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H1N1-associated invasive pneumonia increasing, CDC says.

Investigators at the Centers for Disease Control and Prevention are seeing a "worrisome spike" in serious bacterial pneumonia associated with pandemic influenza A(HlNl) virus, Dr. Anne Schuchat said at a press briefing.

In the Denver metropolitan area, for example, there were 58 reported cases of invasive pneumococcal infections during the month of October. Over the last 5 years, there have been an average of only 20 cases each October.

Invasive bacterial pneumonia is normally seen in individuals older than age 65. But about two-thirds of the patients in Denver are between the ages of 20 and 59 years, said Dr. Schuchat of the CDC. The majority had underlying risk factors in addition to H1N1 influenza.

"People at risk for invasive pneumococcal [infection] include adults with chronic health conditions like diabetes, asthma, emphysema, or chronic lung disease, chronic heart disease, chronic kidney or liver disease, cancer and other immunosuppressive conditions like HIV," Dr. Schuchat said.

"So a lot of adults are at higher risk for pneumococcal complications."

Studies show that only one-quarter of patients in these high-risk groups have received the highly effective and available pneumococcal vaccine. Adults typically require only one dose of the vaccine for lifetime protection.

In a person who is infected with influenza, an easing of symptoms followed by a sudden worsening is a key warning sign of a secondary bacterial infection. "We can see that in children or in adults," Dr. Schuchat said. "And it doesn't necessarily always mean bacterial pneumonia, but it very much can mean that."

Other H1N1 influenza news discussed during the press briefing included confirmation that a physician in West Virginia appears to have come down with laboratory-verified H1N1 influenza twice over a period of 3 or 4 months.

This is uncommon but not impossible, Dr. Schuchat said, and this case does not bear on the efficacy of the H1N1 virus vaccine, which is highly--but not 100%--effective.

The CDC continues to investigate adverse events associated with the vaccine. So far, 94% of such reports relate to mild reactions such as soreness, tenderness, or injection-site pain. Anaphylaxis is not occurring more frequently than expected.
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Title Annotation:CLINICAL ROUNDS
Author:Finn, Robert
Publication:OB GYN News
Date:Jan 1, 2010
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