H1N1 flu victim collapsed on way to hospital [Latest H1N1 updates downthread]

Within minutes, six-year-old Rubjit Thindal went from happily chatting in the back seat of the car to collapsing and dying in her father's arms.

"If we had known it was so serious, we would have called 911,'' Kuldip Thindal, Rubjit's distraught mother, said in Punjabi yesterday. "She just had a stomach ache -- she wasn't even crying.''

Rubjit was pronounced dead at hospital barely 24 hours after showing signs of a fever. Later, doctors told her parents she had the H1N1 influenza virus. She is believed to be the youngest person in Canada with the virus to have died.

Buffalo, NY:

Area schools make plans to cope with flu-caused closings

By Peter Simon
News Staff Reporter
Updated: October 12, 2009, 11:35 PM
http://www.buffalonews.com/home/story/826095.html

If all goes well, the impact of swine flu will be mild, and schools will operate normally.

But school officials can’t count on that.

Instead, they are confronting the possibility that schools will have to be closed or that widespread absenteeism among students and teachers will disrupt instruction.

Contingency plans include offering study packets and course work over the Internet, cutting back on winter and spring break to make up for lost days, expanding opportunities for students to make up for lost class time and seeking assistance from radio, television and newspapers.

“This really is a moving target,” said Williamsville Superintendent Howard S. Smith. “We’re planning for something we don’t know. What we’ve tried to do is be open and proactive.”

New York health care workers file lawsuit over mandatory swine flu vaccines

Posted: Oct 13, 2009 06:36 AM EDT
Reported by: Bethany Tucker
http://www.ksby.com/Global/story.asp?S=11302910

A group of health care workers in New York have filed a lawsuit for being forced to get the swine flu vaccine.

The state says the workers risk losing their jobs if they do not get the vaccine. Many of those who filed the suit question the effectiveness and safety of the shot, and say that getting the vaccine should be their own decision.

“We’re being coerced into consenting to receiving this vaccine,” said Lorna Patterson, one of the health care workers who filed the lawsuit. “It’s a vaccine that we as educated health care professionals don’t believe in.”

To be fair, New York state health officials say the vaccine is safe. They add that the state health commissioner has legal authority to make the vaccine mandatory to workers, in order to protect public health.

Indiana:

Osceola-area tot with H1N1 is out of hospital, but parents warn flu is no ‘joke’

By MARY KATE MALONE
Tribune Staff Writer
http://www.southbendtribune.com/article/20091013/News01/910139983/1129/News

As their 19-month-old son became feverish and fussy on a recent Friday, Chad and Britton Odle never imagined he might have swine flu.

But less than 24 hours later, Hudson Odle was lying in a hospital bed, his little face covered by a breathing mask as a doctor told the Odles their son was suffering from H1N1, a virus that has killed more than 600 Americans since it was first identified last April.

“When the doctor told me that, I was like, ‘Really?’ It was shocking to me because it came on so quick,” Chad Odle said.

Hudson was released a day later, but now the Odles, who live in the Osceola area, are concerned his twin sister, Remi, might share a similar fate.

On Monday, she developed a low-grade fever and a raspy throat. “I’m just praying she doesn’t end up in the hospital,” said Britton Odle, sitting at her kitchen table with Remi’s barely eaten dinner.

“I’m hoping she is better by tomorrow.”

The Odles’ other two children, Braxton, 6, and Chesney, 3, have not shown any symptoms, she said.

Health officials said last week that 76 children have died of swine flu, including 19 last week. It has proven to be unusually dangerous for the young, officials have said.

The trouble, as the Odles found, is detecting symptoms early on.

Hudson Odle’s symptoms were minor at first and difficult to detect as they worsened, his parents said.

Britton did not realize Hudson was struggling to breathe until she gave him a bath and noticed his chest was concave.

“He had good color, and was not visibly struggling. When they’re so little, they can’t tell you, ‘I’m achy,’ or ‘I can’t get enough air,’” she said.

“I’m not the type of parent to let symptoms go ... but there were no symptoms,” she said.

When she saw her son’s chest caving inward, she panicked.

She and Chad took Hudson to the emergency room, where he was admitted and given breathing treatments.

“I sat on the floor of our van the whole way to the hospital, just watching him to make sure he didn’t turn blue and stop breathing,” Britton said.

Britton, a South Bend police officer, was prepared to perform CPR on her son if necessary.

Hudson was released from Memorial Hospital the following day.

And on Monday, the toddler was gobbling up his dinner and playing with his siblings. But his twin sister was fussy and clinging to her mom.

The Odles are watching Remi very closely, she said, and barely sleeping as a result.

Their family doctor prescribed antibiotics for Remi on Monday, but Remi’s condition had not noticeably improved by evening.

Meanwhile, the Odles are telling friends of young children to be watchful if their children exhibit even the smallest flulike symptom.

“(H1N1) is here,” Chad Odle said. “It’s not a joke, and it hits pretty quick.”

Staff writer Mary Kate Malone:
mmalone@sbtinfo.com
(574) 235-6337

Chicago’s first H1N1 outbreak hit some communities harder than others

Alden K. Loury on 10.13.09
http://www.chicagonow.com/blogs/chicago-muckrakers/2009/10/chicagos-first-h1n1-outbreak-hit-some-communities-harder-than-others.html

As Chicagoans gear up for the flu season and another battle with the H1N1 virus, the city’s first outbreak this past spring shows that some parts of the city could be more vulnerable than others.

There were 1,557 laboratory-confirmed cases of the H1N1 virus in Chicago from April to July, according to an August report from the Centers for Disease Control and Prevention. The Chicago Department of Public Health reported the city’s first cases of H1N1, often referred to as the swine flu, on April 28. Within a week, Rogers Park in the northeastern corner of the city and Hedgewisch in the city’s southeastern corner reported the highest rates of infection—at least 30 cases per 100,000 residents, according to the CDC report. The infections spread fast, the report’s authors noted. “By May 23, the fifth week of the outbreak, cases had been reported in 68 of Chicago’s 77 community areas.” The report included the graphic below. The darkest areas reflect the highest rates of infection based on laboratory-confirmed cases per 100,000 residents.

As the graphic shows, H1N1 hit hardest in three general parts of the city, the far North Side, the Southeast Side and in the central part of the city stretching from the Near South Side along the lake to the North Lawndale community on the West Side.

PA:

Pittston Area Prepares for School

By Andy Palumbo
6:40 AM EDT, October 13, 2009
http://www.wnep.com/wnep-luz-pitts-area-back-to-school,0,7703539.story

School is back in session at Pittston Area school district in Luzerne County after last week’s swine flu scare.

Classes here were cancelled Friday because so many students were sick with the flu. Monday was the Columbus Day holiday so Tuesday is the day things are supposed to be back to normal.

On Friday, the Pittston Area school district closed. Students were told to stay home because hundreds of students failed to show up last week. They were sick with the flu, many believed to have the H1N1 virus, or the swine flu.

The school buildings were disinfected. District personnel reasoned that if the students weren’t together, it would lessen the chances of the flu spreading.

The Friday night football game was postponed, because so many Patriots were sick. The game was played Monday night. The flu-delayed game gave some in the stands opportunity to poke fun at the situation. We spotted a pig mask and some anti-germ face masks in the crowd.

An illness-delayed game was new territory for the Pittston Area coach and the Hazleton fans.

“I’ve never dealt with this. You have two or three kids sick at a time, but never this many,” said Pittston Area head coach Tony Donato.

“If Pittston Area was able to catch it in time, even if there’s just a couple cases, it’s better to know it than not to have any idea,” said Peter Domin of West Hazleton.

Pittston Area lost to Hazleton 47-0.

Houston, TX:

3 Swine Flu Cases Cause Heart Concerns

By Elizabeth Scarborough
POSTED: Tuesday, October 13, 2009
UPDATED: 6:35 am CDT October 13, 2009
http://www.click2houston.com/health/21280048/detail.html

HOUSTON — There’s new fear that people with the swine flu could be at risk for heart failure, KPRC Local 2 reported Monday.

Dr. Barry Diner works in emergency medicine at St. Luke’s Hospital, where in the last week they’ve seen a disturbing trend.

“There’s been three cases that also developed into heart failure,” said Diner.

It’s the first we’ve heard of swine flu potentially causing such a risk, and the doctor said he hasn’t seen heart failure with the regular flu.

“It’s kind of concerning because we don’t necessarily see that unless we have overwhelming infection,” said Diner.

With only three cases, Diner said there’s not enough evidence for a direct link between swine flu and heart failure yet, but there is reason for concern.

Of the three patients, one was a teenager and one was a pregnant woman. Doctors delivered the baby early and the new mother is in critical condition.

Doctors said one of the swine flu patients died after heart failure within 24 hours of coming into the hospital.

This comes as Harris County health officials said there have been an additional six swine flu deaths in the county since June.

Three men and three women, all adults over the age of 19 and one over the age of 65, have died. The county said that at least half had pre-existing medical conditions.

“While sadly these deaths are truly tragic for the families, we’re not surprised that we’re having deaths,” said Rita Obey with the Harris County Health Department.

Doctors now are saying if you get flu-like symptoms, you have to judge for yourself if a trip to the hospital is necessary.

“When someone’s not feeling well and they feel like they can’t handle themselves at home, they need to come to the hospital for an evaluation,” said Diner.

(( Swine flu forced the closure Monday of four schools in Jefferson County, while students in a Florissant school became some of the first to be vaccinated against the virus. ))

H1N1 shuts 4 schools in Jefferson County

BY BLYTHE BERNHARD
POST-DISPATCH
10/13/2009
http://www.stltoday.com/stltoday/news/stories.nsf/sciencemedicine/story/48FCE30D86AF66268625764E001340C0?OpenDocument

Swine flu forced the closure Monday of four schools in Jefferson County, while students in a Florissant school became some of the first to be vaccinated against the virus.

The situation illustrates the challenge of the H1N1 virus, which struck before a vaccine became widely available and seems to be more contagious among school-age children. Vaccine supplies have slowly started to arrive, but the distribution system varies by each local health department.

Jefferson R-VII School District, which includes four schools and more than 700 students in kindergarten through ninth grade, will be closed to students until Oct. 20. Nearly a third of the kids were out sick Monday, and many more came to school with flu symptoms, said Superintendent Tom Guenzler.

Jefferson County has received only 1,100 doses of H1N1 vaccine, and most were sent to pediatricians, said Dennis Diehl, director of the county’s health department.

“We haven’t had enough to really do anything (in the schools),” Diehl said. “There may be a fairly long period of time before we’re able to offer it to everyone who wants it. People are going to rightly ask why is it taking so long and why weren’t we first.”

Guenzler said he’s never seen an illness shut down a school during his 32 years in education. The missed days will be made up at the end of the year.

“Our staff and teachers were falling like flies, too,” Guenzler said. “We decided it was in the best interest of the entire district to shut down until next week and make sure everybody gets healthy.”

The decision to close schools is left to individual districts, although the federal Centers for Disease Control and Prevention has said closures do little to prevent the spread of illness in a community.

Young people have been more likely to catch H1N1, and most have endured mild to moderate symptoms. Since the swine flu first showed up in the U.S. last April, 76 children have died from the virus. The seasonal flu kills from 50 to 100 children a year, according to the CDC.

Children are among the priority groups to receive the H1N1 vaccine. The first vaccines to be processed came in nasal spray form, which is only recommended for healthy people ages 2 to 49. Everyone else, including pregnant women and children with asthma, will have to wait for the shots to start arriving later this week.

Diehl and other public health officials are asking for patience and understanding as the vaccines roll out.

Some health departments, including St. Louis city and St. Charles County, asked manufacturers to send the initial doses directly to doctors. Madison and St. Clair counties in Illinois are waiting on additional shipments before hosting clinics. St. Louis County decided to deliver some of its first 5,000 doses to Hazelwood and Rockwood school districts because of their size and level of flu activity.

Hazelwood’s initial doses went to 23 kindergartners and first-graders Monday at Brown Elementary School in Florissant. More will be given out Wednesday to freshmen at Hazelwood Central High School. Students must receive parental consent before getting the vaccine.

The vaccine process includes three steps. First, a nurse takes the child’s temperature to make sure he’s not running a fever. The vaccine is then squirted up the child’s nose, one nostril at a time. The child is kept in an observation room for 10 minutes before going back to class.

The spray feels cold, funny and ticklish but doesn’t hurt, kids said. The kids were told to dab their noses but not blow. Most of the time, the spray didn’t trigger any sneezes.

Rainna Chadduck, 6, didn’t flinch when getting the spray, although later said she “kind of gagged.”

Children under age 10 will need two doses of the H1N1 vaccine, spaced about a month apart. They won’t develop maximum immunity for eight to 10 days after the second dose.

Until then, kids at Brown Elementary have been coached on good hygiene practices like hand washing and sneezing into elbows, even if they don’t fully understand the science behind it.

“Every time my sister doesn’t cough in her sleeve she gives me the swine flu,” said Weldon Streeter, 6.

Hat-tip AlexWyatt on the HCW thread:

http://news.cincinnati.com/apps/pbcs.dll/article?AID=/AB/20091012/NEWS01/910130354/

OH:

Local paramedic has H1N1 flu

By Eric Bradley • ebradley@enquirer.com • October 12, 2009

DEERFIELD TWP. - A paramedic in the Deerfield Township Fire Rescue Department has H1N1 influenza and has been placed on medical leave, the township announced Monday.

The paramedic was not named and it was unclear how the individual was tested for H1N1. A confirmed case of H1N1 would test positive for the strain’s subtype or for Type A influenza, which is assumed to be H1N1 flu during this time of year.

Deerfield officials sought to allay any public concern there might be about an emergency medical responder contracting the virus.

“The health and welfare of our citizens is, and will always be, our topic priority,” said Deerfield Fire Chief Chris Eisele in a statement. “We will continue to implement the safety protocols already in place to ensure that every firefighter, EMT and paramedic who responds to a citizen is free of illness.”

Government-mandated safety protocols implemented by the department included promoting strategies for infectious disease control and prevention, establishing internal surveillance and tracking systems to monitor worker health and ensuring availability of infection protective equipment to reduce the risk of exposure.

The apparent infection of a paramedic comes at a time when the vaccine mist for H1N1 is being distributed to health care professionals, who are considered to be at higher risk of infection.

More than 1,500 deaths from H1N1 have been reported by the U.S. Centers for Disease Control and Prevention.

Ohio has reported five H1N1 deaths.

OH:

Paramedics first to get H1N1 vaccine mist

By Peggy O’Farrell • pofarrell@enquirer.com • October 12, 2009
http://news.cincinnati.com/article/20091012/NEWS01/310120053

A Blue Ash paramedic was among the first Greater Cincinnati residents to be vaccinated against H1N1 flu today.

Health-care workers, paramedics and EMS personnel are first in line for the vaccine as it begins rolling into the region. Hamilton County Public Health received 4,000 doses of FluMist vaccine Friday for distribution to local fire departments.

Health-care workers are high-priority for the vaccine because they’re at higher risk for being exposed to H1N1 and because they’ll be needed to care for the sick as the virus continues to spread, said Stephen Bjornson, medical director of Hamilton County Public Health.

In Ohio, paramedics and other EMS workers are also being trained to administer the vaccine.

“About two-thirds of our department have already been trained,” said Assistance Chief Chris Theders of the Blue Ash Fire Department.

Theders administered the vaccine to Kevin Murphy, a firefighter paramedic in Blue Ash. The county health department’s 4,000 plus doses were distributed to fire departments Friday and Monday.

Murphy said he might already have been in contact with people infected with the new flu strain.

“We’ve already been in contact with it, we think, when we’ve gone out on calls,” he said.

H1N1 is widespread in 37 states, including Ohio and Kentucky. Public health officials are asking Americans to be patient as H1N1 vaccine becomes available.

The first doses of vaccine will go to those at highest risk for the flu strain, including health-care workers with direct patient contact; people 6 months to 24 years old; parents and caregivers of babies younger than 6 months; pregnant women; and adults 25 to 64 with underlying health problems.

Health officials will start scheduling school vaccination clinics as soon as they have enough vaccine, Bjornson said.

“We’ve got about 93,000 school-aged children in Hamilton County, and if 60 percent of them consent to be vaccinated, we’re going to need quite a bit of vaccine,” he said.

FluMist is recommended for healthy people ages 2-49. The nasal spray uses a weakened, live virus, while injectable vaccine uses a killed virus. There is a very slight risk FluMist could give someone the flu, Bjornson said.

This year, children 9 and younger will need to get two doses of H1N1 vaccine, and health officials recommend everyone get vaccinated against both H1N1 and seasonal flu. H1N1 vaccine will not protect people against seasonal flu, and seasonal flu vaccine won’t protect people against H1N1.

In other H1N1 developments:

• The Northern Kentucky Health Department could get its first doses of injectable vaccine this week, said spokeswoman Emily Gresham Wherle. The shipment will be “very small,”she added, just like the shipment of FluMist the department received last week. Wherle estimated this week’s shipment would cover less about one-half of 1 percent of the approximately 385,447 people served by the department.

• The Cincinnati Health Department has upgraded its flu hot line. Callers to the 513-357-7499 phone number now get a voicemail recording that lets them request general information about treating flu, information on who should get the vaccine, school vaccination schedules or the chance to talk to a nurse with specific questions.

• The U.S. Centers for Disease Control and Prevention has reported more than 1,500 deaths from H1N1. Last week, 19 flu-related pediatric deaths were reported, including 16 confirmed H1N1 tests. Ohio has reported five H1N1 deaths, including a 14-year-old Columbus area boy who died from the virus last week. Kentucky has reported five H1N1 deaths, all in adults. Lexington health officials reported Monday that a 60-year-old woman had died of the disease.

• Stephen Blatt, vice president of Infectious Diseases Consultants of Cincinnati, Inc., and medical director for infectious diseases with the TriHealth health-care network, will discuss H1N1 and pandemic flu in a 7:30 p.m. presentation Thursday at the Cincinnati Museum Center. Registration: Clara Matonhodze, 513-287-7230 or cmatonhodze@cincymuseum.org.

Swine-Flu Wave Poses Threat To Hospital ICUs, Studies Warn

OCTOBER 13, 2009
By BETSY MCKAY
http://online.wsj.com/article/SB125535613677080299.html

Three new international studies detailing how patients became gravely ill with swine flu reinforce concerns that U.S. intensive-care units could be severely stressed as the second wave of the disease builds through the fall and winter.

Swine flu is mild for most people, but a portion become so ill they require sophisticated medical techniques and equipment to survive, according to the studies published online Monday in the Journal of the American Medical Association. Some ICUs that treated the patients in the studies had trouble finding enough beds or keeping enough medication on hand.

The studies of patients in Canada, Mexico, Australia and New Zealand were reported a week after the vaccine against the H1N1 flu began being distributed in the U.S. The Centers for Disease Control and Prevention says the disease has become widespread in 37 states.

Taken together, the studies show the proportion of severely ill patients who died from H1N1 varied from 17% in Canada to 41% in Mexico. Most victims were young adults or children who had health conditions that put them at greater risk. The patients deteriorated very rapidly after entering the hospital, struck by severe viral pneumonia, and then respiratory failure, shock and organ failure. They spent prolonged periods on mechanical ventilators.

“This is the most severely ill that we’ve ever seen people,” said Anand Kumar, lead author of one of the studies and an intensive-care attending physician for the Winnipeg Regional Health Authority in Canada. “There’s almost two diseases. Patients are either mildly ill, or critically ill and require aggressive ICU care. There isn’t that much of a middle ground.”

The findings underscore concerns among some U.S. public health and hospital officials that the country’s intensive-care facilities may not accommodate the swell of patients in a large-scale outbreak. An advisory panel to President Barack Obama warned this summer that as many as 300,000 patients could require intensive care at the peak of the infection, occupying between 50% and 100% of all ICU beds in affected regions. Such a scenario, which the panel described as “plausible” but not a prediction, “could place enormous stress on ICU units, which normally operate close to capacity,” the panel said.

A bird flu outbreak in Spain?
http://crofsblogs.typepad.com/h5n1/2009/10/a-bird-flu-outbreak-in-spain.html

Thanks to the reader who sent the link to this report in GuadaQué: Más de 30.000 gallinas incineradas en Almoguera a causa de la Gripe.[Over 30,000 chickens incinerated in Almoguera because of flu] Excerpt, with my translation:
Más de 30.000 gallinas están siendo sacrificadas en Almoguera, un pueblo al Sur de Guadalajara, por la sospecha de que puedan estar contagiadas de Gripe Aviar. Fuentes de la localidad han explicado que el problema comenzó hace aproximadamente una semana, aunque los veterinarios han estado tratando a los animales. Al ver que no había solución, han comenzado el sacrificio de las aves.
Over 30,000 chickens are being sacrificed in Almoguera, a village south of Guadalajara, on suspicion that they have been infected with avian influenza. Local sources have explained that the problem began about a week ago, although veterinarians have been treating the animals. When it was seen the outbreak could not be cured, the cull began.
El viernes 9 de octubre fue cuando comenzó la incineración masiva de todas las aves contagiadas, supuestamente, por la gripe A o la gripe Aviar, aunque el tipo de virus aún no ha sido confirmado por las autoridades sanitarias, pendientes todavía de los resultados de los análisis practicados.
The incineration began on Friday, October 9 of all the birds apparently infected with influenza A or avian flu, although the type of virus has not been confirmed by the health authorities, who are still waiting for laboratory test results.
The story goes on to say that ten farm workers are being given Tamiflu as a preventive measure, and that a total of 400,000 chickens may have to be destroyed.

http://www.flucount.org/

End Of Day Summary for Monday, October 5, 2009 (FluCount.org): During the past week, 322 new swine flu-related deaths were reported across the world (average of 46 deaths/day), representing a 4.2% increase over the number of deaths last week. 26% of those deaths came from the United States, which tops the list this week, and taking the position held by Brazil for more than 2 months. The United States, whose Winter season is approaching, confirmed 83 new deaths. Brazil, whose Winter season has recently ended, confirmed 48 new deaths. India also confirmed 48 more H1N1 deaths (compared to 46 last week), representing an increase of 16%.

The H1N1 vaccine has finally started to ship to some US states, including California, who has the highest number of casualties. Other states are expecting their shipment in the coming week. The vaccines are being manufactured as both a traditional injection and as a nasal spray, although some skeptics will refuse to take either. While the WHO maintains its confidence in the vaccine and urges the public to use it, many skeptics plan to “wait and see.” Despite the initial release of the vaccine coupled with skepticism, most states and nations expect a tremendous shortfall of supply. In the US, many states are restricting the vaccine, at least initially, to health-care workers and other high-risk patients.

This week, more than half of all US states reported new H1N1 deaths. For the fifth week in a row, California reported the most new H1N1 deaths. State-by-state breakdowns are as follows: CA (14), FL (10), TX (10), AL (7), SC (7 [5 in the past week, 2 older]), MN (4), AZ (3), KY (3), NM (3), AK (2), AR (2), MI (2), VA (2), WV (2), CO (1), LA (1), MA (1), MD (1), MO (1), NC (1), NV (1), NY (1), PA (1), WI (1). Additionally, Idaho and South Dakota both confirmed their first H1N1 deaths.

Elsewhere in the world, the total deaths in South Africa increased by 42%, adding 25 new deaths to their count. Mexico confirmed 16 new deaths, while Peru confirmed 10 more. The following territories also confirmed new swine flu deaths: Colombia (9), Bolivia (9), Saudi Arabia (7), Hong Kong (7), Spain (6), Israel (6), Thailand (5), Australia (5), Vietnam (4), Ecuador (4), Venezuela (3), United Kingdom (3), Ireland (2), Iran (2), Kuwait (2), Taiwan (2), Norway (2), Nicaragua (2), Argentina (1), Dominican Republic (1), Iraq (1), Belgium (1), Italy (1), France (1), Japan (1), Bahrain (1), Honduras (1). Additionally, Bulgaria, Barbados, and Cuba each confirmed their first H1N1 deaths.

Oxygen deprivation because of ARDS has long been a concern. However, using ECMO is a high tech solution that is not available in enough numbers in a major epidemic to be practical. However, there might be a way around this problem.

“Oxygen therapeutics blood substitutes” are types of artificial blood that are being researched as blood replacements in emergency situations. However, they have one important difference with blood in that some kinds can carry *more* oxygen than can hemoglobin.

If someone’s lungs are damaged, so they cannot get enough oxygen to their internal organs, they will likely still be getting oxygen, just not enough.

So instead of using a lot of oxygen therapeutics blood substitute to *replace* their blood, why not use it to *augment* their blood? That is, so that their blood carries *more* oxygen through their bloodstream to their internal organs.

Instead of getting a pint of oxygen therapeutics in an IV, just a shot in the arm would have the same effect as increasing the amount of oxygen they are breathing in the air.

If they can still breathe on their own, they could be issued a common oxygen generator and given a shot of oxygen therapeutics in the arm, so even with some lung problems, there would still be a lot of oxygen getting to their internal organs.

Worst-Case Scenario for Swine Flu Season

Reports: Critical illness may occur rapidly in sickest swine flu patients in Canada and Mexico

10:34 a.m. CDT, October 12, 2009
Lindsey Tanner | The Associated Press
http://www.healthkey.com/a-z/swine-flu/sns-health-swine-flu-worst-case,0,2102170.story

CHICAGO (AP) — Rapidly worsening breathing problems in the sickest swine flu patients in Mexico and Canada present a scary worst-case scenario and could foreshadow what U.S. doctors face as winter flu season sets in, new reports suggest.

In the global outbreak’s first wave, many critically ill patients in both countries were obese, although their death rates weren’t higher than others. Many in both countries also were younger than those typically hard hit by seasonal flu, as has been found in the United States.

Patients studied worsened quickly after being admitted to hospitals. Most survived after intensive, lengthy treatment, although the death rate in Mexican patients studied — 41 percent — was much higher.

The reports were published online Monday in the Journal of the American Medical Association.

They aren’t a true snapshot on prevalence. But a JAMA editorial says they provide clues on what hospitals elsewhere may see in coming months.

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