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Swine flu risk to youths, healthy adults: studies

Adolescents and relatively healthy adults are especially at risk from the swine flu, which is associated with respiratory failure Respiratory Failure Definition

Respiratory failure is nearly any condition that affects breathing function or the lungs themselves and can result in failure of the lungs to function properly.
 and a high mortality rate in serious cases, studies have said.

The studies, conducted during the first phase of infection between March 18 and June 1 in Mexico and April 16 through August 12 in Canada, also show how emergency services emergency services Emergency care '…services …necessary to prevent death or serious impairment of health and, because of the danger to life or health, require the use of the most accessible hospital available and equipped to furnish those services'  were sometimes submerged by the number of serious cases that needed to be treated simultaneously.

Serious cases of infection from the influenza A(H1N1) virus in patients in Mexico were all linked to severe acute respiratory distress syndrome acute respiratory distress syndrome
See adult respiratory distress syndrome.
, followed by a state of shock with a high incidence of death.

At least 4,525 people have died from swine flu infections since April and there have been over 378,223 laboratory-confirmed cases, the World Health Organization said Friday, with most deaths occurring in the Americas.

Of the 899 patients admitted to six Mexican hospitals with confirmed or probable A(H1N1) infections during the period studied, 58 were in serious condition, the study's authors said. The median age of critically ill patients was 44.

Most were treated with antibiotics and 45 of them with the antivirals Tamiflu or Relenza, while 54 required an artificial respirator respirator /res·pi·ra·tor/ (res´pi-ra?ter) ventilator (2).

cuirass respirator  see under ventilator.

Among the 58 serious cases, 24 (41.4 percent) died within 60 days of hospitalization, including 19 during the first two weeks.

"Our analysis of critically ill patients with 2009 influenza A(H1N1) reveals that this disease affected a young patient group," wrote the authors of the study led by Guillermo Domínguez-Cherit of the Instituto Nacional de Ciencias Médicas y Nutrición in Mexico City.

"Early recognition of disease by the consistent symptoms of fever and a respiratory illness during times of outbreak" accompanied by "prompt medical attention," the authors said, "may provide opportunities to mitigate the progression of illness and mortality observed in Mexico."

In "almost all cases," fever and respiratory symptoms were harbingers of disease, they added. "There was a relatively long period of illness prior to presentation to the hospital, followed by a short period of acute and severe respiratory deterioration."

Of the 168 patients infected with the virus who became critically ill and were treated at 38 Canadian hospitals during the period studied, 24 (14.3 percent) died within the first 28 days and five within the first 90 days, for a 17 percent mortality rate, according to that study's authors.

The Canadian patients' average age was 32.3 years old, including 113 women (67.3 percent) and 50 people under the age of 18 (29.8 percent).

The study team led by Anand Kumar of St. Boniface Boniface (bŏn`əfās), d. 432, Roman general. He defended (413) Marseilles against the Visigoths under Ataulf. Having supported Galla Placidia in her struggle with her brother, Emperor Honorius, Boniface fled to Africa in 422.  Hospital in Winnipeg, Canada, concluded that A (H1N1) caused serious illness predominantly in young patients with few major underlying diseases.

"Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of 10 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 pandemic /pan·dem·ic/ (pan-dem´ik)
1. a widespread epidemic of a disease.

2. widely epidemic.

Epidemic over a wide geographic area.

," the authors write.

Published in the November 4 edition of the Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world.  (JAMA JAMA
Journal of the American Medical Association
), the studies were posted online on Monday to coincide with their presentation at a meeting of the European Society of Intensive Care Medicine in Vienna this week.

In a JAMA editorial accompanying the studies, two doctors warned that many US hospitals could face a shortage of doctors and nurses to treat serious cases if the pandemic intensifies.

"Hospitals must develop explicit policies to equitably determine who will and will not receive life support should absolute scarcity occur," wrote Douglas White and Derek Angus of the University of Pittsburgh School of Medicine The University of Pittsburgh School of Medicine is the medical school of the University of Pittsburgh, located in Pittsburgh, PA.

As of 2007, the University of Pittsburgh School of Medicine consists of 589 medical students - 53% men and 47% women.

"Any deaths from 2009 influenza A(H1N1) will be regrettable, but those that result from insufficient planning and inadequate preparation will be especially tragic."

The number of pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.

Of or relating to pediatrics.
 deaths linked to the A(H1N1) virus has risen sharply in the past month in the United States, with 19 dead between September 27 and October 3, according to the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center.  (CDC See Control Data, century date change and Back Orifice.

CDC - Control Data Corporation

A total of 76 children have died after being infected by the virus since April, the CDC said.
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Publication:AFP American Edition
Date:Oct 13, 2009
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