CHICAGO — Children should get flu shots through age 18, rather than 5 as previously recommended; free drug samples may put children's health at risk; and young children should not have "exotic" pets such as hamsters. These are among the studies and recommendations to be published in the October edition of Pediatrics, released today.

FLU SHOTS

Public health officials say the increasing number of flu deaths underscores the importance of a new recommendation that all children, from 6 months through 18 years, get routine flu shots. Before this year, shots were recommended for kids younger than 5.

A new government study is based on an analysis of reported flu deaths from the 2004-05 through 2006-07 seasons. Flu deaths in children during those seasons totaled 47, 46 and 73, respectively. Preliminary figures for this past winter's flu season show 86 deaths, said Lyn Finelli, the study's lead author and a researcher for the Centers for Disease Control and Prevention.

More than half the children who died were between ages 5 and 17 and had been healthy until they got the flu.

Though the number of deaths wasn't high, there was more than a fivefold increase in hard-to-treat complications.

This year's flu vaccine should be widely available this month.

FREE DRUGS

A new study suggests that free drug samples, an effective marketing tool for the drug industry, do little to help the poor and may put children's health at risk.

The study analyzing

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a 2004 Centers for Disease Control and Prevention survey found that, once in a doctor's office, children who lack health insurance are more likely to receive free drug samples than their well-insured counterparts.

But of greater concern, the authors wrote, is the types of drug samples physicians provide. In 2004, more than 500,000 children received samples of four medicines that were later the subject of serious safety warnings required by the Food and Drug Administration: Advair, for asthma; Adderall and Strattera, both for attention deficit disorder; and Elidel, for eczema.

The study's lead author, Dr. Sarah Cutrona, an instructor at Harvard Medical School, said the medicines provided as free samples tended to be the newest, so their safety often had not been thoroughly vetted. Samples also often lack instructions for children or information about what parents should do in the event of an overdose.

Dr. David Namerow, a founder of a large pediatric practice in Fair Lawn, N.J., said free samples save parents from having to make an immediate trip to the pharmacy, and they allow parents to make sure a medicine works for their child before buying it.

PETS

The nation's leading pediatricians' group says children younger than 5 should not own "nontraditional" pets such as hedgehogs, hamsters, baby chicks, lizards and turtles, because of risks for disease.

Young children are vulnerable to these animals' potentially deadly germs because of developing immune systems, and because they often put their hands in their mouths.

Kids younger than 5 also should avoid contact with exotic animals in petting zoos or other public places, according to the American Academy of Pediatrics report.

"Many parents clearly don't understand the risks from various infections" these animals often carry, said Dr. Larry Pickering, the report's lead author and an infectious disease specialist at the federal Centers for Disease Control and Prevention.

This report includes information from the New York Times.