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Swine flu's killer streak revealed

Tuesday October 13th, 2009

Two new studies highlight the threat posed by swine flu in the earliest stages of the outbreak - leading to comparisons with the deadly 1918 pandemic.

Doctors from Mexico and Canada - two of the hardest hit countries - say that critically ill victims were mainly young and healthy.

The findings have been published by the Journal of the American Medical Association and are to be reported to the European Society of Intensive Care Medicine this week.

Mexican doctors report on 58 patients who became critically ill in Mexico City. Of these, 24 died with two months despite treatment with anti-flu drugs and antibiotics. Half of the patients in the analysis were under the age of 44.

The doctors said the patients died from failure of the respiratory system and from shock.

In Canada, doctors identified some 168 patients who fell critically ill. Of these, 29 died within three months.

The patients had an average age of 32 and 113 were female and 50 children.

The researchers led by Dr Anand Kumar, of the Health Sciences Centre and St. Boniface Hospital, Winnipeg, Manitoba, Canada, said few of the patients had existing illness and often required lengthy stays of mechanical ventilation.

They warn: "Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of ten and 60 years, a pattern reminiscent of the W-shaped curve - rise and fall in the population mortality rate for the disease, corresponding to age at death - previously seen only during the 1918 H1N1 Spanish pandemic."

Earlier this week Australian researchers reported that 20 per cent of critical care beds in Australia and New Zealand were occupied by swine flu patients during the peak of the epidemic.

A further report from Australia in the JAMA reports on the success of treating patients with a technique that infuses oxygen into the blood. They say that "most" patients survived when treated with Extra-Corporeal Membrane Oxygenation - or ECMO. Some 14 out of 68 critically ill patients died in spite of the treatment.

* In Britain health officials are stepping up efforts to ensure all health staff are vaccinated against the H1N1 flu virus in the face of evidence of resistance, it was reported.

Managers have received six letters in five weeks stressing the need for vaccination - and warning that patients could be put at risk by staff infected with the virus, according to the Guardian.

JAMA. 2009;302(17):doi:10.1001/jama.2009.1536, 1496, 1535

Tags: A&E | Australia | Child Health | Flu & Viruses | North America | Respiratory | Traveller Health | UK News | Women’s Health & Gynaecology | World Health

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