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

that seen in the deadly 1918 Spanish pandemic, the authors noted.

In a second study, researchers in Mexico -- where H1N1 first arose in the spring -- found critical illness in 58 of 899 total patients admitted to the hospital. Here the mean age was older (44 years) but still relatively young. About one-quarter were obese. Again, patients moved from the hospital to the ICU quickly, and most received mechanical ventilation. Within two months of admission, 41.4 percent of the critically ill patients had died, four of them while waiting for ICU beds.

Overall, prompt and proper care did save most lives, the researchers stressed.

A final paper, this one out of New Zealand and Australia, found a rise in the use of a system called extracorporeal membrane oxygenation, which provides extra oxygen to a patient's blood. The survival rate for patients critically ill from H1N1 flu was high in this group.

After reading the reports, Dr. Tamara Kuittinen, an emergency physician with Lenox Hill Hospital in New York City, said that she will be more inclined to err on the side of caution, especially if patients have one or more other health conditions.

"If it were borderline, I would admit [the patient to the hospital] right off the bat," Kuittinen said. She also said she would be advising outpatients to monitor their conditions closely and seek more medical care if symptoms worsen or don't get better.

But the experience observed in the spring might not be as dire this fall, one expert added.

"We're all hoping that a substantial portion of the population in fact was infected [earlier this year], and, if so, they will be immune and they will not get infected," said Dr. Edward Walsh, professor of medicine at the University of Rochester Medical Center and chief of infectious diseases at Rochester General Hospital. "That will reduce the burden, the pool of susceptible people. It will also reduce the potenti
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