The H1N1 patient surge; experiences in four countries reviewed

A recent commentary in the Journal of the American Medical Association compares past clinical experience with H1N1 across four countries. Mexico, Canada, Australia and New Zealand involving intensive care units. Despite differences in normal care and mortality across the countries (which ranged from 14 to 41 percent), the studies signal what hospitals may confront in the coming months. Influenza outbreaks in Canada and Mexico lasted about 3 months. Peak flu periods lasted a few weeks during which time hospitals struggled to accomodate the surge in critically-ill patient volume. Patients tended to be “adolescents and young adults”, who rapidly progressed from flu symptions to respiratory failure. “Shock and multisystem organ failure were common.” The fact that large proportions of critically-ill patients did survive reflects the wide availability of antibiotics, antiviral medicines, and mechanical ventilation. However, authors caution that these experiences also underscore the need for planning on the part of hospitals and public health officials. The authors also raise troubling questions as to who might get life support if scarcities occur.

Editor’s note: The availability of H1N1 vaccines represents a new factor in this flu season and this may mitigate against expected patient surges.

Adagio Teas

JAMA: Preparing for the Sickest Patients With 2009 Influenza A(H1N1)
Health.com: Studies: Swine Flu Hits Young the Hardest

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  1. […] Last week the World Health Organization (WHO) persuasively refuted spurious claims from the Council of Europe that H1N1 was a “fake pandemic” engineered for pharmaceutical companies profit by calmly presenting the timeline of pandemic events. H1N1 turned out to be a pandemic of moderate pathogenicity. However, at the outset clinical indicators revealed a spreading global hazard in the form of a rare but progressively fatal viral pneumonia that was straining intensive care units. […]