JAMA Study: H1N1 Hits Hard at All Ages

New America

Media, News Report, Paul Kleyman and Viji Sundaram,

Evidently, the swine flu upholds an old American tradition, after all: It

doesn’t discriminate by age — especially when it comes to death.

Previous reports suggesting that older H1N1 flu victims are less prone to

severe outcomes than children and young adults have been called into question

by a new report published November 3

in the Journal of the American Medical Association

(JAMA).

The article states, “In contrast with the common perception that

pandemic 2009 influenza A (H1N1) infection causes only mild disease,

hospitalization and death occurred at all ages, and up to 30 percent of

hospitalized cases were severely ill.”

Although one-third of those hospitalized were ages 18 or younger, the authors

write that people age 50 or older have the highest rate of death once

hospitalized.

“What our study shows was that once you were hospitalized, if you were

elderly, you have a higher risk of dying,” said Janice K. Louie, of the

California Department of Public Health, Richmond,

Calif. Louie study appears in

JAMA.

Louie, and her fellow researchers examined the records of the first 1,088

hospitalized and fatal cases due to the pandemic in California. Although seven percent of this

18 or younger died after hospital admission, the death rate was 18-20 percent —

about one in five — for hospitalized adults 50-plus. Overall the death rate was

11%, or one in nine.

Dr. Thomas Frieden, director of the Centers for Disease Control and

Prevention noted that the results of Louie’s study matches with one done by his

agency. H1N1 affects all age groups, including those over 65.

“If they get it, it can be every bit as severe as seasonal flu, consistent

with other data,” Frieden is quoted as saying at a news conference.

To avoid having apparently mild cases escalate into serious illness, Louie

and her colleagues advise clinicians to closely monitor those 50 or older, who

turn up with an flu-like symptoms regardless of initial results.

Once hospitalized, adults, especially those with potentially aggravated

underlying conditions, “should be carefully monitored and treated promptly

with antiviral agents.”

Interestingly, the authors noted that besides the usual risk factors, such

as asthma, a new one appears evident among those hospitalized — obesity. They

call for more study of this finding.

Findings of the new study do not change the CDC’s recommendation for

vaccination, which focuses on younger people, those with such chronic

conditions as asthma and pregnant women.

What they do suggest is that doctors should not dismiss the risks to older

patients, said Frieden.

To contact Louie, call Michael Sicilia at 916-445-2108 or e-mail [email protected].

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