Posted on 06/24/2009 8:04:24 AM PDT by metmom
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.
(Excerpt) Read more at news.guelphmercury.com ...
Thanks , your insight is appreciated , and since ECMO
are in short supply .
Oxygen therapeutics blood substitutes would be very helpful .
Thanks :)
China’s island province reports first A/H1N1 flu case
(Xinhua)
Updated: 2009-10-13 22:48
http://www.chinadaily.com.cn/china/2009-10/13/content_8788730.htm
HAIKOU: China’s southernmost Hainan Province reported its first A/H1N1 case with severe symptoms on Tuesday, a provincial health department official said.
Li Wenlu, a 12-year-old girl from Yuxiong Village, Dongfang City, was confirmed to be infected with the A/H1N1 virus Monday evening. She got a fever on October 7 and was treated at a village clinic for common cold. She was transferred to Haikou Municipal People’s Hospital on Sunday as she had symptoms of respiratory failure, the official said.
Experts sent by the Health Ministry arrived in the provincial capital of Haikou Tuesday evening to offer medical guidance.
The ministry is to distribute 10,000 A/H1N1 vaccines to Hainan to prevent the virus from spreading.
The Chinese mainland is expected to see more serious and even fatal A/H1N1 cases as the weather cools and people return to work after the eight-day National Day holiday, said Deng Haihua, a Health Ministry spokesman on Saturday.
By Friday, the mainland had reported 22,830 cases of A/H1N1, more than 17,000 of them reported in September alone.
Lack of Hospital Surge Capacity Still a Problem
Report highlights importance of surge capacity for pandemic, mass casualties
by Anthony L. Kimery
Tuesday, 13 October 2009
http://www.hstoday.us/content/view/10608/149/
A new report by Trust for America’s Health (TFAH) concluded “that 15 states could run out of available hospital beds during the peak of the outbreak [of the H1N1 influenza virus now spreading across the nation] if 35 percent of Americans were to get sick” from this flu virus.
“Twelve additional states could reach or exceed 75 percent of their hospital bed capacity, based on estimates from the FluSurge model developed by the Centers for Disease Control and Prevention (CDC),” the TFAH report, “H1N1 Challenges,” concluded.
Meanwhile, a report released by the American College of Emergency Physicians disclosed that nearly 90 percent of doctors said in response to a survey in September that they were concerned or very concerned about their hospital’s ability to handle a surge of H1N1 patients.
This could quickly pose problems for many hospitals as serious H1N1 cases mount.
During the last six months, more than a million Americans have been stricken with the H1N1 influenza virus and more than 10,000 have had to be hospitalized. About 1,000 have died, including 76 children. And flu season has just begun. It runs through next spring.
Because of the risk that H1N1 seems to pose to young and at-risk children in particular, many more children could die than the 76 who’ve so far been killed by the virus, which is a number that appears to be a higher rate than pediatric deaths caused by traditional seasonal flu strains. In other words, many more children could die from H1N1 over the next six to seven months than die from seasonal influenza if they are not soon vaccinated.
“We’ve already had 76 children dying from the 2009 H1N1 virus, and it’s only the beginning of October,” Anne Schuchat, head of CDC’s National Center for Immunization and Respiratory Diseases, told reporters last week.
Also at risk are pregnant women. Officials believe at least 28 pregnant women who contracted H1N1 died from the virus or from complications arising from their flu infection.
At least 37 states are reporting widespread H1N1 infections, up from 27 just a week ago. While the number of cases appears to be declining in some areas, it is increasing in others, and could continue to rise and fall in these places – as well as across the nation.
“It’s hard to know how many waves we’re going to have into the fall, winter and spring,” Schuchat said. “We still think the vast majority of people in a given community are vulnerable or susceptible to this virus ... Unfortunately, we do expect more illness, including more hospitalizations and deaths, to be occurring in the weeks ahead.”
Given that we’re just beginning to see the ravages of a full blown H1N1 pandemic season, authorities say it’s not a leap to extrapolate the possible numbers of most at-risk people who could be infected over the next six to seven months and to calculate the possible strain that this could put on the nation’s hospitals’ ERs and intensive care units.
Last April, for example, when H1N1 infections first erupted in the US, adults arriving with flu-like symptoms at New York’s Montefiore Medical Center’s ER - one of the nation’s busiest emergency rooms - rose 20 percent. Child ER visits jumped 40 percent.
Similar situations were experienced by ERs across the nation.
According to a study published last week in the New England Journal of Medicine, H1N1 was responsible for a 15-fold increase in intensive care admissions for viral lung inflammation in Australia and New Zealand, especially among pregnant women, people with chronic lung disease, and people who are obese.
H1N1 patients filled 8.9 percent to 19 percent of all intensive-care hospital beds in each state in Australia and New Zealand, while nearly 65 percent of intensive-care H1N1 patients required ventilators.
Similarly, severely ill patients in Mexico and Canada were in intensive care units on ventilators for nearly two weeks, according to reports published in the Journal of the American Medical Association.
About 17 percent of the Canadian patients and 41 percent of the Mexican patients reportedly died and, in both countries, hospitals’ ICU capacities were strained.
Authorities in the US are bracing for a possible surge in hospital and ER/ICU admissions and a sudden draw down on resources, especially ventilators, if large numbers of H1N1-sickened persons require mechanical ventilation to survive.
But studies such as one conducted in 2006 by the Trauma Center Association of America (TCAA) revealed that in the event of a mass casualty event in which many patients require ventilators, the majority of hospitals that responded to the TCAA survey reported that they would quickly run out, with few hospitals having plans in place to acquire additional ventilators.
Numerous authorities HSToday.us talked to said it’s possible that the H1N1 pandemic could be the first nationwide test of national hospital surge capacity limits, the importance of which can’t be overstated when it comes to being prepared for mass casualties.
For years, Homeland Security Today and HSToday.us have been reporting on the nation’s inadequate hospital surge capacity. In a two-part series a year ago, HSToday.us reported that inadequate surge and mass casualty trauma care capacity remains a problem nationwide.
[Editor’s note: Also see the July 2007 report, “Seeking to Surge,” and the May 2004 feature, “The Trauma in America’s Trauma Care”]
“Surge capacity … is one of the most serious remaining challenges for emergency health preparedness,” the TFAH report stressed, noting that “health care providers and hospitals could be quickly overrun or overextended during the H1N1 outbreak, even though it is currently a mild strain of flu, and the plans and capacities to deal with this influx are limited.”
The report stated that “federal, state, local, and health system officials will have to continue to clearly communicate with the public as to which groups are urged to seek rapid care and who should practice sound selfcare measures and stay home when ill.
The TFAH report stated “one of the biggest ongoing challenges health officials face is that preparations are taking place in the context of a public health system that has been chronically underfunded for decades. Many core systems and capabilities are lagging behind where they should be or could be, which leaves the nation unnecessarily vulnerable during times of emergency. The concurrence of lost workforce due to the economic recession, the continuing need to address other pressing public health issues simultaneously with a pandemic, and the diversion of health department employees to the H1N1 response have placed a severe strain on the public health system.”
In short, the nation’s public health infrastructure is eroding.
The TFAH report “examines the series of challenges the country faces in preparing to deal with the complications that an H1N1 outbreak adds to this flu season related to medical care capacity, antiviral medications, disease surveillance, vaccinations, budget cuts at public health departments, and caring for people in communities, particularly meeting the special needs of at-risk populations, and provides a series of recommendations for how to address preparedness gaps.”
The report “estimates that the number of people hospitalized could range from a high of 168,025 in California to a low of 2,485 in Wyoming, and many states may face shortages of beds or may need to reduce the number of non-flu related discretionary hospitalizations due to limited hospital bed availability. The numbers of people who get sick could range from a high of 12.9 million in California to a low of 186,434 in Wyoming, if 35 percent of Americans were to get H1N1.”
The TFAH report made the following estimates of hospital bed capacity at five weeks into a pandemic based on CDC’s FluSurge using expert predictions that H1N1 is a relatively mild strain of the flu and that up to 35 percent of Americans could potentially become sick with H1N1:
Fifteen states would be at or exceed hospital bed capacity: Arizona (117 percent); California (125 percent); Connecticut (148 percent); Delaware (203 percent); Hawaii (143 percent); Maryland (143 percent); Massachusetts (110 percent); Nevada (137 percent); New Jersey (101 percent); New York (108 percent); Oregon (107 percent); Rhode Island (143 percent); Vermont (108 percent); Virginia (100 percent); and Washington (107 percent).
Twelve states would be at 75 to 99 percent of their hospital bed capacity: Colorado (88 percent); Florida (80 percent); Georgia (78 percent); Maine (83 percent); Michigan (79 percent); New Hampshire (84 percent); New Mexico (93 percent); North Carolina (95 percent); Pennsylvania (77 percent); South Carolina (93 percent); Utah (83 percent); and Wisconsin (75 percent).
Fourth H1N1 death confirmed in Cabell County WV
October 13, 2009 @ 10:02 AM
2009/The Herald-Dispatch
Herald-Dispatch.com
HUNTINGTON — The Cabell-Huntington Health Department confirmed a fourth H1N1-related death in Cabell County.
A 39-year-old woman died, according to a release from the health department. No further details were released as of 10:06 a.m.
Since September, the flu, also known as swine flu, has been credited with three other deaths: Cabell Midland High School student Patrick M. Wheeler II, 14; Amy Mischelle Scott, 37, of Chesapeake, Ohio, a worker at a home health services agency; and Michael Bloomfield, 51, of Kanawha County, a hospital emergency room employee.
Check back for details on this developing story
http://www.herald-dispatch.com/breaking/x1953032786/Fourth-H1N1-death-confirmed
Oxygen therapeutics are only available on the periphery of medicine in the US. Though human use in South Africa and Europe are advancing, even with the Office of Naval Research backing studies in the US, they are still about at only Phase III testing. President W. Bush authorized expedited research, but it is still going at a snail’s pace.
So unless there is a breakthrough by the medical community in studying it as an emergency blood augmentation, it may not be ready in time, in sufficient quantity to matter.
(((”The timing of school closure is critically important,” WHO said. The H1N1 virus has killed at least 3,205 people worldwide since emerging last April in North America.
Despite the ministry’s requests against school closure, TOI was the first to highlight an Imperial College, London, study that showed that closing down schools entirely during a flu pandemic may cut infection rates by 40%. ))
WHO recants H1N1 advice on schools
Kounteya Sinha, TNN 13 September 2009, 12:34am IST
NEW DELHI: The global health watchdog, World Health Organisation, may have learnt a lesson or two from India’s handling of the H1N1 swine flu
outbreak. Almost six months after the bug made its presence felt, WHO has said closing schools at the start of an H1N1 flu outbreak could slow down the virus’ spread by almost 30%-50% and help buy crucial time to build up defences against the highly infectious strain of influenza.
This is exactly what Indian schools, especially in Delhi and Pune, did. And interestingly, they did so against the Union health ministry’s wishes. Following WHO’s advice, the ministry had, for the past few months, been speaking of the lack of benefits in keeping entire schools shut after students tested positive for H1N1 infection.
The ministry’s advice was to shut only those classes where a student had tested positive for H1N1. Health minister Ghulam Nabi Azad had held “shutting a school wouldn’t mean you can stop students from attending parties and meeting friends in the evening where they can get the infection. Schools must stay open.”
But on Saturday, WHO said experience to date has demonstrated the role of schools in amplifying transmission of the pandemic virus, both within and into the wider community. This has led to the revision of its opinion. After “drawing on recent experiences in several countries”, WHO said school closure can operate as a proactive measure in reducing transmission of H1N1.
WHO said, “The main benefit of proactive school closure comes from slowing down the spread of an outbreak within a given area and thus flattening the peak of infections. School closure can also buy some time as countries intensify preparedness measures or build up supplies of vaccines and antiviral drugs.” WHO’s modeling studies suggest school closure has its greatest benefits when this is effected very early in an outbreak. If schools close too late in the course of a community-wide outbreak, the resulting reduction in transmission is likely to be very limited.
“The timing of school closure is critically important,” WHO said. The H1N1 virus has killed at least 3,205 people worldwide since emerging last April in North America.
Despite the ministry’s requests against school closure, TOI was the first to highlight an Imperial College, London, study that showed that closing down schools entirely during a flu pandemic may cut infection rates by 40%.
Mathematical models suggest that swine flu has an attack rate of 30% once it enters a country, that is, the likelihood is 30% of citizens will catch it at some point. Children are thought to be important vectors of transmission and susceptible to most influenza strains than adults. High contact rates in schools also favour transmission.
WHO also highlighted that shutting down schools has a serious economic burden with cost arising from absenteeism of working parents or guardians who have to stay home to take care of their children.
Studies estimate that school closures can lead to the absence of 16% of the workforce. WHO had earlier said that by the end of the pandemic, anywhere between 15% and 45% of a population would have been infected by the new pandemic virus. If one takes the mid-point figure of 30%, it’ll mean two billion people getting the infection, WHO said.
Give Olympic athletes flu shot priority: official
Plenty of time to receive vaccinations, health agency says
Last Updated: Tuesday, October 13, 2009 | 9:32 AM MT
CBC News
http://www.cbc.ca/canada/edmonton/story/2009/10/13/olympic-athletes-h1n1-flu-vaccine331.html
Canada’s Olympic team should receive the swine flu vaccine on a priority basis to prevent an outbreak at the Winter Games, the team’s top medical officer said amid reports that Canadian athletes who come down with the virus may be placed in quarantine
Bob McCormack, chief medical officer for Canada’s Olympic team, told CBC News the Olympics provide a potential breeding ground for the H1N1 virus and that provides justification for making athletes a priority for the vaccine.
“The Olympics is where the viruses of the world come to meet,” Bowman said. “If you have hundreds of countries getting together with thousands of athletes in a small, contained area of the village — it’s a breeding ground for viruses.”
Athletes’ bodies are also under the stress of high-level training, which can affect the immune system, he said.
The Public Health Agency of Canada said it has already decided not to give Olympic athletes vaccination on a priority basis because they have lots of time to get the shot before the competition.
But McCormack said many athletes have a busy schedule leading into the Vancouver Games in February and should be able to receive it now. He would like to see athletes vaccinated before many begin leaving Canada for pre-Olympic competitions beginning in November.
Canada has invested large sums of money into ensuring the team’s success at the event. “If we end up with an outbreak in the Canadian team, it could have a devastating impact on our goals of being the No. 1 medal nation,” he said.
No quarantine: IOC
University of Toronto bioethicist Kerry Bowman said that when pregnant women and aboriginal communities are at a high risk of being infected by the virus, treating athletes on a priority basis could be seen as offensive.
“What some people in the public may certainly say is this is just a privileged group and in fact they are being jumped to the front of the queue,” Bowman said. “That may offend some Canadians.”
The International Olympic Committee has said it will not quarantine athletes who get sick at the Games.
But Canadian officials have told athletes if they are sick at the Games there is a possibility they will be moved away from the rest of Team Canada and potentially removed from the Olympic village, said CBC correspondent Teddy Katz.
“They can’t afford to take the risk that this thing will spread through more than one team or perhaps the entire team,” Katz said.
‘Imagine how Canada would react’
Figure skater Anabelle Langlois thought that Canadians might not favour the athletes getting the vaccine first now, but they might feel differently if the virus does hit during the Games.
“I can’t imagine how Canada would react if the entire men’s hockey team would be wiped out from the H1N1 and wouldn’t compete,” Langlois said.
Figure skater Cody Hay said he is now considering seeking out the vaccine because of the possibility of quarantine.
But his pairs partner, Langlois, said she still wants to research the vaccine more before deciding if she will get the shot.
Because of doping regulations, athletes can be restricted in terms of what medications they can take if they do fall ill at the Games, Katz said. Other athletes and their coaches may be opposed to taking a flu shot because of concerns it may give them symptoms of the illness during their training routines ahead of the Olympics, he said.
McCormack said he is advising all Canadian athletes to get the vaccine.
India:
Seven swine flu deaths take India’s toll to 396
IANS
First Published : 13 Oct 2009 09:08:32 PM ISTLast Updated :
http://www.expressbuzz.com/edition/story.aspx?Title=Seven+swine+flu+deaths+take+Indias+toll+to+396&artid=H/t4ep9NRZQ=
NEW DELHI: Seven swine flu deaths, including five in Maharashtra, took India’s toll to 396 Tuesday, health authorities said here.
In Maharashtra, which has recorded the maximum number of deaths and cases in the country, one death was reported Tuesday, and four others which occurred earlier were confirmed as swine flu toll Tuesday.
“We were awaiting the lab reports of these four cases. It was confirmed that they died due to swine flu today only after the reports came,” a health official said. With these five deaths, the toll in Maharashtra has gone up to 165.
Two people who had died earlier in Karnataka were also found to be infected from the contagious H1N1 virus. With these two deaths, the toll in that southern state has gone up to 112.
Meanwhile, 140 new cases were reported in the country, taking the total number of people infected with the virus to 12,185.
Thirty of the new cases were reported from Delhi. So far, in the Indian capital 3,118 people have tested positive for the virus infection.
A private school in Delhi was shut Tuesday after a class 10 student tested positive for the swine flu.
The other states from where new cases were reported were Maharasthra (23), Karnataka (22), Tamil Nadu (22), Kerala (13), Haryana (, Uttar Pradesh (7) and Gujarat (4).
Swine Flu Kills as Lungs Fail
Nathan Seppa, Science News
http://dsc.discovery.com/news/2009/10/13/swine-flu-virus.html
Oct. 13, 2009 — Lung inflammation and respiratory failure are largely responsible for the fatal cases of H1N1 (swine) flu seen so far, three new studies show. The findings also confirm observations that the influenza hits young adults the hardest but can be fought off in many cases with the use of antiviral flu drugs and a mechanical ventilator to aid breathing.
The new studies offer the first large-scale analyses of how the H1N1 flu causes life-threatening illness. All three reports find a consistent pattern of oxygen deprivation in the blood of critically ill patients, a dangerous condition that in the worst-case scenario leads to shock, organ failure and death, the researchers report online October 12 in the Journal of the American Medical Association. The studies were conducted between early March and late August in Canada, Mexico and Australia and New Zealand.
“The data suggests it starts as a diffuse viral pneumonia,” says physician Anand Kumar of the University of Manitoba in Winnipeg, who co-authored the Canadian study. By the time a person becomes critically ill, he says, it’s no longer clear whether it’s still pneumonia or has developed into a more severe respiratory distress syndrome.
In such severely ill patients, H1N1 causes massive inflammation in the lungs, which leads to fluid build-up in airways and lung tissues and even bleeding in lung tissues, says physician and epidemiologist Robert Fowler of the University of Toronto, who co-authored the studies in Canada and Mexico. These changes hamper the transfer of oxygen from inhaled air to the blood stream.
“Most patients are still able to take breaths, but these breaths are ineffective,” he says. Blood pressure can crash, disrupting circulation. While oxygen deprivation can cause widespread damage, “the lungs are the organs most visibly affected,” Fowler says.
In the largest of the three studies, Fowler and a team of scientists in Canada monitored the course of 168 patients deemed critically ill with H1N1 flu. Although the patients averaged only 32 years of age and received intensive-care-unit treatment, 17 percent died.
Doctors in the study conducted in Australia and New Zealand identified 68 patients critically ill with flu symptoms, most of whom were eventually confirmed to have H1N1. Despite having a median age of 34 years, their fatality rate was 21 percent. Six of the survivors were still in intensive care units when the data were reported.
In the study done in Mexico, scientists examined the records of 58 critically ill H1N1 patients who had a median age of 44 years, finding a fatality rate of 41 percent.
The vast majority of patients in the studies in Canada and Mexico received mechanical ventilation, which typically lasted 10 to 12 days. But the respiratory crash occurred too rapidly in some patients for ventilation to help. In Mexico, for example, four patients died before healthcare workers could get them into an intensive care unit. In Australia and New Zealand, doctors used a treatment called extracorporeal membrane oxygenation, in which blood is extracted from each patient and passed through a machine that adds oxygen. The blood is then returned to the patient.
Many patients in all three regions were also given the flu medication oseltamivir phosphate (Tamiflu), with apparent benefit. In the Mexican analysis, critically ill patients who survived were seven times more likely to have received the drug than those who died.
All three groups of critically ill patients included very few people over the age of 60 and few young children. The numbers support a widespread hypothesis that older people carry some residual immunity against H1N1 flu, Fowler says. The new data don’t explain why very young children were underrepresented in these critically ill groups.
On the other hand, the data fail to explain why people in the prime of life would be most susceptible to the lethal effects of H1N1, a trend eerily reminiscent of the 1918 flu pandemic, which was also caused by an H1N1 strain.
But the studies do provide much-needed empirical knowledge about the H1N1 flu, physicians Douglas White and Derek Angus of the University of Pittsburgh note in an editorial also released by JAMA. “It is remarkable to have any data so early in the course of the influenza pandemic, let alone the systematically collected data present in these reports,” they observe. “These studies provide important signals about what clinicians and hospitals may confront in the coming months.”
Fowler adds: “These papers teach us that in the subset of patients with critical illness due to H1N1, the patients can deteriorate very quickly,” he says. “But with early recognition of the disease, prompt treatment and capacity for aggressive life-support and rescue therapies for oxygenation failure, mortality can be limited.”
Think you can wait out H1N1? Doctors say don’t even try
About 3,800 Americans have died from H1N1 complications since the spring, including 76 children, according to the federal Centers for Disease Control and Prevention. Of those youngsters, about 20 had chronic medical conditions that made them more vulnerable.
H1N1 is widespread in 37 states and is returning to some areas that had big outbreaks in the spring.
Comment: further evidence that the message is clearly changing. Also, WHY is the U.S. leading the world in deaths? Is it due to our accounting, the second wave or is something else at play?
By Lane Lambert
GateHouse News Service
Posted Oct 13, 2009 @ 12:05 PM
4th Person Dies From Swine Flu In Nassau County - NY
Oct 13, 2009 12:42 pm US/Eastern
Health officials confirmed Tuesday that a Nassau County resident with the swine flu has died.
The Department of Health did not release many details about the patient, only saying the victim was an adult over 65 with several other medical conditions.
It’s not known how those conditions played into the patient’s death.
This is the fourth person with the H1N1 influenza virus to die this year in Nassau County.
Nassau County has received 1,000 doses of the H1N1 nasal spray vaccine from the New York State Department of Health, but expects to receive additional shipments as they become available.
The Nassau County Department of Health has established an H1N1 Call Center for residents seeking additional H1N1 information. Residents may call the H1N1 Call Center, Monday through Friday, 9 a.m. to 4 p.m. at 1-888-684-4271.
http://wcbstv.com/topstories/h1n1.swine.flu.2.1245018.html
Earlier Flu Viruses Provided Some Immunity to Current H1N1 Influenza, Study Shows
October 13, 2009
University of California, Davis, researchers studying the 2009 H1N1 influenza virus, formerly referred to as “swine flu,” have identified a group of immunologically important sites on the virus that are also present in seasonal flu viruses that have been circulating for years. These molecular sites appear to result in some level of immunity to the new virus in people who were exposed to the earlier influenza viruses.
More than a dozen structural sites, or epitopes, in the virus may explain why many people over the age of 60, who were likely exposed to similar viruses earlier in life, carry antibodies or other type of immunity against the new virus, immune responses that could be attributed to earlier flu exposure and vaccinations.
Researchers Zheng Xing, a project scientist, and Carol Cardona, a veterinarian and Cooperative Extension specialist, both of the UC Davis School of Veterinary Medicine, report their findings online in the journal of Emerging Infectious Diseases. The report will appear in the November print edition of the journal, published by the Centers for Disease Control and Prevention.
“These findings indicate that human populations may have some level of existing immunity to the pandemic H1N1 influenza and may explain why the 2009 H1N1-related symptoms have been generally mild,” Cardona said.
“Our hypothesis, based on the application of data collected by other researchers, suggests that cell-mediated immunity, as opposed to antibody-mediated immunity, may play a key role in lowering the disease-causing ability, or pathogenicity, of the 2009 H1N1 influenza,” Xing added.
He noted that immune responses based on production of specific cells, known as cytotoxic T-cells, have been largely neglected in evaluating the efficacy of flu vaccinations. In this type of immune response, the T-cells and the antiviral chemicals that they secrete attack the invading viruses.
About 2009 H1N1 influenza
The 2009 H1N1 virus is a new strain of influenza that first appeared in the United States in April 2009. Early on, it was referred to as “swine flu” because it was genetically similar to influenza viruses that normally occur in pigs in North America. Further study, however, revealed that the virus actually included genes from viruses found in birds and humans, as well as pigs.
At first, this H1N1 influenza virus apparently caused a high number of deaths among patients in Mexico and among people with certain pre-existing medical conditions. But as it has progressed to become a pandemic or geographically widespread virus, H1N1 has caused relatively mild symptoms and few deaths.
One hallmark of this new influenza virus, according to the Centers for Disease Control and Prevention, has been the presence of pre-existing antibodies against the virus in about one third of H1N1 2009 patients over the age of 60, a phenomenon that suggested some levels of immunity may have existed to the new pandemic H1N1 virus.
The UC Davis research
To probe this phenomenon, the UC Davis researchers surveyed data from earlier studies of epitopes known to exist on different strains of seasonal influenza A. They found that these epitopes, present in other seasonal H1N1 influenza strains around the world and capable of triggering an immune response, were also present in the strains of H1N1 2009 that were found in California, Texas and New York.
Interestingly, although previous H1N1 viruses seem to have produced a protective antibody response in exposed people, these antibodies largely did not provide cross-protection for individuals infected with the H1N1 2009 strain of influenza. The researchers theorize that, rather than stimulating protective antibodies, the epitopes of the new H1N1 2009 virus produced an immune response by triggering production of cytotoxic T-cells, which boost a person’s immune defenses by killing infected cells and attacking the invading viruses.
Humans can mount two types of immune responses. One type is produced when the invading virus triggers production of protective antibodies that circulate in the bloodstream, and the other type, described above, is known as a cell-mediated immune response. It is produced when the invading virus triggers the activation of cytotoxic T-cells, a process that helps clear the virus from the body. Evidence from earlier studies suggests that cytotoxic T-cell immune immunity can be caused by either an active viral infection or by vaccination against such a virus.
Implications for avian influenza
The researchers note that about 80 percent of the epitopes found in seasonal influenza and flu vaccine viruses are also present in the highly pathogenic H5N1, or avian influenza, virus. They suggest that these epitopes may have protected some individuals infected with the highly pathogenic H5N1 virus through cytotoxic T-cell immunity.
However, the H5N1 virus rapidly reproduces itself and spreads so quickly within vital organs that the body may not be able to launch protective immunity, thus accounting for the high fatality rate of avian influenza.
Furthermore, only a fraction of the human population can recognize the specific epitopes necessary to cause the appropriate protective immune response, which may explain why the H1N1 2009 virus, as well as avian influenza, may vary in severity from person to person.
Xing and Cardona propose that immunity acquired from seasonal influenza or flu vaccinations may provide partial protection for patients infected with the avian influenza virus due to the shared epitopes essential for cytotoxic T-cell immunity.
This is supported by statistics from the World Health Organization indicating that there have been fewer avian influenza infections in people 40 years and older than there were in people under that age, and that the fatality rate of avian influenza was just 32 percent in the older age group but 59 percent in the younger group.
The researchers, therefore, suggest that repeated exposure to seasonal influenza viruses or flu vaccinations may have resulted in cytotoxic T-cell immunity to avian influenza, and that the same type of immunity may also have developed in people exposed to the H1N1 virus.
Funding for this study was provided by grants from the Department of Homeland Security’s National Center for Foreign Animal and Zoonotic Disease Defense, and by the UC Davis Center for California Food Animal Health.
About UC Davis
For 100 years, UC Davis has engaged in teaching, research and public service that matter to California and transform the world. Located close to the state capital, UC Davis has 31,000 students, an annual research budget that exceeds $500 million, a comprehensive health system and 13 specialized research centers. The university offers interdisciplinary graduate study and more than 100 undergraduate majors in four colleges — Agricultural and Environmental Sciences, Biological Sciences, Engineering, and Letters and Science — and advanced degrees from six professional schools — Education, Law, Management, Medicine, Veterinary Medicine and the Betty Irene Moore School of Nursing.
Media contact(s):
•Carol Cardona, School of Veterinary Medicine, (530) 754-5041, cjcardona@ucdavis.edu
•Pat Bailey, UC Davis News Service, (530) 752-9843, pjbailey@ucdavis.edu
http://www.news.ucdavis.edu/search/news_detail.lasso?id=9255
Near Half of Swine Flu Patients Otherwise Healthy
CDC: Nearly half of patients hospitalized for swine flu had no other underlying conditions
By MIKE STOBBE AP Medical Writer
ATLANTA October 13, 2009 (AP) The Associated Press
The largest U.S. analysis of adult hospitalized swine flu patients has found that 46 percent did not have asthma or any other underlying condition.
Health officials looked at 1,400 adult swine flu hospitalizations in 10 states. A Centers for Disease Control and Prevention official released some of the details at a Tuesday press conference.
The CDC has said most swine flu-infected people who have grown severely ill had underlying conditions, but the new details suggest it may not be a large majority.
CDC officials added that it’s preliminary data, and obesity was not classified as an underlying condition.
http://abcnews.go.com/Health/wireStory?id=8818376
Indiana:
Influenza A cases rise as area schools fight back
Tuesday, 13 October 2009
By Rusty Nixon Correspondent
http://www.thepilotnews.com/content/view/131772/27/
PLYMOUTH — Flu-re-lated illnesses are higher than expected for this time of year — according to the Center For Disease Control — and school officials in the area remain wary of the H1N1 virus with a rash of cases that could be attributed to the illness.
Last week cases of “Influenza A” were confirmed around the area, along with the death of a junior high student in South Bend due to “flu-like symptoms.” It started all schools preparing to help students beat the virus.
One mother and son — Donna Babcock and son Isaac, a student at Riverside Intermediate in Plymouth — are going to be together for at least the next week. Isaac’s doctor in Valparaiso confirmed that he has the Influenza A strain and told his mother to keep him home for seven to 14 days.
“He came home Thurs-day and was running a fever of about 103.6 and feeling very tired,” said Babcock. “I couldn’t get his fever down. I was up with him all night. They had us take him straight to the hospital (in Valparaiso), they gave him a throat and nose swab and a blood test. The nurse told me that he has influenza A and it’s 99.9 percent certain that he has H1N1.”
Thankfully Isaac is doing better but he still looks to be out of commission for a while longer.
“I’m trying to keep Pedialyte and Gatorade in him but like any kid he’s begging for Sierra Mist,” said Donna. “I just want parents to know this is out there so they can watch out for it.”
Plymouth Schools have been watching for it encouraging proper sneezing and coughing protocols — in the sleeve and not the hand — using of hand sanitizer and staying away from school if you are exhibiting flu symptoms. Attendance offices in the school corporation continued to gather information about symptoms from those calling in sick.
“Actually absenteeism has dropped — except for Riverside — where it’s gone up from last week,” said Plymouth School Superintendent Dan Tyree. “We’re washing everything thing down as much as we can, making sure surfaces and classrooms are disinfected every night as much as possible.”
Representatives of the Marshall County Health Department were unavailable for comment before press time. Last week, Administrator Wes Burden said that he would be able to order the much-anticipated vaccine for H1N1 last Friday. He said the CDC and Indiana Department of Health were unclear as to exactly when the first vaccine would be available in Marshall County.
Burden said his department would target schools, and pre-schools in the first wave of distribution.
“We’re going to do the best we can and hopefully we’ll have some vaccine soon,” said Tyree.
FL:
First swine flu-related death in Lake County confirmed
47-year-old man was at risk for flu complications
Fernando Quintero
Sentinel Staff Writer
1:31 PM EDT, October 13, 2009
http://www.orlandosentinel.com/news/local/lake/orl-swine-flu-death-lake-101309,0,3172289.story
A 47-year-old man became the first person in Lake County to die from swine flu-related complications, health officials announced today.
UK:
Swine flu vaccine should be available in east by Christmas
Last updated: 13/10/2009 16:19:00
http://www.cambs24.co.uk/content/cambs24/news/story.aspx?brand=HPTOnline&category=News&tBrand=Cambs24&tCategory=xDefault&itemid=WEED13%20Oct%202009%2016%3A22%3A16%3A477
A VACCINE against swine flu is expected to become available in the eastern region by Christmas.
Thx for the pings.
thanks for your pings too :)
Anywhere here is my neck of the woods...
Thurston Schools Suffer Apparent Swine Flu Outbreak
And I guess they closed a school in Seattle too.
It is definitely out here and with us.
Prayers, please. Oldest is off to Urgent Care after being diagnosed with a probable last Monday. Was back at school for 2 days and now has a temp of 103 and cough is much worse.
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