# 3289
The overriding message with the H1N1 swine flu has been that in most people it produces a `mild illness’. Mild being defined as non-life threatening, or not requiring hospitalization.
Indeed, it appears that most people suffer only minor symptoms, such as one might expect with seasonal flu. Even people who, due to age or health problems, are at `higher risk’.
And that is good news.
But a significant number of people have experienced serious complications, and we continue to see deaths from this new flu.
Neither are unexpected findings, as any flu can cause serious illness or death.
While seasonal flu normally strikes the over-65 population the hardest, this Swine flu is hitting young adults and children especially hard.
And, as we are often reminded, it is hitting those with `pre-existing conditions’ the hardest.
Having these pre-existing conditions doesn’t mean that a person will suffer complications from the flu, but it does mean they are at a higher risk of having problems.
No doubt, the reminder that healthy people are less likely to see adverse effects from this virus is comforting to many. But one most bear in mind that the definition of `pre-existing condition’ is fairly broad and includes hundreds of millions of people around the world.
Asthma, for instance, is regarded as a major risk factor. According to the Collaborative On Health & The Environment :
In 2002, an estimated 30.8 million people in the United States had asthma diagnosed at some point in their life, including some 8.9 million children. Asthma is estimated to affect as many as 300 million people worldwide.
Obesity is also being cited as a risk factor. Here in the United States (from American Sports Data, Inc) :
-- 63% of Americans are overweight with a Body Mass Index (BMI) in excess of 25.0.
-- 31% are obese with a BMI in excess of 30.0.
If you just count those with a BMI over 30, that’s 100 million Americans.
Pregnancy, which is often mentioned as a risk factor adds another 6 to 7 million people at risk in the United States.
Diabetes adds another 23 million Americans. Add to that another 37 million people over the age of 65.
And of course millions more have heart disease, are immunocompromised, are under the age of 2, have COPD, or meet any of the other `higher risk’ criteria.
While there are bound to be a significant number of people that fall into more than one of these categories, the truth is that somewhere between 1/3rd and 1/2 of our population fall into one or more of these `higher risk’ categories.
Which means that this new flu, like any flu, should not be taken lightly.
Today we get a breakdown, by pre-existing conditions, of 152 New Yorkers who were recently hospitalized due to the swine flu. I’ve excerpted parts of the press release, below and have reparagraphed a bit for readability.
By all means, follow the link to read it in its entirety.
Press Release # 039-09
Wednesday, June 3, 2009
CONTACT: (212) 788-5290
Jessica Scaperotti/Erin Brady: PressOffice@health.nyc.gov
- Two additional deaths linked to H1N1 virus, bringing the total to seven
- People at risk of flu complications should call a doctor to discuss medication if they develop fever of 100.4 degrees with cough or sore throat
- Flu-related emergency department visits have declined since May 25
June 3, 2009 – Illness from H1N1 influenza continues to occur throughout New York City, with most people experiencing only mild illness. Emergency room visits have declined somewhat after spiking dramatically during the third week of May. As anticipated, however, the infections have caused hospitalizations and deaths.
More than 300 New Yorkers have been hospitalized with H1N1 flu since late April, and the Health Department today provided the first detailed breakdown of risk factors among those hospitalized.
A preliminary analysis of 152 hospitalized patients shows that at least 82% have belonged to one or more groups at higher risk of severe illness or complications from influenza.
Those at higher risk of flu complications include:
- People who are over 65, under age 2, or pregnant
- People with chronic lung problems, such as asthma or emphysema
- People with chronic heart, kidney, liver or blood disorders
- People with neurological disorders that can cause breathing problems
- People with diabetes
- People whose immune systems are weakened due to illness or medication
- People under 18 years who are on long-term aspirin therapy
So far, the most common risk factor in New York City has been asthma – an underlying risk factor among 41% of the New Yorkers hospitalized for H1N1 flu. Other important risk factors include being less than 2 years of age (18% of hospitalized patients), having a compromised immune system (13%), having heart disease (12%), or being pregnant.
<snip>
Additional H1N1-related deaths identified
The Health Department today linked two more deaths to H1N1 influenza. The latest fatalities – both in adults in their early and mid 40s – bring the total number of deaths to seven.
All deaths to date have occurred in people under 65 years of age (the median age is 43). Six of the seven deaths have occurred in people with underlying conditions (including obesity) that can interfere with normal breathing, and one death is still under investigation. To safeguard patient privacy, the Health Department does not report on the clinical details of individual cases.
Other Health Department H1N1 monitoring activities
The City’s syndromic surveillance system shows that flu-related emergency department visits declined last week from their peak on May 25. Flu-related visits, which can reflect factors other than actual illness, were 15 times the expected level for this time of year. The number has since declined but is still far higher than the usual level.
