When Swine Flu Is Bad, It's Really Bad, Data Confirm + link to Obesity

[Guest guest]

As we learn more and more about this new and unique H1N1 flu, more of a profile

is seen, and new data is shared. THis is not to scare people, but to help them

relize this is a serious situation and to take prevention advice very seriously.

It's appearing that in those aged 50 or over, IF they get a severe care and are

hispotalized, the death rate is higher than in any other age group. We thought

at first that the younger children were the hardest hit.

It's also clear that the obese have a poorer immune system, and other problems

that make us more susceptible (see the last part of this article) . PLEASE

consider getting an H1N1 vaccination. I had mine, as a healthcare provider,

last week.

Sandy r

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H1N1 Swine Flu Deadly in All Age Groups

When Swine Flu Is Bad, It's Really Bad, Data Confirm

By J. DeNoon

WebMD Health News

Reviewed by Louise Chang, MD

Nov. 3, 2009 -

H1N1 swine flu isn't always severe, but when it's bad, it's really bad. Patients

hospitalized with pandemic flu have an 11% fatality rate, data from California

suggest.

The pandemic flu bug is far more likely to strike younger people. But when

people aged 50 and older get hospitalized with H1N1 swine flu, their

case-fatality rate is the highest of any group: 18% to 20%.

The findings come from an analysis of data collected from California hospitals

during the first 16 weeks of the U.S. H1N1 swine flu pandemic (April 23 to Aug.

11) by Janice K. Louie, MD, MPH, of the California Department of Health and

colleagues.

" In contrast with the common perception that pandemic 2009 influenza A (H1N1)

causes only mild disease, hospitalization and death occurred at all ages, and up

to 30% of hospitalized cases were severely ill, " Louie and colleagues report in

the current issue of the Journal of the American Medical Association.

In a news conference, CDC Director Frieden, MD, MPH, said the California

data show that H1N1 swine flu is just as deadly as seasonal flu.

" What we have seen in that article and in our own data from around the country

and around the world is the level of severity among those who become ill is

similar to seasonal flu, " Frieden said. " Although a much, much lower proportion

of people over 65 get H1N1 compared with seasonal flu, if they get it, it can be

every bit as severe. "

Louie and colleagues note that the low median age of patients with severe or

fatal H1N1 swine flu -- 27 years -- makes the pandemic flu " markedly different "

from seasonal flu.

" A striking percentage of hospitalized cases were severely ill, with more than

30% requiring intensive care; most adults and more than one-third of children

required mechanical ventilation, " they write. " Eleven percent died; the most

common reported causes of death were viral pneumonia and acute respiratory

distress syndrome. "

And as previous data have shown, pregnant women are at much higher risk of

severe flu than are other healthy women.

" Of note, 20% of hospitalized pregnant women in our series required intensive

care; most were in their second or third trimester of pregnancy, " Louie and

colleagues report. They note that similar observations were made in the flu

pandemics of 1918-1919 and 1957-1958.

Obesity a Risk for Severe H1N1 Swine Flu

As others have seen, more than 70% of adults and more than 60% of children with

severe H1N1 swine flu had underlying medical conditions.

The California data add to a growing body of evidence that extreme obesity -- a

body mass index or BMI of 40 or more -- is a risk factor for severe swine flu.

Nearly half of all the severe cases in California were in obese people; 43% had

a BMI of 40 or more.

Louie and colleagues note that nearly a third of obese Californians with severe

swine flu did not have an established risk factor, although many had other

conditions such as high blood pressure.

" A link between obesity and severe influenza, while not proven, is plausible, "

they suggest.

The CDC's Frieden agrees that obesity may well turn out to be an independent

risk factor.

" We are in the midst of an epidemic of obesity. It has doubled in adults and

tripled in children in the past couple of decades, " Frieden said. " We are still

trying to understand what all of the implications of that are for people's

health. Increased susceptibility to infection is one, reduced respiratory

reserve and ability to fight off infections is another, but this is something we

need to learn that more about. "