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Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

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October 20, 2009

WHO Describes Clinical Features of H1N1 Influenza



October 16, 2009 — The World Health Organization (WHO) today described certain clinical features of the pandemic H1N1 2009 influenza virus and urged clinicians not to delay antiviral treatment so that the risk of severe disease would be reduced.
Dr. Nikki Shindo, a medical officer with the WHO's epidemic and pandemic alert and response team, spoke at a WHO/Pan American Health Organization press conference today in Washington DC.
According to Dr. Shindo, the H1N1 influenza virus can cause severe viral pneumonia in previously healthy people. "The H1N1 virus likes the lower respiratory tract and is more likely to cause viral pneumonia than seasonal flu," she said.
She also noted that previously healthy adult patients with very severe progressive disease typically start to deteriorate on or around day 3 from the onset of symptoms.
There is also increased evidence of bacterial coinfection with H1N1, mostly with staphylococcal and pneumococcal bacteria, estimated to occur in about 30% of hospitalized cases and associated with rapidly progressing disease. "This highlights the fact that antimicrobial treatment is important as well as early antiviral treatment," Dr. Shindo pointed out.
The top 3 groups at increased risk for severe illness and death are pregnant women, children younger than 2 years, and people with underlying lung disease (including asthma), she said.
Widespread Disease in US
According to a US Centers for Disease Control and Prevention (CDC) media briefing today, 41 states are now identifying widespread disease from influenza, representing an increase from 37 states last week.
"The other states are all seeing either regional or local activity," said Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases. "It's unprecedented for this time of year to have the whole country seeing such high levels of activity."
H1N1 continues to disproportionately affect young people, including children. To date, 86 children in the United States have died from the 2009 H1N1 influenza virus. In week 40, ending October 10, 11 more pediatric influenza deaths (10 confirmed to be due to H1N1) were reported.
According to Dr. Schuchat, about half of the deaths in children since September 1 have occurred in teens between the ages of 12 and 17 years. "These are very sobering statistics, and unfortunately, they are likely to increase," Dr. Schuchat said.
As of Wednesday, 11.4 million doses of the monovalent H1N1 vaccine were available, and 8 million of those doses had been ordered by states. "We're in the very beginning of this program and the numbers will be increasing regularly," she added.

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