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.

Swine flu ’killing 11% of infected patients’
Tuesday, November 03, 2009 - 09:21 PM

Swine flu is killing more than a tenth of those it infects in California and up to 20% of older victims, a study has shown.

Researchers in the US state also found almost a third of cases required intensive care treatment. Hospital admissions and death could occur “at all ages”.

The findings, published in the Journal of the American Medical Association (Jama), fly in the face of common perceptions of swine flu being a generally mild illness.

The US researchers looked at 1,088 cases of swine flu reported in California between April 23 and August 11 this year.

Of these, 32% were children under the age of 18, with infants having the highest rates of hospital admissions. The midpoint age of patients was 27.

In total, 340 patients (31%) were admitted to hospital intensive care units. Of the 297 intensive care cases for whom information was available, 65% required mechanical ventilation.

Chest X-rays of 833 patients revealed indications of pneumonia or acute respiratory distress syndrome.

The researchers recorded 118 deaths. Fatalities were most common among people aged 50 and over, who had a mortality rate of between 18% and 20%. Seven per cent of deaths were among children younger than 18.

Among fatal cases, it typically took just 12 days after the onset of symptoms for the patient to die. The most common causes of death were viral pneumonia and acute respiratory distress syndrome.

The authors, led by Dr Janice Louie from the California Department of Public Health, wrote: “In contrast with the common perception that pandemic 2009 influenza A (H1N1) infection causes only mild disease, hospitalisation and death occurred at all ages, and up to 30% of hospitalised cases were severely ill.”

Most patients admitted to hospital had underlying health problems, including high blood pressure and obesity, said the scientists. They suggested obesity might be a newly identified risk factor for fatal swine flu infection.

The researchers added: “Clinicians should maintain a high level of suspicion for pandemic 2009 influenza A (H1N1) infection in patients presenting currently with influenza-like illness who are older than 50 years or have known risk factors for influenza complications, regardless of rapid test results. Hospitalised infected cases should be carefully monitored and treated promptly with anti-viral agents.”

The 11% refers to hospitalised patients.

Here is the abstract of the study:

Factors Associated With Death or Hospitalization Due to Pandemic 2009 Influenza A(H1N1) Infection in California
http://jama.ama-assn.org/cgi/content/short/302/17/1896?home

Janice K. Louie, MD, MPH; Meileen Acosta, MPH; Kathleen Winter, MPH; Cynthia Jean, MPH; Shilpa Gavali, MPH; Robert Schechter, MD, MPH; Duc Vugia, MD; Kathleen Harriman, PhD; Bela Matyas, MD; Carol A. Glaser, MD, DVM; Michael C. Samuel, DrPH; Jon Rosenberg, MD; John Talarico, DO, MPH; Douglas Hatch, MD; for the California Pandemic (H1N1) Working Group

JAMA. 2009;302(17):1896-1902.

Context Pandemic influenza A(H1N1) emerged rapidly in California in April 2009. Preliminary comparisons with seasonal influenza suggest that pandemic 2009 influenza A(H1N1) disproportionately affects younger ages and causes generally mild disease.

Objective To describe the clinical and epidemiologic features of pandemic 2009 influenza A(H1N1) cases that led to hospitalization or death.

Design, Setting, and Participants Statewide enhanced public health surveillance of California residents who were hospitalized or died with laboratory evidence of pandemic 2009 influenza A(H1N1) infection reported to the California Department of Public Health between April 23 and August 11, 2009.

Main Outcome Measure Characteristics of hospitalized and fatal cases.

Results During the study period there were 1088 cases of hospitalization or death due to pandemic 2009 influenza A(H1N1) infection reported in California. The median age was 27 years (range, <1-92 years) and 68% (741/1088) had risk factors for seasonal influenza complications. Sixty-six percent (547/833) of those with chest radiographs performed had infiltrates and 31% (340/1088) required intensive care. Rapid antigen tests were falsely negative in 34% (208/618) of cases evaluated. Secondary bacterial infection was identified in 4% (46/1088). Twenty-one percent (183/884) received no antiviral treatment. Overall fatality was 11% (118/1088) and was highest (18%-20%) in persons aged 50 years or older. The most common causes of death were viral pneumonia and acute respiratory distress syndrome.

Conclusions In the first 16 weeks of the current pandemic, the median age of hospitalized infected cases was younger than is common with seasonal influenza. Infants had the highest hospitalization rates and persons aged 50 years or older had the highest mortality rates once hospitalized. Most cases had established risk factors for complications of seasonal influenza.

This is a confirmation of this little guy, Jared Peters: http://www.singtomeohmuse.com/viewtopic.php?p=259712&highlight=pembroke#259712

Pembroke student dies from Swine Flu
The family of a Pembroke Intermediate School student has confirmed to News 10NBC that their son, Jared Peters, died from a confirmed case of H1N1 influenza.

Peters was 10 years old and a fifth grade at the school. He died in late October. His family did not want to speak with us today on camera.

Gary Mix, Superintendent of the Pembroke schools released a statement today saying the school district has seen a minimum increase in their absence rate. Over the last 15 days, 6.1% of students were absent.

Interim Director of the Genesee County Health Department Randolph Garney says the county received the test results late Monday afternoon from the state health lab.

Garney says the spread of H1N1 (swine flu) is on the rise among children in Genesee County. “We’ve seen in the last couple of weeks an increase in absenteeism in schools,” said Garney. “In one school district it was 20% on one particular day when normally for that period 4% absenteeism occurs.”

Garney said there will be a clinic for H1N1 vaccinations Thursday from 2-4pm at the health department at County Office Building #2 in Batavia.

The priority groups recommended by the Centers for Disease Control and Prevention to receive the 2009 H1N1 influenza vaccine include:

· Pregnant women.
· Household contacts and caregivers for children younger than 6 months of age.
· Health care and emergency medical services personnel.
· All people from 6 months through 24 years of age.
· Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

The Genesee County Health Department advises residents to practice these strategies to decrease the spread of H1N1 in our community:

· Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it and then wash your hands.
· Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleansers are also effective.
· Avoid people who are ill.
· Avoid touching your eyes, nose or mouth since germs can spread that way.
· If you have influenza-like illness (fever >100°F with cough or sore throat) stay at home for at least 24 hours after your fever goes away, without using any fever-reducing medications such as acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin, Advil).
· Clean shared space more often such as phone receivers, keyboards, steering wheels and office equipment.

The Genesee County Health Department can be reached at (585) 344-2580 ext. 5000.

Click here for the Genesee County Health Department website.

http://www.whec.com/news/stories/S1229842.shtml?cat=572

British Columbia, Canada.

These are 3 new deaths. Two of them were recognized in the PHAC update tonight.

Swine Flu wave in B.C. kills three, sends 162 to hospital in one week
http://www.vancouverite.com/2009/11/03/swine-flu-wave-in-b-c-kills-three-sends-162-to-hospital-in-one-week/

Swine Flu has killed three more in B.C. and sent an additional 162 people to hospital in one week, the ministry of health announced on Tuesday.

A total of six people have died in two weeks while the number of people hospitalized rises to 250 in two weeks. 12 more were admitted to ICU.

B.C. has been in the centre of the second Swine Flu wave in the past four weeks with deaths and hospitalizations rising dramatically.

“Since Oct. 27, there have been 162 new severe cases of H1N1 identified in B.C. – seventy-nine in Fraser Health, fifty in Vancouver Coastal Health, seventeen in Interior Health, eight on Vancouver Island and eight in Northern Health – with three new deaths, two in Fraser Health and one in Vancouver Coastal Health,” the ministry announced.

· Since Oct. 27, there have been 162 new severe cases of H1N1 identified in B.C., with three new deaths.

· In total, BC Centre for Disease Control (BCCDC) has confirmed 361 severe H1N1 cases in British Columbia since April 2009, including:

o One hundred and sixty-six in Fraser Health, including nine deaths.

o Forty-eight in Interior Health, including three deaths.

o Fourteen in Northern Health.

o One hundred and ten in Vancouver Coastal Health, including two deaths.

o Twenty-three on Vancouver Island, including one death.

· Of these 361 lab-confirmed cases admitted to hospital, 63 have been admitted to the ICU. Twelve new cases have been admitted to the ICU in the last week.

· To date, fifteen laboratory-confirmed H1N1 cases in B.C. are reported to have died. In thirteen of those cases, there were underlying medical conditions. One case is currently under investigation.

http://tinyurl.com/yk6qs5u

First Iowa Child Dies From H1N1

POSTED: 4:09 pm CST November 3, 2009
UPDATED: 4:27 pm CST November 3, 2009

Snip

DES MOINES, Iowa — Iowa Department of Public Health officials reported Tuesday the first death of an Iowa child related to the H1N1 flu virus.

View latest flu clinic dates, times

Health officials said the child is from eastern Iowa and died in October. Officials said the child “had factors that increased the risk of complications from H1N1.”

“Surveillance is showing a steady increase in pediatric illness and hospitalizations,” said IDPH Medical Director, Dr. Patricia Quinlisk. “This death is a somber reminder of the importance of protecting Iowa’s children from this flu.”

According to the CDC, all children, especially those ages 5 years or younger, and those with chronic medical conditions, are at increased risk for complications and death from influenza.

Officials said that symptoms of H1N1 flu are similar to seasonal influenza and include: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue.

Canada.

Tonights’ update acknowledges the 1 Newfoundland, 1 Yukon and 2 Alberta deaths already reported and counted, as well as 2 of the 3 BC deaths reported today.

It does not include any of the recent Ontario or Quebec deaths.

As the death rate accelerates, it’s again becoming harder for me to match news reports with official PHAC counts. As far as I can tell, there have been at least 8 Canadian deaths reported since 12:01 AM Saturday morning. I expect a new high this week; more than the peak of 11 reached last week and in late June.

Bi-weekly and cumulative number of deaths due to Pandemic (H1N1) 2009, by province/territory, Canada, as of 3 November, 2009, 11h00 EDT
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/surveillance-eng.php

Province / Territory New Deaths reported
(from October 29, 2009 to
November 3, 2009, 11h00 EDT) Cumulative
British Columbia 2 14
Alberta 2 14
Saskatchewan 0 5
Manitoba 0 7
Ontario 0 30
Quebec 0 27
New Brunswick 0 0
Nova Scotia 0 1
Prince Edward Island 0 0
Newfoundland and Labrador 1 1
Yukon 1 1
Northwest Territories 0 0
Nunavut 0 1
Total 6 101

Ukraine

In the hospitals of Ivano-Frankivsk - have 532 patients with viral pneumonia
03/Nov/09

In Ivano-Frankivsk growing number of patients with viral pneumonia.

According to an UNIAN correspondent, this was discussed today at meeting of the Ivano-Frankivsk city Antiepidemic Commission. According to the deputy chief physician of the city of Ivano-Frankivsk GOSHOVSKOY Emma, “the situation in the city has not improved with the flu.”

“The number of patients with pneumonia, - she added. - If the weekend was 368 patients, now they received a 532. She said that now in intensive care unit of hospitals of Ivano-Frankivsk with a severe form of pneumonia is 19 patients, 4 of them - in a serious condition and are on mechanical ventilation. In intensive care there were 8 children, but their health is satisfactory. At the same time, she noted that the number of visits to physicians compared to the holidays has increased. “If on Sunday for medical assistance, please contact 751 people, then on Monday, 2,648 people”, - said the deputy chief physician of Ivano-Frankivsk.

At the meeting, the Commission noted the lack of protective masks and antiviral drugs in pharmacies of the city, as well as the fact that “the first shock of the epidemic in the population has passed, and now is not respected” mask mode “. Chief Sanitary Doctor of Ivano-Frankivsk Nicholas NOT AVAILABLE cited statistics of influenza and ARI in the city. According to him, in October 2007, influenza and ARI in Ivano-Frankivsk hurt 5828 people in 2008 - 5445, and in 2009 - 18080.

He also predicts that the situation with the disease next week is stabilized, and rates of “disease of 48-49 years ago will go on the wane.

Presiding at the meeting of the commission deputy chairman of the city of Ivano-Frankivsk Zinovy FITEL reported that installed additional phone lines for an ambulance. “This is done in order to increase the opportunity to receive calls”, - added the first vice-mayor.

http://www.unian.net/rus/news/news-344802.html

Federal Government Not Prepared For Emergency: Auditor General

2009/11/03 | CityNews.ca Staff - Canada - excerpt

“As the government struggles to efficiently distribute vaccine in the midst of an H1N1 flu outbreak, the federal agency responsible for dealing with various emergencies, including pandemics, has received a failing grade from Auditor General Sheila Fraser. Public Safety Canada, created in 2003, has the important task of responding to federal emergencies, such as pandemics, natural disasters, blackouts and terror attacks, but the agency still has no firm crisis plan in place, Fraser charged in her latest report, released Tuesday.

This finding comes as public anger grows over the delayed rollout of the H1N1 vaccine. Health officials on all levels of government have admitted the overwhelming demand for the shot caught them off-guard. Canadians may feel even more uneasy to know the agency in charge of coordinating various government departments in dealing with such events is still drafting policies and rules about what it’s supposed to do.”

http://tinyurl.com/ygfjyww

Comment: 80 + 86 = 166

Ukraine

Ministry of Health has confirmed 80 cases of death from pneumonia
03/Nov/09

Ministry of Health confirmed 80 cases of death from pneumonia, said deputy chief sanitary doctor Ludmila Muharskaya.

“The latest figures have died from pneumonia, not from the flu and colds, and pneumonia 80 people”, - said, in particular, she said.

At the same time, as reported by Channel 5, according to local authorities, the number of deaths from the flu epidemic in Ukraine has reached 86 people.

It reported, recorded 2 other fatal cases in the Lviv region, all in the area - 39 deaths. In the Volyn region, local authorities ascertain 3 more deaths.

Department of Health today, November 3, reported that as at 22:00 on November 2 confirmed 71 cases of death from influenza and ARI in the Lviv, Ternopil and Ivano-Frankivsk, Chernivtsi, Volyn, Khmelnitsky, Transcarpathian, Vinnitsa and Rivne regions.

Later, the authorities reported that in the Lviv region the number of deaths from influenza and ARI rose to 37 people, and Lviv Mayor Andriy Sadovaya asked the presidential candidates called for transfer of funds from the election funds for the acquisition of modern virology and microbiology laboratories.

Meanwhile, Prime Minister Yulia Tymoshenko, speaking in the Rada, declared stabilize the epidemic in the eight western areas.

As reported, today, 3 November, the Verkhovna Rada adopted in general, the law number 5301 on amending the Law of Ukraine On State Budget of Ukraine for 2009 (on the country’s hospitals to provide all the necessary medicines and equipment to diagnose diseases and counter the spread of a flu epidemic).

As reported, today, 3 November, the mayor of Ternopil appealed to candidates for the post of President and head of political parties to help the city to combat the spread of influenza A/H1N1.

Recall, on Friday in Ukraine confirmed its first cases of swine flu. After this, the Cabinet introduced a quarantine in the nine western areas.

Ukraine’s leaders acknowledged that their forces to stop the spread of the epidemic can not, therefore, appealed for help to a number of countries, as well as to NATO and the EU.

As reported, the Ministry of Health of Ukraine today, 30 October, announced the beginning of the epidemic in California influenza A/H1N1 in the country.

http://korrespondent.net/tech/health/1014491

Ukraine

10 hours the number of patients in the Carpathian region increased by 6 thousand
03/Nov/09

Today, 3 November, in the Carpathian region of influenza and ARI patients increased by 6 thousand people.

This was reported in the management of information and public relations of the Transcarpathian Regional State Administration.

As stated in the message, according to the Health Authority, as of 18:00 Tuesday, November 3, in the Transcarpathian region registered 18 thousand 618 patients with acute respiratory infection and influenza.

Number of patients at 8:00 am on Nov. 3 amounted to 12 thousand 805 people. That is, in fact 10 hours the number of patients increased by almost 6 thousand people.

Of the total number of patients already hospitalized in Transcarpathia 851 people. Among the sick - 4 thousand 222 preschool children, 4 thousand 728 - school age and 9 thousand 668 adults.

* * *

Before, it was reported that the Ministry of Health confirmed 80 cases of death from pneumonia.

According to Channel 5, according to local authorities, the number of deaths from the flu epidemic in Ukraine has reached 86 people.

http://korrespondent.net/tech/health/1014512

Those Over 50 Have Higher Risk of H1N1 Death: Study
By: Mike Huckman, Reporter | 03 Nov 2009 | 05:26 PM ET

A new study says doctors should be especially vigilant about people who are over 50 with flu symptoms because they appear to have a higher risk of death from H1N1.

New York Public Information Campaign Warns of Swine Flu
The “Journal of the American Medical Association” reported deaths among 18 to 20 percent of seriously ill, hospitalized H1N1 flu patients over age 50 who were studied this year. That’s the highest death rate among any age group in the California study, which was a look back at more than 1,000 hospitalized cases that occurred between April and August.

However, infants younger than a year old had the highest rate of hospitalization, especially those less than two months old. Because infants younger than six months can’t get a flu vaccine, the JAMA report affirms the recommendation that people who are in close contact with new babies be in the priority group for the H1N1 vaccine.

In addition, the JAMA study says a disproportionate number of obese patients, when compared with seasonal flu statistics, were affected, and that the finding needs to be studied more. Researchers also say the fact that hospitalization and death occurred among all age groups and that 30 percent of the hospitalized cases were severely ill refutes the “common perception” that H1N1 is mild. The median age of hospitalized flu patients in the study was 27.

The CDC today said that H1N1 is continuing to spread, but there’s no evidence that it is becoming more virulent. Officials said they are seeing “almost no seasonal flu.” As of today, the CDC reports that more than 31 million doses of H1N1 vaccine are available, that the supply is steadily increasing, but not as quickly as the agency would like.

http://www.cnbc.com/id/33607067

Swine flu kills Swedish politician
Nov 3, 2009

Swine flu, the global pandemic that continues to cause wide-spread fears, has claimed a high profile Swedish politician–bringing the total confirmed number of swine-flu related deaths in Sweden to three.

Liberal Party politician, Jan-Erik Brohede, has died of swine flu-related illnesses, local newspaper Nerikes Allehanda has reported. The 48-year-old politician was found dead at his Orebro-home in central Sweden on Saturday, October 31, 2009.

Medical officials from the Orebro county health board told the newspaper that Brohedo – who belonged to a demographic considered as a high risk for contracting the H1N1 virus – was likely killed by medical conditions resulting directly from the deadly infection.

Nerikes Allehanda reports that the Orebro county health board is now urging everybody in indentified risk-groups to get themselves immediately vaccinated against swine flu. Risk groups include pregnant women, diabetics, patients with lung and heart conditions and children below the age of two.

Mats Bjoreman, Orebro country medical advisor told the newspaper that Brohede had several risk factors that could have lead to a fatal bout of influenza, stressing that the politician had not been in contact with health authorities; and had not been vaccinated.

There have been a total of 2,126 recorded cases of swine flu infections in Sweden so far, according to official statistics released by medical authorities.

http://www.icenews.is/index.php/2009/11/03/swine-flu-kills-swedish-politician/

Two swine flu deaths take India’s toll to 477
November 3rd, 2009

NEW DELHI - Two more people succumbed to the contagious swine flu Tuesday, taking the toll in India to 477, health authorities said here.

At least 76 new cases were reported in the country, taking the total number of people affected with the virus to 14,049.

One death was reported from Maharashtra and Kerala each.

With the latest casualty, the toll in Maharashtra has gone up to 204 - the highest in the country.

In Kerala, 16 people have died.

Of the 76 new cases, 22 were reported in the national capital alone. With this the total number of people affected with the virus in the Indian capital rose to 3,488.

However, it is Maharashtra that records the highest number of people who have been tested positive for the flu. As many as 3,675 people have been detected with the virus in the state. It is the highest in the country.

New cases were also reported from Karanataka (23), Tamil Nadu (16), Maharashtra (12), Goa (2) and Kerala (1).

http://blog.taragana.com/health/2009/11/03/two-swine-flu-deaths-take-indias-toll-to-477-14916/

http://www.myfoxhouston.com/dpp/health/swine_flu/091103_houston_area_h1n1_death_toll

Montgomery County Reports 1st H1N1 Death
Updated: Tuesday, 03 Nov 2009, 4:43 PM CST
Published : Tuesday, 03 Nov 2009, 4:43 PM CST

MENA EL-SHARKAWI
Web Producer
HOUSTON - Swine flu has claimed the lives of four more Houston-area residents, bringing the death toll up to 26.

Among the four victims is a resident of Montgomery County, which had yet to report any deaths. The other three victims were residents of Harris County.

The 26 deaths include residents from Houston and Harris, Fort Bend, Galveson and Brazoria counties.

At least 10 of the deaths were victims between the ages of 25 and 29, and at least three were residents between 50 and 64.

At least four victims were children up to 18 years old, including a baby boy who was between 6 and 11 months old.

Nationwide, there have been more than 1,000 H1N1 deaths.