- The Washington Times - Friday, September 4, 2009

The Centers for Disease Control and Prevention said Thursday that the new H1N1 flu virus appears to be hitting a different group of children than the usual flu virus — older children with other underlying medical issues, particularly neuromuscular diseases.

Two-thirds of the 36 U.S. children who have died this year from the virus, popularly known as swine flu, had at least one underlying condition, usually a disability such as cerebral palsy, muscular dystrophy, epilepsy or long-standing respiratory or cardiac problems, Dr. Thomas Frieden, CDC director, said in Atlanta.

Citing a study released Thursday in the CDC’s weekly Morbidity and Mortality Report, Dr. Frieden noted that other flu deaths to children under 18 were attributed to bacterial infections. He said in a press conference that “when you get the flu, your immune system can be a little weakened and you can be more susceptible to other infections.”

Normally, more than half the people under 18 who die of influenza strains are 4 years old or younger; with H1N1, more than 80 percent of the child fatalities so far have been aged 5 through 17.

Dr. Frieden said that about 50 to 100 child influenza deaths occur in an average year, but that while the novel H1N1 has affected people throughout spring and summer, it doesn’t appear to be significantly deadlier overall. In a typical year, 36,000 flu deaths occur in the U.S., mostly to the elderly and the already ill. More than 550 lab-confirmed H1N1 deaths and 8,800 hospitalizations have been reported.

The former New York City health commissioner urged doctors who treat flu patients to realize how often such people appear to be getting better but then relapse with a high fever.

“That’s a clue that maybe they should be treated with antibiotics and things that will help them.” However, he emphasized that “most people with flu don’t need treatment.”

He said the statistics showing greater risk to older children, who are now heading back to school for the fall, demonstrate why children of all ages should be vaccinated as early as possible for the new strain, as well as people over 65 with other medical issues and others in high-risk groups.

“The good news is that, so far, everything that we’ve seen, both in this country and abroad, shows that the virus has not changed to become more deadly,” he said, adding that this new flu, while unpredictable in nature, usually doesn’t make people very ill.

Children and young people up to age 34 are in a high-risk target population to get vaccinated against H1N1 when such drugs become available through public and private health providers, likely to be in mid-October. Pregnant women and health care workers are other target groups.

In another development, the Institute of Medicine, part of the National Academy of Sciences, recommended that health care workers wear N95 respirators — a kind of fitted mask better able to filter than routine surgical masks — to help guard against respiratory infection from the new virus.

The respirators cover both the nose and mouth and, if fitted correctly, are capable of filtering out “at least 95 percent” of small viral particles, the report released Thursday stated.

Institute scientists, who had been asked by the CDC and the Occupational, Safety and Health Administration to judge the effectiveness of personal protective equipment, noted that it remained an open question the extent to which flu viruses are spread through the air versus by physical contact with contaminated fluids or surfaces.

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