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Swine Flu Tied to Rise in Pneumonias Among Young
Date:11/25/2009

On more positive note, CDC sees few signs of trouble with the H1N1 vaccine,,

WEDNESDAY, Nov. 25 (HealthDay News) -- The ongoing H1N1 swine flu pandemic may be driving a recent spike in dangerous pneumonias among younger patients, a U.S. health official said Wednesday.

"We are seeing an increase in serious pneumococcal infections around the country," Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention, said during a press conference. "Pandemics put us at risk for not just flu problems, but also bacterial pneumonia problems," she added.

These bacterial infections commonly infect the lungs and sometimes the bloodstream. During most flu seasons, secondary infections such as pneumonia typically occur in people 65 and older, she said.

However, in this pandemic the increase in pneumococcal infections is being seen primarily among younger people, Schuchat said.

For example, in Denver, the average number of severe pneumococcal infections in October typically averages about 20. "But in October 2009 they had nearly triple that number -- 58 serious pneumococcal cases," she said. "Most of that increase has been in adults under the age of 60."

The findings mirror trends in other parts of the country, Schuchat said.

Schuchat noted that a vaccine to prevent pneumococcal infections is available, but "only about one-quarter of high-risk adults have received the pneumococcal vaccine," she said.

People with diabetes, emphysema, chronic heart, lung and liver disease should get this vaccine, Schuchat said.

The supply of H1N1 swine flu vaccine continues to grow, she said. As of Wednesday there were a total of 21.2 million doses "available for the states to order," Schuchat said, and since last Friday, the supply has increased by over 7 million doses. The total number of doses is now 61.2 million, she said.

Questions about the safety of the H1N1 vaccine have lingered, but Schuchat sought to assuage any fear with some of the first safety data available since mass vaccinations began.

"So far, everything we have reviewed is extremely reassuring," she said. "In our look at all of the safety data in the U.S. so far, we are seeing patterns that are pretty much exactly what we see with the seasonal flu vaccine."

The majority of reports (94 percent) are classified as not serious, Schuchat said. These reports concern mostly soreness in the arm or tenderness at the vaccination site. These are common with any injected vaccine, she said.

The CDC has specifically looked at cases of Guillain-Barre Syndrome, she said. In 1976, the swine flu vaccine was associated with increases in this rare but serious neurological disorder.

But the current vaccine has not led to any problems with Guillain-Barre Syndrome, Schuchat said.

Currently, there are 10 reports of potential cases of Guillain-Barre Syndrome among vaccinated individuals, Schuchat said. However, "the number of reports, given the number of doses that have gone out there, are not at all notable," she said. "With conditions like Guillain-Barre Syndrome, we think it's important to remember that that happens with or without vaccines, that every week between 80 and 160 people in the United States are diagnosed with Guillain-Barre Syndrome. So it's not really surprising that we have a few in our reports right now."

Guillain-Barre Syndrome is often severe and is usually associated with ascending paralysis with weakness in the legs that spreads to the arms and face along with complete loss of tendon reflexes. Most people recover, but the condition can be fatal.

In addition, severe allergic reactions are not more common than expected with the H1N1 vaccine, Schuchat said.

Despite this reassuring news, in Canada a batch of 172,000 doses of the H1N1 swine flu vaccine was recalled by maker GlaxoSmithKline earlier this week after use was associated with severe allergic reactions, the Associated Press reported.

In other swine flu news, China is reporting eight cases of mutated virus, and last week the World Health Organization was investigating samples of variant swine flu tied to two deaths in Norway.

However, "Shu Yuelong, director of the Chinese National Influenza Center, told the official Xinhua News Agency that the mutated swine flu virus found in China has shown an 'isolated' spread in the mainland, is not resistant to drugs and can be prevented by vaccines," the AP reported. The report did not mention if the new variants had been linked to any deaths, the AP added.

On Monday, tests conducted by the CDC revealed that four patients at Duke University Medical Center in Durham, N.C., had contracted strains of H1N1 flu resistant to the antiviral medication Tamiflu. All of the patients became very ill and have multiple, underlying medical problems, according to a Duke news release. The emergence of H1N1 strains resistant to antivirals such as Tamiflu or Relenza has been of particular concern to health experts.

With so many Americans traveling for the Thanksgiving holiday, the CDC cautioned that swine flu could accompany you on your journey, especially as you pass thorough train stations and airports. To decrease the risk of getting or spreading the flu, the agency advises not traveling if you are ill, washing your hands often and covering your cough.

More information

For more on H1N1 swine flu, visit the U.S. Health and Human Services Administration.



SOURCES: Nov. 25, 2009, teleconference with Anne Schuchat, M.D., director, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention; Associated Press, Nov. 20, 2009, news release, Duke University Medical Center


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