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The authors comment on the study "Paediatric mortality related to pandemic influenza A H1N1 infection in England: an observational population-based study," by Nabilah Sachedina and Liam Donaldson, published within the issue. A brief description of the methodology is offered. The observations that mortality rate was higher in children with H1N1 infection than those with seasonal influenza are considered. The authors contend that the study support anecdotal and published studies of rapid clinical decline in previously healthy children.