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Stolen: Get your flu shot

by Joanne Stolen

In some parts of the U.S., the H1N1 (swine) flu seems to be ebbing, but around the world people are still coming down with the swine flu and some are dying. As of January, an estimate of more than 11,500 people worldwide have died from the disease since the outbreak began in April. This so far is still less lethal than the seasonal flu, which kills between 250,000 and 500,000 people each year. What are the current demographics?

Senior citizens have been mistakenly told they are less at risk, but the facts emerging are that the risk of death for a senior who contracts H1N1 is more than four times that of a child who gets it. That’s according to Peter Sandman, a longtime scholar of risk communication, as reported in Newsweek. http://www.newsweek.com/id/229947 While people 65 and older are less likely to be infected with 2009 H1N1 flu, those who do become infected are at greater risk of having serious complications from their illness. Children newborn to 17 are at higher risk from catching H1N1 than they are from seasonal flu, and they tend to spread it to more people than seniors do. CDC’s decision to prioritize children – especially during the fall, when vaccine was in short supply – made sense from this perspective. However, the federal government’s explanation that seniors can rest easy is misleading.

We have been told that children face a much greater risk from this disease, and they are dying from it in numbers never seen with regular, seasonal flu – and maybe seniors even have some special immunity to H1N1. The problem is that the numbers don’t add up, and H1N1 is more than twice as deadly to seniors as to children. As a result of this message, many older adults underestimate their own risk and the importance of getting vaccinated. According to recent statistics from the Centers of Disease Control (CDC), analyzed by Peter Sandman, a scholar of risk communication, an estimated 21.3 percent of children newborn to 17 (of whom there are 75 million) have contracted H1N1. Of those 16 million cases, there have been 71,000 hospitalizations and 1,090 deaths. That works out to a case-hospitalization rate (the chance of being hospitalized if you contract H1N1) of 0.44 percent, and a case-fatality rate (the risk of dying of the flu if you get it) of 0.007 percent. Compare those numbers with those for America’s 194 million 18-to-64s. Of them, 27 million have contracted H1N1, 121,000 have been hospitalized, and 7,450 have died. A little math shows that 13.9 percent of this age group has contracted the illness, but that the case-hospitalization rate is 0.45 percent and the case-fatality rate is 0.028 percent – quadruple that of children. Finally, among the nation’s 39 million seniors, there have been 4 million cases, 21,000 hospitalizations, and 1,280 deaths. That yields a 10.3 percent risk of contracting H1N1, a case-hospitalization rate of 0.52 percent, and a case-fatality rate of 0.032 percent – the highest of any age group.

Why do elderly people die of H1N1? Seventy-five percent of the fatalities examined had underlying medical problems, including heart disease and cancer. The remaining 25 percent had no obvious complicating factors. Most of the patients who died had breathing difficulties. All of the patients who underwent the autopsies showed evidence of acute lung injury and also had some sort of bacterial infection as well. By contrast, the patients with heart disease, cancer and other underlying causes had lung bleeding. Studies show an overly vigorous inflammatory response triggered by the viral infection may cause damage to lung tissue.

Right now there seems to be an abundance of vaccine available. Some states are overstocked and have not enough cold storage facilities and are actually returning their oversupply. Get your flu shot. Have I gotten mine? Not yet. I’m trying to get over a slight cold first, but I will. I picked up a form to fill out at City Market.

Breckenridge resident Dr. Joanne Stolen is a former professor of microbiology from Rutgers now teaching classes at CMC. Her scientific interests are in emerging infectious diseases and environmental pollution.


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