. Sunday afternoon the baby’s temperature had risen above 41 degrees. Mother Piera and father Marco were worried: it could not simply be a flu, and they called the ambulance that brought Emma to the emergency room of the Treviso hospital. The doctors immediately understood that the clinical picture was extremely serious: at first alert, the child could no longer stand.

Very rare pathology

The investigations continued incessantly, calling the primaries back in the middle of the night. Doctors first ruled out meningitis, then found that the girl had been infected with a type B influenza virus. Hence the suspicion of “acute metabolic-immune-mediated necrotizing encephalopathy”, which according to early research it may have been triggered by the flu.

The whole hospital did everything possible, giving every supportive therapy but there was nothing to do: Emma died on Tuesday afternoon. “This is an extremely rare pathology correlated with viral infections, including type A and B flu viruses”, explains Roberto Rigoli, chief of microbiology of the “Ca ‘Foncello” of Treviso.

“No more than a hundred cases have been reported worldwide, of which ten are pediatric. It is caused by a bio-humoral alteration that creates cerebral edema and ischemia. It occurs in a few hours, from 12 to 72.”

“We have isolated the virus, and it was not the most aggressive, it is that of the current seasonal epidemic. But in some cases, and we don’t know why, complication occurs: the pathogenesis of acute necrotizing encephalopathy is unknown. The flu virus could have triggered an enzymatic action of the immune system, creating damage to organs. “

Rigoli is one of the leading experts on the subject: the Microbiology department is one of the excellence of the Treviso hospital and its team is still at work. Confirmation of the hypotheses on what killed Emma will therefore take place after the next diagnostic tests. It occurs in a few hours, from 12 to 72. We have isolated the virus, and it was not the most aggressive, it is that of the current seasonal epidemic. But in some cases, and we don’t know why, complication occurs: the pathogenesis of acute necrotizing encephalopathy is unknown. The flu virus could have triggered an enzymatic action of the immune system, creating damage to organs. “

Pain

Meanwhile, the USL 2 reiterates that the death of the baby is not a direct consequence of the flu virus: “The girl arrived in already serious conditions, the clinical picture worsened very quickly due to a very rare complication of the infection” he explains Stefano Formentini, director of the Treviso hospital.

“For all the operators in the wards that followed the patient, it was a huge tragedy, we did everything we could.”

What could have been a form of widespread fear, understandable when a healthy child dies in a few days from the complications of a flu virus, did not occur: in the Lanzago di Silea school attended by Emma there is only so much pain.A similar tragedy had been recorded a year ago in Verona: Elia Rizzotti was eleven years old, was in the first grade and arrived in hospital with a high fever, initially connected to a banal flu. He died shortly after hospitalization from myocarditis, an inflammation of the heart muscle associated with infections such as seasonal virus, bacteria or fungi.