Swine flu growing more potent

Now dominant strain of influenza

Charlie Houley, 8, of Annapolis, Md., received a shot of a trail vaccine for the swine flu last week from nurse Peggy Hughes, as his brother Jack, 10, watched. Charlie Houley, 8, of Annapolis, Md., received a shot of a trail vaccine for the swine flu last week from nurse Peggy Hughes, as his brother Jack, 10, watched. (Susan Walsh/ Associated Press)
By Lauran Neergaard
Associated Press / August 31, 2009

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WASHINGTON - The alarm sounded with two sneezy children in California in April. Just five months later, the never-before-seen swine flu has become the world’s dominant strain of influenza, and it’s putting a shockingly younger face on flu.

So get ready. With flu’s favorite chilly weather fast approaching, the United States is going to be a sick nation this fall. The big unknown is how sick. One in five people infected or a worst case - half the population? The usual 36,000 deaths from flu or tens of thousands more?

The World Health Organization predicts that within two years, nearly one-third of the world’s population will have caught it.

“What we know is, it’s brand new and no one really has an immunity to this disease,’’ Health and Human Services Secretary Kathleen Sebelius says.

Colombian authorities reported yesterday that President Alvaro Uribe has the swine flu, and officials are contacting other South American governments whose leaders attended a recent summit in Argentina along with the Colombia leader.

Uribe, 57, began feeling symptoms Friday and the diagnosis was confirmed Saturday, said Social Protection Minister Diego Palacio. He said Uribe was not considered a high-risk patient and is not under quarantine.

In the United States, a lot depends on whether the swine flu that simmered all summer erupts immediately as students crowd back into schools and colleges - or holds off until millions of vaccine doses start arriving in mid-October.

Only this week do US researchers start blood tests to answer a critical question: How many doses of swine flu vaccine does it take to protect? The answer will determine whether many people need to line up for two flu shots - one against swine flu and one against the regular flu - or three.

The hopeful news: Even with no vaccine, winter is ending in the Southern Hemisphere without as much havoc as doctors had feared, a heavy flu season that started early but not an overwhelming one. The strain that doctors call the 2009 H1N1 flu isn’t any deadlier than typical winter flu so far. Most people recover without treatment; many become only mildly ill.

Importantly, careful genetic tracking shows no sign yet that the virus is mutating into a harsher strain.

We’re used to regular flu that, sadly, kills mostly grandparents. But the real shock of swine flu is that infections are 20 times more common in the 5- to 24-year-old age group than in people over 65. That older generation appears to have some resistance, probably because of exposure decades ago to viruses similar to the new one.

Worldwide, swine flu is killing mostly people in their 20s, 30s, and 40s, ages when influenza usually is shrugged off as a nuisance. Especially at risk are pregnant women. So are people with chronic conditions such as asthma, diabetes, heart disease, and neuromuscular diseases including muscular dystrophy. Some countries report more deaths among the obese.

Still, some of the people who’ve died didn’t have obvious health risks.

“People who argue we’re seeing the same death rates miss the point - they’re in young adults. To me, that shouldn’t happen,’’ said one infectious disease specialist, Dr. Richard P. Wenzel of Virginia Commonwealth University. He spent the past few months visiting South American hospitals to help gauge what the Northern Hemisphere is about to face.

Children, however, are the flu’s prime spreaders. Already, elementary schools and colleges are reporting small clusters of sick students. For parents, the big fear is how many children will die.

Panicked crowds flooded India’s hospitals in August after a 14-year-old girl became that country’s first death. In the United States, regular flu kills 80 to 100 children every winter, and the Centers for Disease Control and Prevention has reports of about three dozen child deaths from swine flu.

Even if the risk of death is no higher than in a normal year, the sheer volume of ill youngsters means “a greater than expected number of deaths in children is likely,’’ said Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases. Swine flu quietly sickened hundreds in Mexico before US researchers stumbled across two children in San Diego who had the same mystery illness. More than 1 million Americans caught swine flu in spring and summer months when influenza hardly ever circulates; more than 500 have died.

Schuchat said people should continue to get a regular flu vaccine. There’s still enough regular flu circulating to endanger people, especially the 65-and-older generation.

This week brings a key milestone. Hundreds of US adults who rolled up their sleeves for a first shot in studies of the swine flu vaccine return for a blood test to see if they seem protected. It will take government scientists a few weeks to analyze results, but the volunteers get a second vaccine dose right away, in case the first wasn’t enough.

The vaccine, merely a recipe change from the usual flu vaccine, seems safe. Federal authorities two weeks ago gave the go-ahead to start children’s vaccine trials. In the United States, Britain, and parts of Europe, vaccinations are set to begin in mid-October, assuming those studies show they work.

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