# 3290
With each passing day we continue to see scattered reports of deaths related to the H1N1 swine flu virus. While deaths from influenza are not uncommon - particularly among the elderly- this flu is attacking younger people.
In my last blog, New York Health Officials announced:
All deaths to date have occurred in people under 65 years of age (the median age is 43).
Today we learn of a 9 year-old girl from California who died from a combination of H1N1 and a secondary bacterial infection. First the story, then some discussion.
9-Year-Old Concord Girl Dies Of Swine Flu
Posted: 11:13 am PDT June 4, 2009Updated: 11:45 am PDT June 4, 2009
WALNUT CREEK, Calif. -- A 9-year-old Concord girl who had been diagnosed with the H1N1 virus has died, marking the Bay Area's first swine flu-related death, health officials announced Thursday.
Contra Costa Health Services announced the child's death Thursday after a state laboratory confirmed that she had the H1N1 virus in addition to a secondary bacterial infection, Contra Costa Public Health Director Dr. Wendel Brunner said.
The coroner's office confirmed it was investigating the death along with the health department, but the child's official cause of death was pending further test results. The state Department of Public Health and the Centers for Disease Control and Prevention were working to determine the exact role the H1N1 virus played in the death, Brunner said.
Brunner said the county has identified only 90 probable cases of swine flu through laboratory testing, but that health officials stopped testing most suspected cases of the virus several weeks ago and believe there are at least several times that number in the county.
Swine flu has been blamed for three deaths in California and at least 20 deaths nationwide, Brunner said.
Pediatric deaths, of course, are all the more tragic. I’m sure all of our hearts go out to this little girl and her family.
Sadly, during an average flu season, we lose between 50 and 100 children due to complications from influenza. In recent years, we’ve seen an upsurge in secondary bacterial pneumonias, including from MRSA.
So far, with this H1N1 virus we’ve seen very little mention of secondary pneumonia, which is somewhat surprising. When asked about MRSA coinfection on May 19th the CDC stated:
So far as we′ve been looking at the patients with the H1N1 virus, we don′t have evidence of coinfection. Not everybody has been tested for bacterial infections. But among the ones that have been tested, we aren′t seeing an important role for bacterial coinfection, including MRSA.
So this case appears to be a bit unusual, at least based on the reports we’ve seen to date.
The other thing to keep in mind is that deaths that occur among those hospitalized, or to young adults and children, are more likely to be fully investigated to determine the cause.
That may skew the numbers we see when it comes to deaths due to this virus.
According to the WHO, there are cases now in 66 countries, but only 4 (United States, Canada, Mexico, and Costa Rica) have reported fatalities.
Quite frankly, this lack of reported deaths around the world may say more about the state of surveillance and reporting than it does the virus’s virulence.
Of course, even in the United States, it is likely that we are missing H1N1 related deaths.
We don’t identify every seasonal flu victim (see Arizona & Illinois Report Swine Flu Related Deaths) and must rely on statistical models to estimate the number of fatalities each year.
Something to keep in mind when reading the daily statistics.
They only tell part of the story.
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