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The Boston Globe reports that “of the 86 children who have died since the new swine flu arose last spring, 43 deaths have been reported in September and early October alone, the Centers for Disease Control and Prevention reported. That’s a startling number because in some past winters, the CDC has counted 40 or 50 child deaths for the entire flu season — and no one knows how long this swine flu outbreak will last.”

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This in turn caused what is known as acute respiratory distress syndrome — an often fatal development that leaves patients gasping for breath.

“This is almost exactly what we see with avian flu,” Zaki said. “This looks like avian flu on steroids.”

Zaki said 90 percent of the fatalities he looked at had some condition that would predispose them to serious disease. They had a median age of 38 and one victim was a two-month-old infant who died within a day of getting sick.Nearly half — 46 percent — were obese, many had fatty liver disease, 27 percent had heart disease and 22 percent had asthma, he said.

So, in the vein on not being an alarmist, this guy only examined 90 people.  And this still has not surpassed the 30,000 + deaths in the U.S. from seasonal flu.  And no one really knows what will ultimately happen with the life of this H1N1 virus.

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Or, in the words of Arrested Development, “No touching!”  This works perfectly for me, as I have an extremely large area of personal space I expect others to stay out of.

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An advisory panel is recommending a major step up in protection for health workers dealing with patients suspected or confirmed to have H1N1 influenza.

The Institute of Medicine said Thursday, in recommendations requested by the CDC, said loose paper masks are inadequate because the workers could still breathe in the virus.

Instead, health workers should switch to N95 respirators that form an airtight seal around the nose and mouth.

If properly fitted and worn correctly, N95 respirators filter out at least 95 percent of particles as small as 0.3 micrometers, which is smaller than influenza viruses, the report notes.

However, it is important to remember that “there is a lot we still don’t know about these viruses, and it would be a mistake for anyone to rely on respirators alone as some sort of magic shield.”

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“In six weeks it travels the same distance that other viruses take six months to cover,” Chan said.

“Sixty percent of the deaths cover those who have underlying health problems,” Chan said. “This means that 40 percent of the fatalities concern young adults — in good health — who die of a viral fever in five to seven days.

“This is the most worrying fact,” she said, adding that “up to 30 percent of people in densely populated countries risked getting infected.”

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Severe respiratory failure

Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.

During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services. Some cities in these countries report that nearly 15 percent of hospitalized cases have required intensive care.

Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.

Vulnerable groups

An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.

Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.

When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.

Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.

Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.

Higher risk of hospitalization and death

Several early studies show a higher risk of hospitalization and death among certain subgroups, including minority groups and indigenous populations. In some studies, the risk in these groups is four to five times higher than in the general population.

Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension.

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