Rhiza Labs FluTracker Forum

A recent article from the New England Journal of Medicine states that the Pediatric Death Rate for Pandemic H1N1 has been ten times that of seasonal influenza.

I think, when the numbers come in (months from now) the public will find that all the "hype" about this virus being milder than seasonal flu will finally be put to rest. From what I see at work, another wave is starting to swell.

http://content.nejm.org/cgi/content/full/NEJMoa0907673

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"Old Mother Goose, when she wanted to wander, would ride through the air on a very fine gander."
1916
"Mother Goose had a house,
'Twas built in a wood,
Where an owl at the door
For sentinel stood."

Are the new cases more severe?

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www.twitter.com/hniman

in the young adults they are. In the kids.... they go undiagnosed for the most part, but they are worse than they were last August-September (or so it appears to me) with More Pneumonia, and higher oxygen requirements, but most of the kids get over it without needing a ventilator (so far). Last fall, I think some kids were in the hospital JUST because they had H1N1 but they weren't that sick. There were more of them back then, but they had milder flu-like symptoms than what I'm seeing now.

All in all, we're starting to see more flu cases (even flu positive test results).

It's unusual for a toddler, or child to NEED supplemental oxygen for any viral pneumonia... unless they have health problems to begin with. I'm seeing kids who can't wean off of oxygen for a week or so. Even after they "feel" better... they have to stay in the hospital because of a supplemental oxygen requirement that doesn't go away as fast as it should... very strange.

Also, a lot of my co-workers are reporting that their teenagers are catching flu (with positive flu tests from their doctors). Many of the doctors are now treating with Relenza.

_________________
"Old Mother Goose, when she wanted to wander, would ride through the air on a very fine gander."
1916
"Mother Goose had a house,
'Twas built in a wood,
Where an owl at the door
For sentinel stood."

Is coughing common? I had a cough that last MUCH longer than other symptoms, which were mild and brief. I suspect the oxygen requirment is linked to H1N1 in lungs, which persists and causes significant damage, which can impact oxygen requirements.

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www.twitter.com/hniman

The coughing is SEVERE... that's one of the reasons they are brought in. The parents of the kids say that they were coughing so hard that they were gagging and vomiting. I've seen babies coughing so hard that they have laryngospasms (which causes the kid to turn blue and not be able to breathe for a few seconds) it's one of the reasons parents bring them into the E.R. It's a frightening thing to see happen to an infant. RSV can also cause horrible coughing in people of all ages, but these kids are RSV negative. RSV is easy to test for.

_________________
"Old Mother Goose, when she wanted to wander, would ride through the air on a very fine gander."
1916
"Mother Goose had a house,
'Twas built in a wood,
Where an owl at the door
For sentinel stood."

They still do not treat with antivirals without a positive flu test. My friends twenty year old daughter tested positive for flu last week, she was VERY sick, and the doctor gave her Relenza. She was better in 48 hours.

_________________
"Old Mother Goose, when she wanted to wander, would ride through the air on a very fine gander."
1916
"Mother Goose had a house,
'Twas built in a wood,
Where an owl at the door
For sentinel stood."

Why Relenza? Still problems with Tamiflu supply or are they seeing a lot of random resistance?

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I am not a doctor, virologist, or any of type of medical/life sciences professional.

I am a layman with a background in the physical sciences.

> The overall rate of death was 1.1 per 100,000 children,
> as compared with 0.1 per 100,000 children for seasonal influenza in 2007

infected children or all children

add "children" to the headline (else it's incorrect anyway)
and "Argentina"

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no patents on genes, publish the GISAID sequences !

I suspect that either there was a directive issued or Drs are starting to read between the lines. The transmision of resistance in the train in Vietnam was in the NEJM, which will usually get the attention of MDs. Similarly, the outbreaks at Duke and UK hospital were addrressed in the WHO report, and the CDC weekly flu report has had some rather dramatic spikes in H274Y cases (the numbers for the past 1-2 months are VERY different than last spring or fall).
Relenza is more of a concern for children (with undiagnosed asthma) or those with breathing problems, so treatment of a 20 year old with Relenza should become more common, as long as Relenza supplies last.
There have also been many anectdotal reports of Tamiflu not working in certain areas (and H274Y has now been document in two different H2H transmission in North Carolina).

_________________
www.twitter.com/hniman

We had a tamiflu resistant case on a ventilator a few weeks ago. So I guess the doctors aren't trusting it.

_________________
"Old Mother Goose, when she wanted to wander, would ride through the air on a very fine gander."
1916
"Mother Goose had a house,
'Twas built in a wood,
Where an owl at the door
For sentinel stood."