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"Just The Flu", Not Exactly

Friday, October 29, 2010 // Uncategorized

10/20/2009 10:01:03 PM

I referred to H1N1 in a previous blog as “just the flu”.  For the most part that is true, but it may be more severe in certain situtations which distinguishes it from seasonal flu.  It is more likely to cause viral pneumonia.   Also, vaccine production is slower than anticipated.  That comes as no suprise to many of us.

Here is the latest from ProMed Digest:

Viral pneumonia commoner with swine flu than common flu
– ——————————————————-
The World Health Organization (WHO) on Friday [16 Oct 2009] urged doctors
to treat suspected swine flu cases as quickly as possible with antiviral
drugs, warning that the virus can cause potentially life-threatening viral
pneumonia much more commonly than the typical flu, sometimes in relatively
young, otherwise healthy people. “It’s not like seasonal influenza,” said
Nikki Shindo, a medical officer in the WHO’s Epidemic and Pandemic Alert
and Response Department. “It can cause very severe disease in previously
healthy young adults.” Shindo’s comments came at the conclusion of a
special 3 day meeting in Washington of more than 100 experts from around
the world. WHO called the meeting to review the latest research on the new
H1N1 virus [the pandemic (H1N1) 2009 virus] and to revise guidelines for
treating the infection [see part [2] below}.

Unlike the seasonal flu, Shindo said, the virus appears more likely to
travel deep into the lungs, where it can cause viral pneumonia. Such a
condition can cause severe lung damage and a life threatening condition
known as acute respiratory distress syndrome. “Remarkably different is this
small subset of patients that presents very severe viral pneumonia,” Shindo
said. Shindo noted that some hospitals in Australia and New Zealand were
severely strained by seriously ill swine flu patients during their recently
ended winter.

“This disease overwhelmed emergency rooms and especially intensive care
units because of the very severe patients that required special care,”
Shindo said, urging hospitals to prepare for the possibility of a
significant number of patients requiring intensive care. “We can expect
more severe disease during the upcoming influenza season,” she said. Shindo
noted that, although a few cases have been reported of people who have been
infected with virus that is resistant to antiviral drugs, the medications
remain highly effective for most patients if administered quickly. “Do not
delay treatment,” Shindo said. “Do not miss this opportunity for early
treatment.”

WHO’s warnings came as US health officials announced that the number of
states reporting widespread flu had increased from 37 to 41 and regional or
local outbreaks were being reported in the remaining parts of the country.
The number of deaths from pneumonia and flu-like illnesses had surpassed
what the federal Centers for Disease Control and Prevention (CDC) considers
an epidemic level, said Anne Schuchat of CDC. About 6 per cent of all
doctor visits are for flu-like illnesses, she said. “It’s unprecedented for
this time of year to see the whole country seeing such high level of
activity,” she said.

CDC also reported that vaccine production was proceeding slower than
officials had hoped, meaning less vaccine was probably going to be
available by the end of the month than originally projected. While
officials had hoped about 40 million doses would be available by the end of
October [2009], that would probably fall short by about 10 million to 12
million doses, Schuchat said. “We do still expect to have the large number
of doses,” Schuchat said. “Eventually anyone who wants to be vaccinated
will be able to be vaccinated. But it’s a slow start. We unfortunately
won’t have as much by the end of this month as we had hoped.” So far 11.4
million doses have become available and states have ordered about 8 million
doses, but large amounts of vaccine will not become available until
November [2009], she said.

The number of children and teenagers who have died from the disease
continued to mount, Schuchat said. At least 86 Americans younger than 18
have died from the disease, including 11 deaths that have been reported in
the past week. About half of the deaths that have occurred in the past
month were among teenagers, she said. Since 30 Aug 2009, 43 pediatric
deaths have been reported, including 3 in those younger than age 2; 5 among
those ages 2 to 4, 16 in those ages 5 to 11; and 19 among those ages 12 to
17, she said. “These are very sobering statistics,” Schuchat said, noting
that only about 40 or 50 children die during an entire flu season. While
many of the deaths occurred among those with other health problems, some
occurred in children who were otherwise healthy, she said. “Every death we
take seriously, but as a society the deaths of children are very hard to
take,” she said.

[byline: Rob Stein]

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