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

Girl, 5, presumed healthy, dies of swine flu - CA

UNION-TRIBUNE
3:20 p.m. October 14, 2009

SAN DIEGO – A 5-year-old girl with no known underlying medical conditions has died of swine flu, San Diego County health officials said Wednesday.

Officials with the county’s Health and Human Services Agency scheduled a news conference Wednesday afternoon to discuss the case. No further details were immediately available, including where in the county the girl lived.

Dr. Wilma Wooten, county public health officer, and Dr. John Bradley, director of the Division of Infectious Disease for Rady Children’s Hospital, will attend the news conference.

So far, 332 county residents have been hospitalized with H1N1 influenza, officials said. There have been 24 deaths of county residents associated with H1N1, plus three deaths of non-residents.

Health authorities said anyone with influenza-like illness or symptoms should stay home from work or school. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue.

For additional information on swine flu, see www.sdcounty.ca.gov or www.cdc.gov or call 2-1-1 San Diego

http://www3.signonsandiego.com/stories/2009/oct/14/bn14flu-girl-dies/?metro&zIndex=182778
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3 people with swine flu die in Utah

Associated Press - October 14, 2009 6:35 PM ET

SALT LAKE CITY (AP) - Utah health officials say three people with swine flu have died in the last week.

The Utah Department of Health also says 127 people have been hospitalized either with the H1N1 virus or the seasonal flu. Officials say that number is unusual so early in the flu season.

Meanwhile, the injectable form of the swine flu vaccine has arrived in Utah.

Salt Lake Valley Health Department officials plan to make the vaccine available at four clinics on Thursday.

The injectable form, for now, is reserved for children 4 and younger.

The Bear River Health Department in Logan has also received its first shipment of injectable vaccine.

Officials have closed Cleveland Elementary School in Emery County for the rest of the week after about half of its 190 students stayed home sick Tuesday, many reporting flulike symptoms. It’s unclear how many might have swine flu.

http://www.localnews8.com/Global/story.asp?S=11316160

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The Salt Lake Tribune

Updated: 10/14/2009 04:39:01 PM MDT

Since the beginning of September, the deaths of three Utah women have been linked to the H1N1 swine flu and 127 Utahns have been hospitalized.

And Utah’s rate of influenza-like illness, as assessed by the state Health Department, has been above the “outbreak” level for the second consecutive week, officials announced Wednesday.

“If you think of an outbreak occurring on a bell-shaped curve, we appear to be at the base of what could be a steep climb to the peak,” said Rachel Herlihy, the department’s deputy state epidemiologist.

The women were from Salt Lake, Utah and Weber counties. These are the first deaths to occur in the 2009-10 flu season.

The severity of Utah’s cases does not appear to have changed — instead, more people are becoming ill with H1N1 flu, so more are developing severe illnesses, state officials explained.

Each of the state’s 12 local health departments is setting its own policy for distributing the limited supply of H1N1 vaccine in the state. Generally, only certain age groups currently qualify for vaccination.

“It makes the most sense for us to vaccinate those who are high risk first,” said Gary Edwards, executive director of the Salt Lake Valley Health Department. “We hope the public will be patient, understanding that over the next few weeks we should have enough vaccine to start immunizing everyone who falls into a priority group.”

http://www.sltrib.com/news/ci_13561188

Health Care Workers Calling in Sick - WI

Updated: Oct 14, 2009 7:11 PM EDT
By Sarah Thomsen

Prevea says it’s never seen anything like this — hundreds of people every day coming in to clinics with the flu.

Now health care workers are getting sick, forcing Prevea to hire more doctors just to keep up.

When you go to the doctor, the first person to great you is the patient services representative. Now people like Judy are the ones getting sick. Tuesday 20 of her coworkers stayed home.

“We have a lot of staff members having to go home or not come in because they’re running fevers,” Dr. Ashok Rai, Prevea president/CEO, said.

“It’s tough, supply versus demand. Right now the demand is really high right now and supply is even getting sick.”

Prevea is seeing so many patients and sick health care workers, they’re bringing in temporary providers and hiring more doctors.

“We were planning on it anyway because we’re a growing company so we have more and more volumes, but right now in areas I’m kind of re-shuffling providers to kind of meet the demand,” Rai said.

Prevea says it’s seeing record numbers of patients with the flu or similar viruses needing to be seen, especially in pediatrics and urgent care.

To give you an idea just how busy Prevea has been, at just one urgent care location the health care workers treated 130 patients in an eight-hour period.

“And wait times are a little longer than they are. We don’t want anybody to ever have to wait, but right now with the amount of illness, it is very bad,” Rai said.

Wednesday Prevea was giving out its first H1N1 shots to health care workers, hoping to keep them as healthy as possible so they’re ready and able to treat other sick patients.

http://www.wbay.com/Global/story.asp?S=11316397

Severe Swine Flu Could Lead to Blood Clots in Lungs: Study

HealthDay News
4:00 p.m. Wednesday, October 14, 2009
http://www.ajc.com/health/severe-swine-flu-could-162969.html

People who are severely ill with the H1N1 swine flu run the risk of blood clots in the lungs, University of Michigan researchers say.

And because standard chest X-rays may not be able to spot the potentially fatal condition, more sophisticated CT scans may be needed to identify the risk, the researchers said.

Technically called a pulmonary embolism, the condition occurs when one or more arteries in the lungs become blocked. Aggressive use of blood-thinning drugs can reduce the risk of death, the researchers said.

“The high incidence of pulmonary embolism is important. Radiologists have to be aware to look closely for the risks of pulmonary embolism in severely sick patients,” study lead author Dr. Prachi P. Agarwal, assistant professor of radiology at the University of Michigan Medical School, said in a university news release.

“With the upcoming annual influenza season in the United States, knowledge of the radiologic features of H1N1 is important, as well as the virus’s potential complications. The majority of patients with H1N1 that undergo chest X-rays have normal radiographs. CT scans proved valuable in identifying those patients at risk of developing more serious complications as a possible result of the H1N1 virus,” he added.

The Michigan study included 66 patients diagnosed with the H1N1 swine flu; 14 of those were so sick they had to be admitted to the intensive-care unit.

All 66 patients underwent chest X-rays to look for problems caused by the H1N1 virus. Pulmonary embolisms were detected by CT scans in five of the 14 intensive-care unit patients. The researchers added that initial chest X-rays were normal in more than half of the patients with H1N1 infections.

“These findings indicate that imaging studies would have to be repeated in severely ill patients to monitor disease progression,” said study co-author Dr. Ella Kazerooni, director of the University of Michigan’s division of cardiothoracic radiology. “It’s important to heighten awareness not only among the radiologists, but also among the referring clinicians.”

The study findings are to be published in the December issue of the American Journal of Roentgenology.

[snip]

On Tuesday, a leading disease-surveillance expert from Europe reported that the swine flu is killing fewer people than seasonal flu, but is causing greater alarm because it’s targeting an unusually large number of children, who typically are less susceptible to flu than older adults.

Denis Coulombier, head of the European Centre for Disease Prevention and Control’s preparedness and response unit, told the Agence France-Presse news service that the H1N1 swine flu has killed a very small proportion of those infected with the virus — about 0.2 to 0.3 deaths per 1,000. That compares to a fatality rate from seasonal flu of roughly one patient per 1,000, he said.

Also on Tuesday, a U.S. health official said that, while the majority of people hospitalized with the H1N1 swine flu have chronic medical conditions, many were healthy before coming down with the disease.

More than half of hospitalized adults had conditions such as asthma, chronic lung diseases, heart disease or immune system disorders, Dr. Anne Schuchat, director of the U.S. Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said during a press conference.

But, she added, “This virus can be serious even in people with no underlying conditions.”

Health experts warn about flying with the flu

12:58 PM CDT on Wednesday, October 14, 2009
By STEVE STOLER / WFAA-TV
http://www.wfaa.com/sharedcontent/dws/news/localnews/tv/stories/wfaa091014_wz_swinefluplanes.216f4aa64.html

D/FW AIRPORT — When it comes to swine flu, airlines say their jets and planes are as safe as trains and schools.

The nation’s carriers are already taking precautions, and soon they may start doing health screenings at U.S. airports.

The advice from health experts continues to be: If you are feeling sick from swine flu symptoms, stay home. But what if you’re away from home and facing expensive delays in your travel plans?

That was Kimberly Koschital’s dilemma recently when her 18-month-old girl Kendall woke up sick.

“She was cranky; her fever hit about 103,” Koschital said.

Kendall’s mom wanted to reschedule their flight back to Atlanta, but making the change would have cost $500 for a one-way ticket, including a cancellation fee.

After Kendall Koschital fell ill, her mom was able to postpone their flight to Atlanta. “I was rushing there, nervous, crying,” Koschital said. “What do I do? Do I put her on the plane? Do I not put her on the plane? What if someone else is sick there? What if she gives somebody something? What if somebody gives her something worse?”

Finally, the airline offered the frantic mom some help. They rescheduled her on a Monday flight with no added fees.

But Koschital wonders how many others are facing the same tough choices.

“What do you do? Do you take your sick kids on a plane or you don’t?” she asked. “What if the airlines won’t let your kid on the plane? What do you do?”

Overseas, airlines are already conducting health screenings at airports.

“In China, for example, when I arrived there, they are checking people right on the plane,” said international traveler Oliver Schmid.

Signs now in place at Dallas/Fort Worth International Airport security areas warn passengers about the H1N1 swine flu virus, advising anyone with symptoms to stay at home or avoid close contact with others.

The situation is making passengers like Curtis Pulley very uncomfortable. “On my flight out here last week, there was someone on the plane who was coughing,” he said.

Kimberly Koschital said flying with her sick daughter just wasn’t worth the risk. “I’d rather her be healthy than have to go through this,” she said.

Airlines can stop someone from boarding a jet if they have a disease that can spread to others.

Some carriers are now stowing blankets and pillows to limit transmission of germs.

E-mail sstoler@wfaa.com

NY:

Swine flu death in Clinton County

Last Update: 4:13 pm
http://www.13wham.com/news/state/story/Swine-flu-death-in-Clinton-County/voTl-jEpn0e9rCwQ7Ok7Sw.cspx

ALBANY, N.Y. (AP) — Health officials say an adult in upstate New York has died after contracting swine flu.

The Clinton County Health Department says that the person who died had underlying health conditions. Officials refused Wednesday to release the person’s name, gender or other information.

The person was admitted to Champlain Valley Physicians Hospital in Plattsburgh for flu symptoms.

County and state health officials are encouraging New Yorkers to take the usual seasonal precautions, including regular hand washing and getting vaccinated.

Middletown Will Hold Clinic Thursday

POSTED: 4:21 pm EDT October 13, 2009
UPDATED: 9:49 pm EDT October 13, 2009
http://www.wfsb.com/health/21285878/detail.html

MIDDLETOWN, Conn. — As the new H1N1 vaccine makes its way into Connecticut, flu clinics are popping up all over the state and they are going to be vaccinating the youngest residents first.

The city of Middletown will be holding an H1N1 flu clinic for healthy children between the ages 2 and 4 later on this week. Officials plan to offer the vaccine in schools as soon as more shipments arrive.

The H1N1 flu virus is on the minds of many people in Connecticut, including doctors.

Dr. Joe Havlicek is encouraging parents in and around Middletown to sign their children up for the city’s first H1N1 flu clinic for children.

Currently there are about 700 doses of the nasal vaccine with hopes that more will be shipped as soon as possible.

Havlicek said, “My worry is that the virus could change this winter and become more virulent.”

Middletown is not the only city that has plans to hold flu clinics for kids.

The following is a list of schools that responded to Eyewitness News’ question about flu clinics. If your school is not listed, then Channel 3 Eyewitness News suggests that you get in contact with the school for more information.

Pine Point/Stonington:” We are coordinating with and being guided by Ledge Light Health Department. They have been excellent throughout the process of information updates and planning strategy.”

Danbury Public Schools:” We hope to partner with the health department to offer some vaccine for kids in school, but we won’t know much more until we get specifics on how much the vaccine will cost.

Mill Hill Elementary/Southport:” We are not expecting to receive doses at the school for children or for staff.”

Darien Public Schools::” All information on H1N1 is released from the superintendent’s office. You can check the website for latest updates.”

Har-Bur Middle School/Burlington:” Our position is to work with the Bristol Health District and the Torrington Health District to make our schools available during after school hours for the community if they wish to get the vaccine. Parents could bring their children to the school to get the vaccine.”

Granby Memorial High School/Granby:” Granby does not have plans at the moment. The board has discussed the possibility and if we do offer a flu clinic it would be during after school hours.”

Pomfret Community School/Pomfret:” Our hope is to administer the H1N1 vaccine to our students. A final decision will be made on the matter on Wednesday, October 14th.”

Country School/New Canaan:” The school is not getting the vaccine. We recommend that families ask their pediatricians for guidance in this regard.”

Ethel Walked/Simsbury:” We are registered with CT Dept. of Public Health. They have given us no specific date of delivery. Younger students will be the first to get them. Parents must provide us with a consent form to give the shot.”

Windham Public Schools:” The school-based health center program for Windham Public schools is currently offering seasonal flu vaccine for all students enrolled in the SBHC program and who qualify for the State of CT Vaccine for Children (VFC) program.”

Sterling School/Sterling:” We will not know when the H1N1 vaccine will be distributed until October 15th.”

Rocky Hill Public Schools:” We are not expecting the vaccine at our schools.”

Preston Public Schools::”Preston Veterans Memorial School will be running a flu clinic next weekend.”

Madison public Schools:” The H1N1 flu vaccine is expected to be available for school children. There are no dates set at this time; you will be notified when they become available.”

Danbury Public Schools:” At this time we are putting plans in place for the vaccine to be administered to all of our students. The vaccine has been ordered and we are waiting for it to come in.”

Complication of H1N1 flu includes pulmonary emboli

Submitted by Kathleen Blanchard RN on Oct 15th, 2009
http://www.emaxhealth.com/1020/39/34118/complication-h1n1-flu-includes-pulmonary-emboli.html

A study published online Oct. 14, 2009, in the American Journal of Roentgenology warns that H1N1 flu can cause pulmonary emboli. The study authors suggest evaluation with CT scan for the presence of pulmonary emboli (blood clots in the lungs) when caring for patients diagnosed with respiratory complications from H1N1 flu.

Blood clots in the lungs can lead to death. The current study suggests that patients should be screened for pulmonary emboli using CT scan. The findings are based on examination of 61 patients diagnosed with H1N1 flu at University of Michigan Health Service.

Fourteen patients from one group studied were admitted to ICU – five had developed pulmonary emboli. A second group of 52 patients were also included in the study with H1N1 flu but not admitted to ICU.

According to Prachi P. Agarwal, M.D., lead author of the study, “Our study suggests that patients who are severely ill with H1N1 are also at risk for developing PE [pulmonary embolus], which should be carefully sought for on contrast-enhanced CT scans.”

The study authors also say that most patients with H1N1 flu have normal chest-x-rays, but it is important to recognize the potential complication of pulmonary emboli. Blood clots in the lung from H1N1 flu require aggressive treatment with blood thinners (anticoagulants).

Volunteer ’Flu Fighters’ to hit streets in NYC

ASSOCIATED PRESS
Last Updated: 1:21 PM, October 14, 2009
Posted: 1:20 PM, October 14, 2009
http://www.nypost.com/p/news/local/volunteer_flu_fighters_to_hit_streets_Z69rw0x1R4X78WjXuJ7pvO

Some 800 volunteers will help New York City health authorities spread the word about getting vaccinated for both swine flu and seasonal flu.

Mayor Michael Bloomberg announced the “Flu Fighters” program on Wednesday.

The volunteers will help manage the flow of people in and out of weekend vaccination centers that will be set up around the city. They will also distribute posters and brochures about the importance of getting vaccinated.

New Yorkers who want to volunteer can visit www.nyc.gov or call 311.

Wanna Get Swine Flu?

Posted at 3:32PM on Oct 14, 2009
http://cityfile.com/dailyfile/7562

If you’re going to eventually catch swine flu anyway, you might as well perform a little volunteer work in the process. Earlier today, Mayor Bloomberg announced a “Flu Fighters” program, which will recruit 800 volunteers to help the city spread the word about getting vaccinated for both swine flu and seasonal flu. Among other things, volunteers will be asked to help “manage the flow of people in and out of weekend vaccination centers that will be set up around the city.” This will bring you into contact with thousands of totally random (and possibly infected) New Yorkers, and you’lll ost likely fall ill a few days later. But the city will thank you for your service. And at least you can now coordinate your H1N1 infection around your busy schedule, which isn’t such a bad thing. [NYC.gov, AP]

CT:

Flu vaccine distribution mishandled

Updated: 10/14/2009 04:52:46 PM EDT
http://www.newstimes.com/search/ci_13560670?IADID=Search-www.newstimes.com-www.newstimes.com

Starting this week, doctors are appropriately receiving the first shipments of the H1N1 vaccine (also referred to as swine flu), but distribution of the seasonal flu vaccine is being handled much differently. Medical practices across Fairfield County are receiving only a fraction of their orders for the seasonal flu vaccine, which is equally important for high-risk patients.

Instead, much of the initial seasonal flu vaccine has been sent to pharmacies, grocery stores and other large-scale outlets where the sick, the elderly and the frail should not visit.

From a public health perspective, it makes little sense to give priority distribution of the H1N1 vaccine to physicians and not do the same for the seasonal flu vaccine. Since doctors are on the front line in caring for the most fragile of patients, they should be first in line to receive both flu vaccines. There is a precedent for this type of action. Under the settlement agreement that has just been reached with Attorney General Richard Blumenthal, who raised similar concerns on behalf of the Visiting Nurses Associations, at least one vaccine manufacturer will now double the amount of seasonal flu vaccine distributed to the VNAs. Physicians also should have priority access to the seasonal flu vaccine.

We are concerned overly anxious, high-risk patients may feel compelled to get their seasonal flu shot in an environment that is less favorable to their health.

Mark S. Thompson

Executive Director,
Fairfield County Medical Association

Number of A/H1N1 flu cases rises to 10 in Turkish primary school

www.chinaview.cn 2009-10-15 07:19:25
http://news.xinhuanet.com/english/2009-10/15/content_12234524.htm

ANKARA, Oct. 14 (Xinhua) — Turkey’s Health Ministry said Wednesday five more people were diagnosed with the A/H1N1 flu in a primary school in the capital city Ankara, bringing the number of infected there to 10.

The ministry said the first five people, including two parents and three students, had been diagnosed with the flu in the Bilkent University Preparatory School Elementary School, the semi-official Anatolia news agency said.

One of the infected students returned to Turkey from Scotland and was hospitalized after symptoms of the flu were detected, it said.

The ministry said late Tuesday the school was closed for a week and would be disinfected, the Turkish newspaper Hurriyet Daily News reported Wednesday.

Turkey has seen 411 A/H1N1 flu cases as of Oct. 8, with no death reports, according to Anatolia.

Swine flu claims sixth life; hospital sets up triage tents

BY JAMES BURGER, Californian staff writer
jburger@bakersfield.com | Wednesday, Oct 14 2009 06:06 PM
Last Updated Wednesday, Oct 14 2009 06:06 PM

A 25-year-old woman died Tuesday from complications of the H1N1 flu virus, which has put 66 Kern County residents in the hospital this year, said Public Health Services Director Matt Constantine.

The woman’s story is likely to be repeated here as the fall flu season continues.

Over the last week, the emergency room at Memorial Hospital has seen record volumes of patients. Hospital Director of Emergency Services Jennifer Cook said the emergency department is handling between 210 and 230 patients.

That breaks records swine flu recorded in May when the hospital’s previous highest attendance of 180 was shattered by a 207-patient day.

Overwhelmed by the numbers, the hospital on Wednesday moved its triage and treatment functions for flu patients into tents in the doctor’s parking lot.

Patients with mild to moderate flu symptoms are evaluated immediately and treated in the tents, given prescriptions to handle their symptoms and discharged with instructions to go home, stay home, sleep a lot, drink a lot of fluids and stay away from healthy people, Cook said.

The tents, Cook said, keep sick people away from other emergency room patients and relieve the cramped conditions in the emergency room halls and waiting room.

“We needed to cohort the patients who have those flu-type symptoms,” Cook said. “They’re not getting any different care than they would get in the emergency department.”

Seriously ill patients with high fevers and other conditions like pneumonia, who cannot care for themselves, are being admitted to the hospital.

By Wednesday afternoon, Cook said, 30 people had been treated and released through the tents — a total slowed a bit by light rain.

Kern Medical Center has also changed procedures to handle rising worry about the “swine flu.”

Restricted visitation rules to fight the spread of the disease have actually been well-received by patients, said CEO Paul Hensler.

“Our visitors and patients have been surprisingly understanding. I really thought there would be more concern,” Hensler said. “I think they really understand it’s for their protection.”

Public Health has also been swamped with inquiries about the illness.

“We’re getting a number of calls — just a tremendous number - so much so that we’ve had to bring in people to answer phones,” Constantine said.

And the agency distributed all of the 2,000 doses of H1N1 nasal mist vaccine it received last week in a couple well-attended public clinics.

Patients waiting for the clinic on Saturday were lined up in a great loop around the parking lot of the Public Health building.

Hensler still has not received any of the H1N1 vaccine at KMC, but he stockpiled doses of the more traditional seasonal flu vaccine and has been able to weather a recent shortage on the non-H1N1 cure.

The California Department of Public Health said it will have an update Thursday on pandemic influenza and the vaccine delivery status for both seasonal flu and H1N1 flu.

Other health care organizations are dealing with different flu-related complications.

Steve Schilling, CEO of Clinica Sierra Vista, said he received 1,400 doses of the H1N1 nasal mist vaccine. What he’s running short of is the seasonal flu shot.

“What last drop we have of our stockpile is going out as we speak — it’ll be gone by the end of the week,” he said.

http://www.bakersfield.com/news/local/x1675932698/Swine-flu-claims-sixth-life-hospital-sets-up-triage-tents

25 students on school trip reportedly got H1N1 flu

by Edythe Jensen - Oct. 14, 2009 05:22 PM
The Arizona Republic .

More than 25 students on a recent Southeast Valley school bus field trip contracted the H1N1 flu, Assistant Fire Chief Marc Walker said. The incident is giving Chandler emergency workers another sign that things could get worse in coming weeks and residents must be more vigilant to prevent spreading the disease, Walker said.

Walker briefed the Chandler Neighborhood Advisory Commission on Tuesday, telling members that the city is prepared for an outbreak that could sicken nearly half of the population before the end of the year, leaving government offices, hospitals and businesses seriously understaffed.

The assistant chief learned of the post-field trip outbreak from another firefighter whose children were on the trip, became ill and tested positive for the virus.

Walker said outside the commission meeting that it was in the Chandler Unified School District trip but that he did not know which school sponsored the excursion. On Wednesday, Fire Chief Jeff Clark said the field trip was from a Southeast Valley school but not one in the Chandler district. He declined to name the institution.

“It is not our place as a fire department to release information about another school district,” he said.

Walker said the firefighter whose children became ill after the trip “is not comfortable releasing family medical information” or the school’s identity.

Terry Locke, spokesman for the Chandler Unified School District, said he hadn’t heard about the illnesses, and campuses are no longer required to report H1N1 cases to district officials.

The district has stepped up efforts to educate parents and students about preventative measures like hand-washing and keeping ill students home.

Walker said the city is developing a system to report and track cases of H1N1 among municipal employees. Chandler has become more vigilant lately about sanitizing work surfaces and conference areas used by multiple employees and educating workers about healthful practices. “Don’t shake hands if you don’t have to,” he said.

“We’re at the beginning of a four- to eight-week cycle,” Walker told the commission, urging them to spread information in neighborhoods about stepped-up sanitation practices, vigilant hand-washing and staying home from work or school when ill.

The new flu strain is expected to be more disruptive than others because people lack natural immunity and few have been vaccinated. The first 200 doses of the vaccine to arrive in Chandler will come this week and be given to firefighters, Walker said.

The next batch won’t come until November and will likely be set aside for pregnant women and young children.

Chandler also is preparing for the possibility of having to temporarily cut services or close some libraries to preserve critical municipal functions if large numbers of employees call in sick. Personnel shortages could bring cuts to bus and light-rail services and will likely affect staffing in stores, banks, doctors’ offices and hospitals, Walker said. Supplies of prescription anti-viral medications are being depleted at local drug stores; so are their stocks of over-the-counter cold and flu medicines, he told the commission.

http://www.azcentral.com/news/articles/2009/10/14/20091014cr-flu1016.html

Flu bug bites LeBron, Cavaliers

Reigning NBA MVP LeBron James missed Wednesday night’s exhibition game.
AP

CLEVELAND (AP) — The flu bug has bitten LeBron James and the Cleveland Cavaliers.

James will miss the club’s final home exhibition game against the Washington Wizards on Wednesday night because of flu-like symptoms that have been bothering him for several days. Forward Darnell Jackson and guard Coby Karl were also out with the flu.

James and his two teammates were told to stay home so they don’t spread the flu.

As a standard precaution, all of the players will be tested for the H1N1 virus, team officials said.

The NBA’s reigning MVP, James has been under the weather for the past few days. He was sent home from practice on Tuesday and was not at the Wednesday morning shootaround.

In addition, the Cavaliers will be without guards Mo Williams (groin), Delonte West (personal reasons) and forward Danny Green (leg bruise).

West returned to practice this week with the Cavs, who allowed him to leave the team to attend to medical and personal issues. West has been treated for bipolar disorder, and last month he was arrested near his home in Maryland on misdemeanor weapons possession charges.

During media day, West indicated he had stopped taking his medications this summer.

The Cavaliers gave West the option of working out at Quicken Loans Arena or staying at the team’s training facility in Independence. He chose to stay at Cleveland Clinic Courts.

Coach Mike Brown said there is no timetable for West to make his preseason debut.

“I’m literally taking it one day at a time,” Brown said. “I haven’t thought much about it except to make sure he is OK.”

http://sportsillustrated.cnn.com/2009/basketball/nba/10/14/Cavaliers.James.ap/index.html?eref=si_topstories
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