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Smokin’ Joe I pinged your list and some other freepers to some new h1n1 news ...

CDC Investigates Spike In H1N1 Hospitalizations In Georgia

Recombinomics Commentary 23:00
March 29, 2010
http://www.recombinomics.com/News/03291001/H1N1_GA_CDC.html

Today the CDC held a tele-briefing on the spike in H1N1 hospitalizations in Georgia. CDC had been asked to investigate on March 4 because the number of hospitalized cases was spiking toward levels seen last fall, when H1N1 was widespread in GA and much of the country. At this time the level remains at regional, even though the 152 hospitalizations for the two most recent weekly entries represents the largest number even recorded by GA for pH1N1,

The CDC investigation confirmed that the hospitalized cases were H1N1 and that the demographic was similar to last fall, adults with underlying conditions. The CDC noted that most had not been vaccinated and expressed a concern that the public was not taking pH1N1 seriously and the low vaccination rate would lead to unnecessary hospitalizations and deaths. The geographic distribution of the current cases may be slightly different than the fall, but that data was preliminary and the CDC suggested similar outbreaks may appear nationwide and the start of a third wave could not be ruled out.

The H1N1 was said to have not changed, but small differences can have large effects. The CDC was also involved in the H1n1 investigation in Ukraine last fall and the WHO issued a press release stating that there were no significant changes, but Mill Hill released sequences the following day, which showed that 4 of 4 fatal cases had D225G, a receptor binding domain change that was linked to increased affinity of gal 2,3 receptors, which are at high levels in human lung, and D225G had been found in two of the five 1918/1919 autopsy lung samples, including the only 1919 sequence. The CDC has also not commented on D225G/N in the Duke death cluster where 3 of the 4 patients died, so it would be useful if the CDC would simply release sequences from the recent hospitalized patients. To date there is only one public sequence from Georgia in 2010, A/Georgia/01/2010 (27F collected 2/6/2010 deposited by the CDC at GISAID), which has 8 newly acquire synonymous changes.

Georgia Cases Put Swine Flu Back On Radar

6:38 pm
March 29, 2010
By Richard Knox
http://www.npr.org/blogs/health/2010/03/georgia_cases_put_swine_flu_ba.html?ft=1&f=1001

Most people may think the new flu strain that popped up about a year ago has gone away. Largely, it has. But it’s still putting some Americans in the hospital.

Just like last spring, the nation’s influenza hot spot -— well, call it a warm spot — is in the southeastern part of the country.

In the last week, swine flu has put more than 40 Georgians in the hospital. In fact, this is the third week in a row that Georgia has had more flu hospitalizations than any other state.

H1N1 suspected in death

By Kristi L. Nelson
Posted March 28, 2010 at midnight
http://www.knoxnews.com/news/2010/mar/28/h1n1-suspected-in-death-vaccine-is-available/

Cathy Briscoe-Graves and her 23-year-old daughter both got very sick on a Friday with serious, flu-like symptoms: coughing, headaches, body aches.

Their primary-care physician suspected the H1N1 influenza strain, Briscoe-Graves said, though he didn’t test them, because that’s the most common flu strain circulating in this area.

In fact, the national Centers for Disease Control and Prevention has noted a recent spike in H1N1 activity - and the number of related deaths - in Tennessee and the Southeast region.

By a Tuesday, Briscoe-Graves was feeling significantly better. Her daughter was worse.

Briscoe-Graves took her to Parkwest Medical Center’s emergency department.

“I thought they’d give her an IV and some antibiotics,” Briscoe-Graves said. “I thought maybe she had walking pneumonia.”

Instead, a chest X-ray showed filled lungs, a life-threatening case of pneumonia, probably caused by the young woman coughing so hard with the flu that she aspirated stomach acid.

On March 19, Briscoe-Graves’ young, vibrant daughter - who loved painting, drawing, genealogy and scrapbooking and looked forward to being a bridesmaid in her brother’s October wedding - died of pneumonia, despite specialists’ valiant efforts to save her, her mother said.

Several recent deaths in local hospitals could be linked to H1N1, said Knox County Medical Director Martha Buchanan.

“It’s hard to say” exactly how many, Buchanan said. “They may get sick at home and come to the hospital with something else and not even know they have” the flu.

Health officials think the recent rise in the number of H1N1 cases in this region could represent the expected “third wave” of the pandemic.

As with the previous two waves, the virus is claiming younger, healthier people than does regular seasonal flu, which typically kills babies and elderly people. About a third had no serious health problems before.

The CDC estimates as many as 17,160 people nationwide have died from H1N1, though only about 2,500 deaths have been confirmed; Tennessee has reported 40 H1N1 deaths, including nine children.

This was the first U.S. region to see a peak in H1N1 cases during the first wave, Buchanan said, so it’s not surprising that it’s peaking again before other parts of the country.

Of the local H1N1-linked deaths, Buchanan said, none of the victims had been vaccinated “that we know of.” She urged people to get the H1N1 vaccination, available at all four Knox County Health Department locations: “We have plenty of it. It’s free. Come and get it, please.”

Neither Briscoe-Graves nor her daughter had had the H1N1 vaccine. She regrets not taking her daughter to the hospital sooner, although pneumonia can set in as quickly as an hour.

“If you do think you’ve gotten the flu and you do think you might have pneumonia, get a chest X-ray,” she said. “You hear about everyone else having it, but you don’t think it’s going to be you or one of your family members.”

Her daughter, who lived with her, “was just a wonderful person,” Briscoe-Graves said. “I’m sorry she’s gone so soon.”

Kristi L. Nelson may be reached at 865-342-6434.

Thanks so much for the ping. Prayers for the folks in Georgia - even the milder cases are no fun for this nasty “Chimera” flu, and definitely downright scary when the flu knocks down your defenses and you end up susceptible to secondary bronchial and respiratory infections...

When my daughter was in the hospital in mid-February here in Central Wisconsin (a regional “magnet”/higher-level hospital) the Peds ward was literally filled with children suffering from infectious diseases with flu-like symptoms (you could tell by looking at them frankly - and hearing the coughing of course). I will admit that I do not know how many were suffering from H1N1 other than two children who were on respirators in the PICU, or how many had other similar viruses and/or infections (I know two of them had Blastomycosis like my daughter, but the more normal respiratory pneumonia-like presentation. I think the real name is Pulmonary Blastomycosis. But that was 2 of perhaps 40-50 children if I do the math counting two beds per room as it looked like all if not most had.)

Now, I don’t know all of the thinking that went into the decision, but my daughter was automatically given a room in the Pediatric Oncology Ward — the reason we were told is because the children in the regular ward were very sick and contagious, and in the oncology section all parts have special airborne ventilation units with alarms on the patient rooms when too much “non-clean” air enters the room. The best way to prevent her from catching anything in the other section while we figured out what was wrong with her leg.

(To tell you the truth the way the nurses were talking made me a little wary at times to breath while passing through the regular ward, or while needing to be in that section for any extended period of time, as I had to do numerous times of the day while we were there! I made good use of the hand sanitizer conveniently placed in many spots around the ward.)

I also wanted to mention to you (forgot to ping you the other day), that the Pediatricians and my daughter’s Infectious Disease doctor discussed our family’s illness from last April with me for a while. They all agree that we most likely did have H1N1, and they also said that although it’s too soon to tell definitively that my family most likely had built up immunity to at least the original strain.

Also, despite hanging out in the family lounge with relatives of these infectious sick children, and walking through the regular ward numerous times a day (and definitely touching the counters and such in there when speaking with the docs and nurses...) none of us fell ill after my daughter’s hospitalization.

I know it’s all anecdotal information, but thought you may be interested to know... I feel fairly confident that due to getting this illness - unless it mutates a lot - those exposed and who became ill do have some sort of immunity which is good news. As I said about the mutation — that’s the only thing that worries me at this point... But then that’s a risk we face every year even with the more common flu viruses...