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Increase in respiratory illness reported in southeast Alabama: 10 hospitalizations, 2 deaths - multiple pathogens detected, including influenza A/H1N1, influenza A/H3, and rhinovirus

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  • #16
    Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

    This story is getting picked up and broader attention

    http://vitals.nbcnews.com/_news/2013...ma-2-dead?lite

    Comment


    • #17
      Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

      Published Date: 2013-05-21 19:37:13
      Subject: PRO/EDR> Undiagnosed respiratory disease - USA: (AL), fatal, RFI
      Archive Number: 20130521.1729125

      UNDIAGNOSED RESPIRATORY DISEASE - USA: ALABAMA, FATAL, REQUEST FOR INFORMATION
      ************************************************** ****************************
      A ProMED-mail post
      http://www.promedmail.org
      ProMED-mail is a program of the
      International Society for Infectious Diseases
      http://www.isid.org

      [1]
      Date: 21 May 2013
      Source: Alabama Department of Public Health [edited]
      http://adph.org/news/assets/130521.pdf


      Undiagnosed Respiratory Illness, Alabama, USA
      ---------------------------------------------
      NEWS RELEASE / ALABAMA DEPARTMENT OF PUBLIC HEALTH, RSA Tower 201 Monroe Street, Suite 914 Montgomery, AL 36104, Phone 334-206-5300 Fax 334-206-5520, www.adph.org


      Increase in respiratory illness reported in southeast Alabama

      FOR IMMEDIATE RELEASE


      CONTACT: Mary McIntyre, M.D., M.P.H., (206-5325


      The Alabama Department of Public Health (ADPH) and the Houston County Health Department, in consultation with the Centers for Disease Control and Prevention, are investigating a cluster of respiratory illnesses of unknown origin in southeast Alabama.

      7 people have been admitted to a hospital with fever, cough and shortness of breath; 2 of the 7 have died.

      Laboratory samples have been obtained from all patients. Laboratory testing continues at both ADPH Bureau of Clinical Laboratories and CDC's Respiratory Laboratory. ADPH and CDC have recommended the hospital use respiratory precautions, which include staff using N95 masks when caring for patients presenting with respiratory symptoms.

      If you or your family members have respiratory symptoms of fever, cough and shortness of breath, please contact your health care provider to be evaluated.

      --
      Communicated by:
      Giuseppe Michieli
      <gimi69@libero.it>
      http://www.FluTrackers.com

      ******
      [2]
      Date: 21 May 2013
      Source: Dothan Eagle [edited]
      http://www.dothaneagle.com/news/arti...9bb30f31a.html


      7 people have been admitted to area hospitals, and 2 of them have died, in what health officials described Tuesday as a "cluster" of respiratory illnesses with flulike symptoms.

      Of the 7 people, 2 have died and the other 5 remain hospitalized, one in an intensive care unit. No specific hospitals were named.

      The illnesses date back as far as [19 Apr 2013] and to as recent as Monday [20 May 2013].

      The Houston County Health Department held a press conference on Tuesday [21 May 2013] morning to release some details.

      The symptoms are flu-like, with those affected suffering from fever, shortness of breath, and cough. There are no other similar clusters of this illness in Alabama. All the cases are from within a 10-county area in Southeast Alabama.

      The Alabama Department of Public Health and the Centers for Disease Control have recommended hospitals use precautions, including having staff use protective masks.
      Health officials aren't sure who is at risk, but advise anyone displaying symptoms to seek advice from their physician.

      Anybody with general questions can contact the Houston County Health Department at 334-678-2800.

      [Byline: Matt Elofson]

      --
      Communicated by:
      ProMED-mail
      <promed@promedmail.org>

      [Reports of clusters of undiagnosed severe acute respiratory illness [SARI] associated with fatalities are disconcerting at any time, but given the outbreaks of SARI due to influenza A (H7N9) in China this year, and the ongoing occurrence of SARI due to the MERS-CoV related to contact in the Middle East, this report of a cluster of as yet undiagnosed SARI in Southern Alabama in the USA raises concerns. While one presumes the routine influenza virus testing has been done, results of such laboratory testing are not mentioned in the above reports.

      More information on this cluster would be greatly appreciated including laboratory testing thus far, epidemiologic features of the cases -- age, sex, history of travel, history of contact with other cases or animals.

      For a map of Alabama showing counties, see http://www.digital-topo-maps.com/cou.../alabama.shtml.
      For the interactive HealthMap/ProMED map of the USA showing the location of Alabama, see below. - Mod.MPP

      A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1FEr.]

      http://www.promedmail.org/direct.php...130521.1729125

      Comment


      • #18
        Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

        Source: Dothan Eagle, full page: http://www.dothaneagle.com/news/arti...9bb30f31a.html

        Posted on May 21, 2013 by Matt Elofson

        (...)

        Peggy Williams, a state Department of Health investigator, said of the five people who remained hospitalized Tuesday, one was in an intensive care unit at a local hospital.

        (...)

        -
        ------

        Comment


        • #19
          Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

          The wording here suggests more than one positive result for influenza:

          http://www.foxnews.com/health/2013/0...heast-alabama/


          Mysterious respiratory illness kills 2, leaves 5 others hospitalized in Alabama
          Published May 22, 2013
          Associated Press

          UNDATED: A worker at the Center for Disease Control and Prevention sits at a station in the emergency operations center at the CDC. (AP)

          MONTGOMERY, Ala. ? A mysterious respiratory illness has left five people hospitalized and two dead in southeast Alabama, state health officials said Tuesday.

          Seven people have been admitted to hospitals with a fever, cough and shortness of breath in recent weeks, Alabama Department of Public Health spokeswoman Mary McIntyre said in a statement.

          Two of the seven have died. The Alabama Department of Public Health and the Centers for Disease Control Respiratory Laboratory are analyzing lab tests from all seven patients. McIntyre says officials hope to have preliminary results on the samples back by Wednesday or Thursday morning.

          The illness was first reported late last week and the last of the seven patients was hospitalized Monday, McIntyre said.

          It wasn't immediately clear which municipalities the illnesses were concentrated in.

          "We're only aware of the Southeast, but we don't know -- we haven't received reports from anywhere else," McIntyre said. "That's why we're trying to get the information out."

          McIntyre said it's unclear what's causing the illness but some of the seven patients also had the flu. Authorities are urging hospital staff to wear masks when caring for patients who appear to be suffering from respiratory illnesses.

          The Centers for Disease Control referred all questions to Alabama health officials.

          Comment


          • #20
            Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

            http://www.krmg.com/news/news/local/...ficials/nXyxH/

            [snip]

            State health officials can?t seem to find common ground among the patients either.

            Patients range from young to elderly, so there?s no clear group more susceptible to whatever it is causing people to get sick.

            Health officials also say they?re not sure how contagious the condition is either, but they do not that no family members of the current patients have gotten sick.

            Comment


            • #21
              Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

              More details, read the whole article:

              http://www.dothaneagle.com/news/arti...9bb30f31a.html

              [snip]

              Corey Kirkland, the assistant administrator for the area, said those two deaths occurred on Saturday and Sunday.

              [snip]

              Smith also said they don?t have a general common denominator among the seven people admitted to the hospital. She said they?ve had several young people and an elderly person among the cases, so it?s been difficult to determine who might specifically be at risk.

              Comment


              • #22
                Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths -at least one case positive for H1N1

                As I suspected by the wording above, a second positive:

                http://www.wsfa.com/story/22313426/u...theast-alabama

                [snip]

                The state health department says they are trying to find connections to these patients. So far, they have gathered that they are all adults ranging in age from early 20's to late 80s and they were all admitted into the Southeast Alabama Medical Center starting last Thursday.

                Officials say one patient tested positive for the H1-NI flu virus and another person tested positive for Type A Flu. Right now health officials are treating the mystery illness like the flu.

                Comment


                • #23
                  Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths - one case positive for H1N1, another for unspecified influenza A

                  [Source: Alabama Department of Health, full PDF document: (LINK). H / t HealthMap via Twitter.]


                  Alabama Department of Public Health ALERT Message 5/21/13


                  On 5/16/13, a pulmonologist in Southeast Alabama reported to the Alabama Department of Public Health (ADPH) that three patients had been hospitalized with cough, shortness of breath, and pneumonia, were on ventilators, and had no known cause for their illness. The ADPH and the Houston County Health Department began an epidemiology investigation to interview the families about travel and exposure.

                  Specimens were requested and submitted to the ADPH Bureau of Clinical Laboratories (BCL) in Montgomery.

                  On 5/17/13, BCL reported one of the three patients tested positive for 2009 H1N1. On 5/18/13, this patient died. On 5/19/13, the same hospital reported that a transferred patient on a ventilator with respiratory symptoms had died. On 5/19/13, this hospital had nine additional patients present to the emergency department with influenza-like illness and three of those patients were admitted. Specimens have been collected on all patients. The BCL has tested all specimens on a PCR flu panel and one tested positive for AH3. The specimens were also forwarded to CDC for additional testing.

                  At this time, there is no epidemiological link between these patients. While two patients have tested positive for influenza, the exact role of influenza in this cluster is unknown. On 5/21/13, ADPH sent a News Release regarding the situation.

                  ADPH has reiterated that healthcare providers should use standard precautions when dealing with patients with respiratory illness. Physicians should use clinical judgment in determining the best treatment for their patients since the etiology of the outbreak is unknown at this time.


                  REPORTING

                  Please report all patients currently hospitalized with pneumonia, with unknown cause (regardless of quick flu test results), to www.adph.org/epi, Respiratory Illness REPORT Card.


                  SPECIMEN COLLECTION

                  For patients who present with fever (>100.4F) and cough or shortness of breath with unknown cause (regardless of quick flu test results), please submit an upper tract specimen, ie, oropharyngeal (OP) swab or nasopharyngeal (NP) swab, to the Bureau of Clinical Laboratories as part of ADPH's year-round influenza surveillance program. For more information about collecting, packing, and submitting lab specimens, please go to http://adph.org/bcl/assets/Guide_Lab_Test_Inf_Virus_092210.pdf or call BCL 334-260-3429, Microbiology Division.

                  For patients who present with pneumonia with unknown cause (regardless of quick flu test results), please collect and submit a lower tract specimen, ie, bronchoalveolar lavage, tracheal aspirate, or sputum, to the BCL.

                  For patients admitted to the hospital with cough or shortness of breath, and pneumonia (regardless of quick flu test results), with unknown cause, please send both upper and lower tract specimens. Multiple respiratory specimen types with ample volume are preferred.

                  If you have any questions, please contact the Epidemiology Division at 1-800-338-8374 and ask to speak with staff involved in the Respiratory Illness Outbreak.


                  -
                  -------

                  Comment


                  • #24
                    Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 cases, 2 deaths - one fatal case positive for influenza A/H1N1, another for influenza A/H3

                    That is an excellent summary.

                    So the patient who tested positive for H1N1 has died on May 18. One additional patient (no test results) died on May 19. One surviving patient admitted later has tested positive for (presumably seasonal) H3. So the 7 patients hospitalized consist of the original 3 (1 dead), the extra death on May 19, and the three later admissions (all alive).

                    It also indicates that other cases have reported to the ER, but not been admitted. Perhaps not surprising, because comments on some of the other articles have indicates an overall increase in ARI in the area.

                    Comment


                    • #25
                      Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 hospitalizations, 2 deaths - one fatal case positive for influenza A/H1N1, one hospitalized case for influenza A/H3

                      http://www.troymessenger.com/2013/05...heast-alabama/
                      Mystery illness hospitalizes seven, kills two in southeast Alabama
                      Published 11:00pm Tuesday, May 21, 2013
                      By Stacy Graning
                      [snip]
                      Dr. Mary McIntyre, an assistant sate health officer for disease control and prevention with the Alabama Department of Public Health, said Tuesday the seven reported cases are all linked to one hospital in Dothan...
                      _____________________________________________

                      Ask Congress to Investigate COVID Origins and Government Response to Pandemic H.R. 834

                      i love myself. the quietest. simplest. most powerful. revolution ever. ---- nayyirah waheed

                      (My posts are not intended as advice or professional assessments of any kind.)
                      Never forget Excalibur.

                      Comment


                      • #26
                        Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 hospitalizations, 2 deaths - one fatal case positive for influenza A/H1N1, one hospitalized case for influenza A/H3

                        Source Alabama Department of Health: http://www.adph.org/

                        Respiratory Illness Outbreak - Information for healthcare providers who need to submit a hospitalized patient with pneumonia and unknown cause, as well as other information, is on our Epidemiology Division Website (http://www.adph.org/epi ).

                        Comment


                        • #27
                          Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 hospitalizations, 2 deaths - one fatal case positive for influenza A/H1N1, one hospitalized case for influenza A/H3

                          Multiple causes suspected?

                          http://tbo.com/health/cdc-chases-cau...f8ae8d627427bb

                          CDC chases cause of mystery illness in SE Ala.
                          Published: May 22, 2013
                          MONTGOMERY, Ala. (AP) ? Doctors throughout Alabama have gotten notices from the State Department of Health about the unidentified respiratory illness that has killed two and hospitalized five more.

                          The Centers for Disease Control and the Alabama State Department of Health were investigating a cluster of hospital admissions Wednesday of people that have recently been admitted with flu-like symptoms in southeastern Alabama. Three remain hospitalized and two have been released.

                          Dr. Mary McIntyre of the Alabama Department of Public Health said that all of the severe illnesses were accompanied by pneumonia and may have had more than one contributing factor. McIntyre says the two people that died had different, but relatively common, forms of influenza.

                          Further information from the CDC is expected on Thursday morning. McIntyre says obesity can complicate serious respiratory illnesses.

                          Comment


                          • #28
                            Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 hospitalizations, 2 deaths - one fatal case positive for influenza A/H1N1, one hospitalized case for influenza A/H3

                            CDC continues search for Ala. mystery illness cause

                            <NOSCRIPT></NOSCRIPT><!--END wnDate-->Updated: May 22, 2013 3:13 PM CDT<NOSCRIPT></NOSCRIPT><!--END wnDate-->
                            By Tametria Conner -
                            By John Shryock -

                            Alabama Department of Public Health spokeswoman Dr. Mary McIntyre says those admitted for treatment suffered from fever, cough and shortness of breath. She says all of the severe illnesses were accompanied by pneumonia and may have had more than one contributing factor,

                            "We are running a multiple panel test that actually looks for viruses and bacteria so we can try to make sure we're not dealing with anything unusual," Dr. McIntyre said. Further information from the CDC is expected on Thursday morning.

                            Dr. McIntyre says the two people who died had different, but relatively common, forms of influenza.

                            Public health officials say they really don't know what they are dealing with and they have no idea if it has spread to other areas. That's why they are in constant contact with the Centers for Disease control, hoping the CDC can figure it out. The CCDC and ADPH are currently investigating the string of illnesses.
                            ...

                            Full text:
                            http://www.wsfa.com/story/22313426/mystery-illness-kills-2-alabama-residents-hospitalizes-5-others
                            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                            -Nelson Mandela

                            Comment


                            • #29
                              Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 9 hospitalizations, 2 deaths - one fatal case positive for influenza A/H1N1, one hospitalized case for influenza A/H3

                              One illness fatality linked to H1N1 flu virus
                              Total cases increased to 9

                              Posted: Wednesday, May 22, 2013 3:44 pm | Updated: 4:54 pm, Wed May 22, 2013.
                              by Matt Elofson

                              Officials with the local office of the state Department of Public Health said Wednesday that one of the two deaths that are part of a recent respiratory illness outbreak could be associated with the H1N1 flu virus.

                              Lesa C. Smith, a registered nurse with state Department of Public Health, also said the number of people admitted to local hospitals during the recent respiratory illness outbreak has increased from seven to nine.

                              ?We can?t say that the person died with H1N1, but we can say it was a death associated with it,? Smith said. ?A total of nine have been admitted. We know some people are recovering, and are going home.?
                              ...
                              ?We?re still in the investigative state, and we?re still waiting other tests to come back,? Kirkland said.

                              Health department officials have said all nine people admitted to local hospitals were within an eight-county southeast region, which includes Barbour, Coffee, Crenshaw, Dale, Geneva, Henry, Houston and Pike County.
                              ...
                              http://www.dothaneagle.com/news/arti...9bb30f31a.html
                              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                              -Nelson Mandela

                              Comment


                              • #30
                                Re: Increase in respiratory illness reported in southeast Alabama (Health Dept., May 21 2013): 7 hospitalizations, 2 deaths - one fatal case positive for influenza A/H1N1, one hospitalized case for influenza A/H3

                                Ala. mystery illness cases climb to 10; CDC still investigating

                                Posted: May 21, 2013 12:05 PM CDT Updated: May 22, 2013 5:09 PM CDT
                                By Tametria Conner -
                                By John Shryock -

                                HOUSTON CO., AL (WSFA) -

                                The number of mystery illness cases affecting Alabama is growing.
                                Wednesday, Alabama Department of Public Health spokeswoman Dr. Mary McIntyre confirmed the number rose to ten overnight from a previous report of seven. Two people have died.

                                "Since we sent out the alert to providers last night, we have had three additional patients/cases," Dr. McIntyre told WSFA 12 News. "These patients all have the same symptoms of cough, shortness of breath and "something" on their chest x-rays," she explained.

                                Dr. McIntyre says it wasn't immediately known if all the new cases were in southeast Alabama, like the previous seven. But she said at least one person was admitted to Southeast Alabama Medical Center in the last 24 hours.

                                "We have staff right now in the field trying to get additional information about the other two patients," McIntyre said. No additional information on the three new cases is immediately available.

                                More...
                                http://www.wsfa.com/story/22313426/c...es-climb-to-10
                                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                                -Nelson Mandela

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