I’ve reposted this study in response to the previous posting about the dangers of H1N1 and the regular flu vaccines. I hope the statistics  will give us insite on the chances of catching one and ending up in the hopistal’s ICU.

Critical Care Services and 2009 H1N1 Influenza in Australia and New Zealand conducted by The ANZIC Influenza Investigators and published by the New England journal of Medicine on October 8, 2009.

As of September 6, 2009, the World Health Organization had reported over 277,607 laboratory-confirmed cases of 2009 H1N1 influenza, world-wide with at least 3205 deaths, this study focused on patients that needed critical care on the intensive care units (ICUs) in Australia and New Zealand from June 1 through August 31, 2009.

The study identified 722 patients with confirmed infection with the 2009 H1N1 virus (28.7 cases per million inhabitants) were admitted to an ICU in Australia or New Zealand. 

The study identified infants (0 to 1 year of age) and adults 25 to 64 years of age to be at particular risk. Pregnant women, adults with a BMI greater than 35, and indigenous Australian and New Zealand populations also appeared to have an increased risk. In-hospital mortality, estimated on the basis of data available at the time of this report, exceeded 16%. Patients infected with the 2009 H1N1 virus were in the ICU for a total of 8815 bed-days (350 per million inhabitants). The median duration of treatment in the ICU was 7.0 days (interquartile range, 2.7 to 13.4)

The age-specific incidence rates were highest among infants and adults 25 to 64 years of age. Although the ICU admission varied across the age groups and was low for patients 65 years of age or older, the risk of death increased with increasing age.

A total of 66 of the 722 patients (9.1%) admitted to the ICU with 2009 H1N1 influenza were pregnant women. Of the 722 patients, 669 (92.7%) were under 65 years of age and of the 601 adults for whom data were available, 172 (28.6%) had a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 35.

Data on existing pulmonary disease were missing for 15 of the 722 patients with 2009 H1N1 influenza in our study; of the remaining 707 patients, 231 (32.7%) had asthma or another chronic pulmonary disease.

Data on the use of mechanical ventilation in the ICU were available for 706 patients; of these, 456 (64.6%) underwent mechanical ventilation for a median of 8 days (interquartile range, 4 to 16).

As of September 7, 2009, a total of 103 of the 722 patients (14.3% ) had died, and 114 (15.8%) remained in the hospital.

The proportion of patients who died in the hospital in our study is no higher than that previously reported among patients with seasonal influenza A who were admitted to an ICU. Patients admitted to an ICU with seasonal influenza A predominantly are elderly and have coexisting conditions. Among patients admitted to ICU, older age, the presence of coexisting conditions, and a requirement for invasive ventilation were independently associated with increased risk of death, but because there were greater numbers of younger patients in our cohort, the majority of deaths occurred in younger patients

The next study was conducted in the U.S. by the 2009 Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team and published also by the New England journal of Medicine on the same date, October 8, 2009.

Hospitalized Patients with 2009 H1N1 Influenza in the United States, April–June 2009

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.

Methods: Using medical charts, we collected data on 272 patients who were hospitalized for at least 24 hours for influenza-like illness and who tested positive for the 2009 H1N1 virus with the use of a real-time reverse-transcriptase–polymerase-chain-reaction assay.

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. 

All credits on these publications are given to the New England Journal of Medicine, the ANZIC Inflienza Investigators, the U.S. 2009 Pandemic Influenza A (H1N1) Virus Hospitalizations Investigation Team and all their affiliates. Reposted for educational purposes only. No copyright infringement intended. Read complete text and references of these studies in their website:  www.nejm.org

Photo source: publicdomainclip-art.blogspot.com

Other H1N1  Related Topics:

Influenza A (H1N1) Facts

How Can I Protect Myself From H1N1?

How do I know if I have influenza A(H1N1)?

What should I do if I think I have the illness?

What about using a mask? What does WHO recommend?

Should I go to work if I have the flu but am feeling OK?

Can I travel?

What about using a mask? What does WHO recommend?

US President , Barrack Obama delared H1N1 (Swine Flu) a national emergency last Friday, October 23, and was made public last October 24, 2009.

 The Associated Press’ Headline (by Philip Elliott) : Obama declares swine flu a national emergency.

(US) Administration officials said the declaration was a pre-emptive move and was not in response to any single development.

The declaration, signed Friday night and announced Saturday, comes with the disease more prevalent than ever in the US and production delays undercutting the government’s initial, optimistic estimates that as many as 120 million doses of the vaccine could be available by mid-October

Health authorities say more than 1,000 people in the United States, including almost 100 children, have died from the flu, known as H1N1, and 46 states have widespread flu activity. So far only 11 million doses have gone out to heath departments, doctor’s offices and other providers, according to the Centers for Disease Control and Prevention officials.

Since the vaccine is available or will be available in the market soon, do we need to be vaccinated?This is the big question me and my wife is trying to answer since our 8-year old kid belongs to the “high risk” category.

And while looking for some answers I found this heart breaking video of a  young woman with a dream of becoming a football cheerleader who’s life was changed forever by a regualar Flu shot which are considered safe after years of testing. We know that chances of getting this kind of side effect from Swine Flu or regular flu shot is very rare, but is it worth the risk?

Other topics about H1N1:

Influenza A (H1N1) Facts

How Can I Protect Myself From H1N1?

How do I know if I have influenza A(H1N1)?

What should I do if I think I have the illness?

What about using a mask? What does WHO recommend?

Should I go to work if I have the flu but am feeling OK?

Can I travel?

What about using a mask? What does WHO recommend?

photo source: myfoxdc.com

Don’t have extra cash to donate? Donate your time! Call your local Red Cross Chapter, your local church organization like the Catholic Relief Services, your local relief organization like the Salvation Army, etc., for any help that you can extend. They may need an extra helping hands more than cash, cans of sardines or used clothing!

If you think relief operations are for trained personnel only, your dead wrong! There are more than 1,001 ways to help others through your Red Cross and other relief organizations.

Help in the kitchen: help cook food for distribution to evacuation centers, food for canteen services of the rescuers, police officers, firemen, etc and of the volunteers and staff that are working tirelessly 24/7. bring extra disposable plates, spoons. forks and cups if you can.

Help in the office: help receive goods, accommodate visitors, guide volunteers, file reports, answer phone, operate the 2-way radio, clean office, organizer clutter, etc. Bring your 2-way radio if you have, your celphone and its charger. Bring flashlight if you can.

Help in errands: drive transport unit, buy supplies, pick up donations, pick up/drop off personnel and volunteers, etc. Bring your car, motocycle, or bicycle if you can.

Help in relief operations:  load and unload supplies, sort out relief goods, drive supply trucks, distribute goods, gather field information, etc., bring working gloves, masks, hard hat, rubber or military boots, pocho or raincoat, extra clothing, jacket, sleeping bag if you can.

Help in the rescue operations: If you have a military background or have skills in outdoor sports, a trained rescuer, if you have medical backgroud, a nurse, a doctor, a midwife, a first aider, a life guard or if you have knowledge in logistical operations, you will be a very valuable rescue team personnel. If you own a boat, a generator set, rapelling ropes and accessories, binoculars, spot lights, etc. call the organization’s operations center.

These are just a few examples of what you can do and a few examples of opportunities that you can meet  people and good friends.

Lastly, please remember them, the tens of thousands, victims of typhoon Onday, that desperately need your help!

If you want to help through monetary donation:

Philippine National Red Cross: http://www.redcross.org.ph/Site/PNRC/wtd.aspx

Catholic Relief Services: https://crs.org/donate/

Salvation Army: https://secure.salvationarmy.org/donations.nsf/donate?openform&t=PH_PHL

(Photo Source: AP)

Let’s HANGOUT in Iloilo City and join the Annual International Coastal Cleanup!

The Ocean Conservancy is inviting everyone to join the Annual International Coastal Cleanup held on 2nd or 3rd weekend of September. This is a global effort to clean-up the coastline, rivers and lakes of trash and recording them for future references and studies.

The 2008 International Coastal Cleanup campaign gathered 400,000 volunteers from around the world and collected 6.8 million pounds of trash. The Philippines has been actively participating since 1994 in this annual global effort with 2,625,284 volunteers throughout the country.

There is no specific data about the clean-up activities in Iloilo city and province. But to give us some idea, here is the 2007 Ocean Conservancy Summary Report for the Philippines by ICC Coordinator Geronimo P. Reyes and Samuel Umandap:

In Philippines, 50,526 volunteers participated in the ICC, removing 250,973.9 pounds of trash and debris from 217.2 miles of shoreline. In addition, 721 volunteer divers participated in underwater cleanups, removing 6,999.8 pounds of debris from 31.5 miles of seafloor. 65.9 percent of the debris found in Philippines came from land-based activities like picnics, festivals, sporting events, and beach outings. Litter washed from streets, parking lots, and storm drains also contributed to this category.

Ocean and water-based activities offshore such as boating and fishing accounted for 17.9 percent of Philippines’s debris. Globally, 6.3 percent of collected debris came from ocean and waterway-based activities

Smoking-related products (cigarette filters, cigar tips, and tobacco packaging) accounted for 13.6 percent of the debris found in Philippines. Worldwide, these items comprised 33.6 percent of the six million pounds of debris collected.

Plastic bags top the list of debris collected.

To illustrate further some coastal area conditions in our country, here is a couple of pictures I grabbed from my friend’s facebook. These were taken during a bird population census last January of 2007.

photo source: kaakbay

Ocean Conservancy’s International Coastal Cleanup has thousands of volunteers and supporters. HANGOUT in Iloilo and  help clean-up Iloilo River and Coastal areas! 
To register: http://www.oceanconservancy.org

Areas already identified for clean-up in Iloilo and nearby provinces:

Parola-Quirino Bridge, Fort San Pedro-Ortiz, Sto. Nino Sur in Arevalo,

Nogas Island, Boracay Island

Brgy. Sampirit in Negros, Punta Ballo also in Negros

(Article and photo sources: oceanconservancy.org, apps.facebook.com)

How can I protect myself from H1N1? Now is the time to be aware.

( Source: WHO )

Insect repellent lotion and spray, insecticide spray, screened or airconditioned rooms, mosquito nets + iloilo’s food and places could still be a lot of fun!! Check all these information about degue fever.

Aedes Mosquito

The principal mosquito vector, Ae. aegypti, prefers to feed on humans during daytime: in the morning for several hours after daybreak and in the late afternoon for several hours before dark. Nevertheless, the mosquito may feed at any time during the day, especially indoors, in shady areas, or when it is overcast. Studies placed the estimated risk for travelers returning from dengue-endemic areas near one illness per thousand travelers. This estimate may overstate the danger for tourists who may have less contact with the vector when they stay only a few days in air-conditioned hotels with well-kept grounds, or when they participate in outdoor recreational activities where the vector mosquito may be absent (such as sunbathing or playing golf in the middle of the day). Moreover, travelers who stay in the homes of friends and relatives in locations with intense disease transmission may have a higher risk of illness. Therefore, everyone in the (and travelers to) endemic and epidemic areas should take precautions to avoid mosquito bites.

Risk Factors

Current data suggest that co-circulation of all four dengue strains in the same geographic region, virus genotype, and host factors such as immune status (i.e., having had a previous dengue infection), age, and genetic background are the most important risk factors for developing DHF. In Asia, where a high proportion of the population has experienced a dengue infection early in life, DHF is observed most commonly in infants and children younger than 15 years of age who are experiencing a second dengue infection. In the Americas and the Pacific, where primary infection at a young age is less common, DHF is typically observed in older children and adults. Therefore, international travelers from nonendemic areas (such as the United States) are generally at low risk for DHF.

Pregnant Women and Dengue Fever

There is little information in published reports about the consequences of dengue infection for pregnant women. No convincing evidence demonstrating an association between dengue infection during pregnancy and congenital malformations has been reported. However, if the mother is ill with dengue at the time of delivery, the child can be born with dengue infection or can acquire dengue through the delivery process itself, and then develop the manifestations of dengue fever or DHF. Passive transplacental transfer of maternal anti-dengue antibodies acquired from a previous maternal infection can also place infants at greater risk of DHF with their first dengue infection, but these maternal antibodies are cleared by 9-12 months of age.Transfusion-related dengue infection is a theoretical possibility

Sources:photo: AidanJones’ photostream and zenproof flickr.com, Article: CDC

You will not be able to tell the difference between seasonal flu and influenza A(H1N1) without medical help. Typical symptoms to watch for are similar to seasonal viruses and include fever, cough, headache, body aches, sore throat and runny nose. Only your medical practitioner and local health authority can confirm a case of influenza A(H1N1).

What should I do if I think I have the illness?

If you feel unwell, have high fever, cough or sore throat:

• stay at home and keep away from work, school or crowds;
• rest and take plenty of fluids;
• cover your nose and mouth when coughing and sneezing and, if using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;
• if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;
• use a mask to help you contain the spread of droplets when you are around others, but be sure to do so correctly;
• inform family and friends about your illness and try to avoid contact with other people;
• If possible, contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary.

When should someone seek medical care?

A person should seek medical care if they experience shortness of breath or difficulty breathing, or if a fever continues more than three days. For parents with a young child who is ill, seek medical care if a child has fast or labored breathing, continuing fever or convulsions (seizures).

Supportive care at home – resting, drinking plenty of fluids and using a pain reliever for aches – is adequate for recovery in most cases. (A non-aspirin pain reliever should be used by children and young adults because of the risk of Reye’s syndrome.)

Should I go to work if I have the flu but am feeling OK?

No. Whether you have influenza A(H1N1) or a seasonal influenza, you should stay home and away from work through the duration of your symptoms. This is a precaution that can protect your work colleagues and others.

Can I travel?

If you are feeling unwell or have symptoms of influenza, you should not travel. If you have any doubts about your health, you should check with your health care provider.

What about using a mask? What does WHO recommend?

If you are not sick you do not have to wear a mask.

If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly after wards.

If you are sick and must travel or be around others, cover your mouth and nose.

Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of spreading infection.

(source: WHO Epidemic and Pandemic Alert and Response)

Influenza A (H1N1) is a new virus causing illness in people.  This new virus was first detected in people in April 2009 in the United States.  This virus is spreading from person-to –person, probably in much the same way that the regular seasonal influenza viruses spread.

Influenza A (H1N1) is fatal to humans

Signs and symptoms in humans

- similar to the symptoms of regular flu such as

• Fever
• Headache
• Fatigue
• Lack of appetite
• Runny nose
• Sore throat
• Cough

- Vomitting or nausea
- Diarrhea

Mode of Transmission

- Exposure to droplets from the cough and sneeze of the infected person
Influenza A (H1N1) is not transmitted by eating thoroughly cooked pork.

Prevention

- Cover your nose and mouth when coughing and sneezing
- Always wash hands with soap and water
- Use alcohol- based hand sanitizers
- Avoid close contact with sick people
- Increase your body’s resistance
- Have at least 8 hours of sleep
- Be physically active
- Manage your stress
- Drink plenty of fluids
- Eat nutritious food

DOH Hospitals designated as Referral Centers for Emerging and
Re-emerging Infectious Diseases

National Referral Center

Research Institute for Tropical Medicine (RITM)
Alabang, Muntinlupa, Metro Manila
Tel No. 809-7599

Sub-national Referral Center

A. Luzon and Metro Manila
San Lazaro Hospital
Quiricada St., Sta. Cruz, Manila
Tel. No. (02) 732-3776 to 78

Lung Center of the Philippines
Quezon Avenue, Quezon CIty
Tel. No. (02) 924-6101 / 924-0707

B. Visayas

Vicente Sotto Medical Center
Cebu City
Tel. No. (032)-253-9891 / 254-0057

C. Mindanao

Davao Medical Center
Bajada, Davao City
Tel. No. (082) 221-6574

Satellite Referral Hospitals

Regional Hospitals/Medical Centers of 16 regions

How do I know if I have influenza A(H1N1)?

Source: http://www.doh.gov.ph/swine_flu