Rhiza Labs FluTracker Forum

Video includes names of fatally infected children (Lowell and Venessa) of index case (Ruth Blake).

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not to sound like a WHO situation update, but did any of the victims have contact with sick poultry? It's on the Bay, so I know it's a water fowl haven, plus there are lots of poultry yards in the surrounding area. Because their presentation is sounding identical to every H5N1 WHO report I've ever read. (And I've read them all over the years.)

And how come the CDC is involved but nobody's saying which influenza A subtype it is? If it's just seasonal flu that was not "treated properly"... then why the Hazmat suits?

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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."

Update on Calvert County Respiratory Illness Investigation

Preliminary Testing Indicates Influenza



Dori Henry
Director of Communications
Maryland Department of Health and Mental Hygiene


BALTIMORE (March 6, 2012) – The Maryland Department of Health and Mental Hygiene (DHMH) is working in conjunction with the Calvert County Health Department to investigate a cluster of respiratory illnesses in Calvert County. As the Calvert County Health Department has reported, DHMH is aware of four cases in adults from a single family with severe respiratory illness; three have died. At this time, no other similar clusters have been reported from Calvert County or elsewhere in the state.

The cause for these illnesses is under investigation and testing is being conducted by the DHMH Laboratories Administration. Preliminary testing at the DHMH Laboratories Administration indicates that two of the fatal cases had influenza, and these cases may have been complicated by bacterial co-infections. Bacterial co-infection is a known complication of influenza infection. Additional testing is being conducted for all cases.

DHMH recommends all individuals continue to take the following precautions during influenza season: hand washing, staying home if sick, and staying up to date with influenza vaccinations. DHMH also reminds Maryland residents with influenza-like illness (fever and sore throat or cough) to consult their healthcare providers for evaluation. DHMH is not recommending any additional measures at this time. The Department will provide additional updates as more information becomes available.

There have been no new cases reported as of 10:00 p.m.
For current info call 410-535-5400 x349

http://www.calverthealth.org/

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I think it is likely to be H3N2v and for the CDC, H3N2v in a fatal cluster is probably worse than H5N1 because H3N2v is already widespread, as indicated by the spike in "low reactors" reported in week 8 FluView.

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I guess I'm thinking outside the box. I don't see an H3 flu killing three adults that fast. (it hasn't proven fatal before).

if it's H5, we'll never know. An H5N1 cluster in this country would be the kiss of death to a multi-billion dollar poultry export industry. The USDA trumps the CDC.

_________________
"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."

The profile on this clusters is far too high to ignore. One of the fatalities was sent to autopsy, so the CDC will have optimal lung samples (for isolating virus). Similarly, one case is still in the ICU, and all three have tested positive for influenza A, so there is little doubt that a sero-type and sequence will be released (I expect a serotype by tomorrow and a sequence this week).

H3N2v, H5N1, and severe H1N1pdm09 cases have D225G so all have the potential of presenting as was seen in the cluster (this has some similarities with the Duke Medical Center which was H1N1pdfm09 with D225G and D225N). However, I suspect H3N2v because it has been circulating in humans since 2010 and the number of pneumonia cases has been high in many regions, including Maryland (although most have been on the mild side).

Moreover, the CDC was unusually silent on the spike in H3N2 low reactors repoorted last week, again suggesting that H3N2v was widespread and the CDC was delaying the announcement because they are not sure how serious it is (and this cluster is SERIOUS).

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www.twitter.com/hniman

The other daughter, 51, was transferred from Calvert to the hospital center Monday and is “doing better today,” Orlowski said.

That woman arrived with the same flu-like symptoms as her siblings, including fever, aches, cough and shortness of breath, Orlowski said.

Tests confirmed the siblings who died had a strain of flu virus known as influenza A, and each also acquired a serious staph infection, according to Orlowski. She said it was unlikely the infection was acquired in the hospitals because the siblings arrived coughing blood. “It’s likely they came to the hospital with the infection, which is what caused the cough and fever,” Orlowski said.

The mother was Lou Ruth Blake, according to a funeral home notice that was confirmed by a county official who did not want to be identified because the investigation is not closed.

Tests are being conducted to determine whether the second daughter has the same influenza virus and infection. Officials at the Centers for Disease Control and Prevention will determine what strain of the influenza A virus infected the family, Orlowski said.

This year’s flu season has gotten off to a late start, but Orlowski said there has been an increase in the number of patients with flu-like symptoms in recent weeks. Hospital center officials are looking into at least one other recent death — unrelated to the Calvert cluster— to determine whether it was related to flu.
http://www.washingtonpost.com/national/ ... story.html

_________________
"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."

-- Three members of a Maryland family died after contracting severe respiratory illnesses, and a fourth family member is hospitalized in critical condition, the Calvert County Health Department announced Tuesday.

Officials are trying to identify the illness that killed an 81-year-old woman and two of her children, both in their 50s, who cared for her in her home in Lusby. Another of the woman’s children is seriously ill at Washington Medical Center.

The elderly woman became ill around Feb. 23 and died on March 1, according to WJLA. The woman’s son and daughter developed symptoms around Feb. 28 when they came to care for her. They died on Monday.

The health department announced that no one outside the family has fallen ill and they are not recommending special precautions at this time.

Although few details are available about the illness, infectious disease specialists speculate there could be a number of causes.

“The first thing that comes to mind is influenza. It can be devastating and make people very ill,” said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville. “But when they’re a cluster like this, we have to wonder if it may be a mutant strain of flu virus. There’s been some concern about a swine flu variant.”

Pneumonia is also a possibility, as is Legionnaires’ disease.

“Legionnaires’ could cluster, and that would implicate perhaps something about this home environment,” Schaffner added. “Bacteria like moisture, so there would need to be an investigation of the heating and air conditioning systems.”

There could also be other environmental causes, such as a toxin, or even carbon monoxide poisoning.

Dr. Gio Baracco, associate professor of infectious diseases at the University of Miami’s Miller School of Medicine, speculated, based on the very limited amount of information available, that the cause is non-infectious and could be something environmental.

“The reason is that for most infections, transmission rate is not 100 percent and the fatality rate is not 100 percent,” he said. If the woman’s hospitalized daughter dies, the case fatality rate will be 100 percent, he explained.

“The fact that they’re in the same household and they’re not seeing the same thing going on in the community is unusual,” he added.

An earlier press release from the health department said the woman’s home is about a mile away from a power plant, but there has been no link between their proximity to the plant and the illness cluster.

The health department recommends that people regularly wash their hands and limit contact with anyone who is sick. They also urge anyone experiencing flu-like symptoms to seek medical attention.

http://www.kgoam810.com/rssItem.asp?fee ... d=29810887

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www.twitter.com/hniman

The above comments raise H5N1 concerns because of the high CFR (case fatality rate).

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Tip for Dr Gio Baracco - didn't a funeral director subsequently get sick? Must be an awful lot of carbon monoxide around there.

And I didn't know it made you cough up blood.