H1N1 carries infection threat

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By Ann Geracimos

Serious cases of respiratory disease have accompanied the H1N1 flu virus in populations not normally vulnerable to such a complication, the Centers for Disease Control and Prevention reported Wednesday.

In Denver, one of 10 metropolitan areas under investigation by the CDC, 58 cases of "invasive pneumococcal disease" have occurred, mainly in adults aged 20 to 59, a majority whom had underlying medical conditions that make a person vulnerable to serious flu complications.

Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, called the report "worrisome," because a typical October in Denver sees about 20 such pneumonia cases.

"Findings in Denver probably reflect findings that are occurring in other parts of the country where the surveillance hasn't been as intensive," she said.

Flu infections can reduce the lining of the respiratory tract and attract common bacteria that then can lead to a secondary pneumonia.

"Pandemics put us at risk for not just flu problems, but also bacterial pneumonia problems," Dr. Schuchat said, urging high-risk adults - those with chronic underlying conditions such as asthma, diabetes, emphysema and heart disease - to obtain a new pneumonia vaccine designed to prevent such problems.

The vaccine, which is only available privately through doctors' offices or pharmacies and retail centers, is given once and protects a person for life, unlike flu vaccines. But only 25 percent of high-risk adults younger than 65 have gotten it, she noted.

"Pneumococcus is a bacteria that commonly affects the lung or sometimes the bloodstream," Dr. Schuchat explained. "In a typical non-pandemic year, most serious pneumococcal infections occur in people 65 and over." In previous pandemics, there has been an increase of these in younger people.

(Corrected paragraph:) About 61.2 million doses of H1N1 vaccine were available for ordering by states as of Wednesday, and local sources are planning to step up promotion activities for vaccinations after Thanksgiving. Dr. Schuchat said the vaccine is proving to be as safe as the seasonal flu shot.

"In our look at all of the safety data so far, we're seeing patterns that are pretty much exactly what we see with the seasonal flu vaccine," she said, with the number, pattern and types of "adverse event reports" similar to what is found with seasonal flu vaccines.

About 94 percent of those reports are minor, such as a sore or red arm and injection-related tenderness.

CDC has three systems to monitor whether the rare neurological problem called Guillain-Barre Syndrome has emerged "in any kind of excess amount with the H1N1 vaccine," but no significant signs of a relationship between GBS and the vaccine are evident, Dr. Schuchat said.

Reported cases still are under review, but normally 80 to 160 people a week in the United States are diagnosed with conditions such as GBS, she cautioned, with or without vaccines.