New strain of H1N1 that kills rapidly?

In a previous blog about the Situation in India, I mentioned a report indicating that patients there might be dying more rapidly of the new H1N1 virus:

From the Deccan Herald, September 16, 2009

Health experts believe the A(H1N1) virus has been mutating with local variants to become more virulent, with low temperatures and wet weather providing an ideal breeding ground.

As a way of substantiating their claims, they say that patients are dying within 24 to 48 hours after being infected by the virus. “The virus is not giving any chance to the doctors to treat the patient. That’s why even patients with good immunity are dying,” said Dr E A Ashok Kumar, superintendent of the government-run Gandhi hospital here.

Dr S V Prasad, superintendent of the government-run Chest Hospital—the nodal agency for swine flu treatment—believed the virus must have undergone change in its genetic make-up as it seem to affect patients faster than before.

Although the Indian health authorities attribute this apparent change in behaviour of the virus to genetic changes that occurred in India, there have been recent reports of more rapid deaths due to the new H1N1 virus in the United States as well.

From The Dallas Morning News, September 16, 2009

Cynthia Garcia left school ill on Thursday and died Sunday, hours after being admitted to the hospital. She was the first child in Dallas County to die of swine flu and the first to die who didn’t have a chronic health problem.

Cynthia also was the second Garland resident to die of swine flu, also called H1N1 influenza.

Cynthia Garcia was a healthy 11 year old who became ill at school and died less than 72 hours later. Concern about a more severe strain developing in Texas was expressed by a physician in Houston back in July.

At PFI_Forum, reports on the “Rumors” thread suggest there may be other cases of very rapid progression from illness to death.

There is insufficient evidence to suggest that a new, more lethal strain of H1N1 is circulating and infecting people with increasing frequency. However, given the consequences of such a strain, all isolates from fatal cases should be sequenced. Further, isolates that cause unusually rapid death should be tested in ferrets to determine if this property is due to virus or host factors.


10 thoughts on “New strain of H1N1 that kills rapidly?

  1. And is the CDC or any other countries health dept sequencing those who have died? Most are not even reporting cases to the CDC anymore or WHO.

  2. Some isolates from fatal cases are likely being sequenced. However, it is not clear that this is being done in systematic way. Further, unless information is attached to the sequence indicating that it came from a fatal case, it is obviously impossible to compare sequences from fatal cases with mild cases. Ideally, information on symptom onset and other patient data would also be attached to the sequence. Some of this may be available on a private data base run by a former ski instructor (Peter Bogner). I recently wrote a blog on the extreme danger posed by having critical data locked up in this way.

  3. It’s a disgrace that we don’t have a real time ability to track and compare isolates in the context of the illness observed and the medical profile of the person it was observed in.

  4. We do have the technical ability. The CDC has simply decided not to do it. All their protestations about “how hard they are working” are nonsense. Lots of labs could do this. If they can’t, they should get out of the way and let someone who knows what they are doing get the job done. The CDC is more of hindrance than a help.

  5. You’re right Monotreme I did misstate that. The correct way to put it is:

    It’s a disgrace that we ARE NOT USING OUR real time ability to track and compare isolates in the context of the illness observed and the medical profile of the person it was observed in.

  6. Yep.

    My question is: how many people have to die before someone credible makes it clear to the authorities that the CDC leadership is incompetent and botching our response to the pandemic.

    1. I’ve been thinking about the how many people have to die before … questions and actually it is probably quite a few.

      For one it’s a big country. To get to the 90,000 in the PCAST report you’d have about 200 deaths in each Congressional district between now and the end of the year. With maybe 50 in the peak week.

      And two it could be that as deaths start to peak the number of new cases will be going down and there will be a lot of vaccine administration coverage.

      That sort of event might not cause any real accountability problems for the CDC. If it is a magnitude worse then they say it mutated. Again no accountability problems.

      By the time epidemiologists have conferences to explain what really happened during The Pandemic those managing the message now will have moved on.

  7. This is strange. My daughter lives in San Antonio, yesterday she told me that a student at one of the local schools had died of swine flu. One of the news stations, WOIA, had a report about the boy’s death. He went home with a sore throat on Friday and died hours later. It is very unsettling because he was a healthy, very athletic young man. It sounds like he was in real bad shape by the time his mom got him to the hospital. He must have gone downhill real fast.
    His relatives and classmates must be in shock.

  8. Doctors being, “shocked” people with good healthy immune systems are dying rapidly from panflu are ignoring what happened in 1918-1920, and, what is now know about cytokine disregulation (cytokine, “storm”).

    ‘Our’ govt is causing more harm to our nation
    by having prevented honest public education about panflu threat/impact, and, actual home & community Preparation during 4 years of Alert
    (and, more years than that of H5N1, “Rapid Response & Containment” and, sheer Luck)
    than any enemy attack has been able to do in our history.
    Shame on public hellth & politicians & bureaucrats!

    Governments derive their “just” powers from the (Informed) consent of the governed.

    This, “sneaky” H1N1 PanFlu has always been able to kill some people very rapidly:

    May 22 “WHO Epidemiological Report”
    (see p 2 for CFRs by age decades!)

    ..”Among 45 fatal cases in Mexico, 54% were among previously healthy people (Table 2), most of whom were aged 20–59 years (Table 1); 1 was a pregnant woman at 34 weeks’ gestation”…

    ..”In Mexico, the clinical course has been notable for severe pneumonia, multifocal infiltrates including nodular alveolar and, less frequently, basilar opacities on chest radiographs, as well as rapid progression to acute respiratory distress syndrome (ARDS) and renal or multi-organ failure (24% of fatal cases).
    The median time from symptom onset to death was 10 days (range, 2–33 days).”…

    Fastest, “onset to death” reported by the WHO was
    2 days, as of May 20th.

    The low range of the time from symptom onset to *requiring* Hospitalization was only
    1 day.

    If there’s no way to know which 5% of cases can’t recover by themselves at home,
    and, since govts did not plan to be *able* to treat all cases with antivirals at onset
    (even though H5N1 was and is fatal otherwise! it’s been needing a 10-day course of effective antiviral),
    as number of infections is allowed to rise by keeping schools open and refusing to ban public gatherings for short-term, “economic” reasons,
    the numbers of innocent people up and dying from panflu unfortunately will keep increasing.

    Child infections come before adult infections (who then have much higher CFR’s: see that WHO link),
    “rapid” deaths come weeks before the vent cases finally succumb, and, these current losses and ICU overcrowdings come before the Mortuary sectors Unpreparedness for panflu surge year becomes visible to the public.

    “Community Mitigation” was supposed to be used;
    the public was supposed to be told
    how to really avoid infection by something
    contagious Before symptoms & Airborne contagious,
    and, PPE was supposed to have already been stockpiled for front-line responders!
    Officials chose not to. (Shame!)

    “And so it goes”.

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