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Swine Flu Can Move Quickly to Severe Illness
Date:10/12/2009

mand because our health-care system operates near capacity most of the time, and there's not a lot of excess capacity in the system," said Dr. John J. Treanor, a professor of medicine and of microbiology and immunology at the University of Rochester Medical Center. "I think there's a cause for alarm -- though not undue alarm -- because one would predict a pretty intense flu season and there will be a lot of demand placed on emergency rooms and hospitals."

Indications are that, overall, most cases of H1N1 flu remain mild. But with more people getting sick overall, the number falling severely ill will swell.

The types of people hospitalized in Canada, Mexico and Australia are consistent with U.S. trends seen so far.

"What all of them have in common is the burden was seen primarily in older adolescents and young adults as opposed to the elderly, which is what is typically seen with seasonal influenza," noted Dr. Nathan Litman, director of pediatrics and chief of pediatric infectious diseases at the Children's Hospital at Montefiore Medical Center in New York City.

The average age of the 168 confirmed or probable H1N1 swine flu cases in the Canadian study was 32.3 years. A large proportion was female (113), 50 were children and 43 were aboriginal. Although average time from the onset of flu symptoms to hospitalization was four days, the patients' condition typically deteriorated so quickly upon admission that they were sent to an ICU within 48 hours. More than 80 percent of these very sick individuals needed mechanical ventilation, many experienced shock or organ failure and, by one month after admission, 14.3 percent of them had died.

Although many patients had other health conditions, including obesity, these conditions tended not to be severe and included being smokers, being overweight or having high blood pressure, Kumar said.

This pattern of the virus affecting younger, healthy people is similar to
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