NEJM: Review Of Hospitalized US Patients With Novel H1N1

[indigo girl]

http://afludiary.blogspot.com/2009/10/nejm-review-of-hospitalized-us-patients.html

Tonight Maggie Fox of Reuters brings us an excellent overview of a new study, published today in the NEJM, which confirms just how hard the novel H1N1 virus has hit younger patients.

Unlike seasonal flu, which is most devastating to those over 65, this novel swine flu virus has a predilection for the young. Ninety-five percent of the patients hospitalized included in this study were under the age of 65 and 45% were under the age of 18.

One of the other unusual aspect to this flu is the high percentage of vomiting and diarrhea reported. The early application of antivirals was seen to be therapeutic, and once again the question of morbid obesity being a serious complicating factor is raised.

First the Reuters report, then a link to the study. Follow the link below to read the entire article.

US flu study confirms H1N1 more serious in youth

Thu Oct 8, 2009 10:41pm BST

* 45 percent of those hospitalized were under 18

* Diarrhea, vomiting in 42 percent of children with H1N1

* Quick drug treatment may save lives

By Maggie Fox, Health and Science Editor

WASHINGTON, Oct 8 (Reuters) - A study of people who became seriously ill and died with the new pandemic swine flu confirms it is hitting a younger population than the seasonal flu and causes often different symptoms.

The study of 272 patients sick enough to be hospitalized showed about 40 percent had diarrhea and vomiting -- usually rare with seasonal flu -- and confirmed that quick treatment with antivirals could save lives.

Dr. Seema Jain of the U.S. Centers for Disease Control and Prevention, who led the study, said the findings had informed the CDC's advice on who should worry about the new H1N1 virus and when to get treatment.

http://uk.reuters.com/article/idUKN0815749920091008?rpc=401&

ABSTRACT (Excerpts)

Background During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics of the patients who were hospitalized with 2009 H1N1 influenza in the United States from April 2009 to mid-June 2009.

Results Of the 272 patients we studied, 25% were admitted to an intensive care unit and 7% died. Forty-five percent of the patients were children under the age of 18 years, and 5% were 65 years of age or older. Seventy-three percent of the patients had at least one underlying medical condition; these conditions included asthma; diabetes; heart, lung, and neurologic diseases; and pregnancy.

Of the 249 patients who underwent chest radiography on admission, 100 (40%) had findings consistent with pneumonia. Of the 268 patients for whom data were available regarding the use of antiviral drugs, such therapy was initiated in 200 patients (75%) at a median of 3 days after the onset of illness. Data suggest that the use of antiviral drugs was beneficial in hospitalized patients, especially when such therapy was initiated early.

Conclusions During the evaluation period, 2009 H1N1 influenza caused severe illness requiring hospitalization, including pneumonia and death. Nearly three quarters of the patients had one or more underlying medical conditions. Few severe illnesses were reported among persons 65 years of age or older. Patients seemed to benefit from antiviral therapy.

[oramar]

Here is my question. Should a HCW(MD, DO, PA, NP) who has power to prescribe Tamiflu order it for everyone they suspect of being infected with H1N1 give it or not?

[jennifer0702]

I find the GI symptoms to be alarming.