USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 13 fatalities - Montgomery county health says 2 confirmed H1N1pdm09

[Pathfinder]

Re: USA - Texas: Media report: Unidentified illness - 4 died out of 8 hospitalized including 2 "very sick"

Montgomery County Public Health
(Facebook)

...
Brooke Montgomery Have all the schools been notified about this? I'm really concerned because parents are sending their children to school sick.

1 ? 11 hours ago..

Montgomery County Public Health Brooke Montgomery All of the area schools are aware of this and should handle the situation accordingly. Please share our posts with your friends to help emphasize the importance of staying home if you are sick. Thank you!
about an hour ago..

Jackie Albring Jackson Did the people who have this get a flu shot this year?
17 hours ago via mobile..

Montgomery County Public Health At the moment, we do not have this information. However, we are recommending for everyone to get the flu shot. Montgomery County residents may call the Public Health Clinic at (936) 523-5020 to set up an appointment to receive their flu shot, while supplies last.
4 ? 17 hours ago

Kim Nelson If they are testing negative for the flu, how would the flu shot help against this?
2 ? 16 hours ago via mobile ? Edited

County Public Health Kim Nelson each year the flu shot prevents a number of strains of the flu. While the patients have tested negative for the most common strains of influenza, there are still a number of other variations. For this reason, we are recommending for everyone to still receive the vaccine.
...

https://www.facebook.com/mctxpublichealth

[Pathfinder]

Re: USA - Texas: Media report: Unidentified illness - 4 died out of 8 hospitalized including 2 "very sick"

Montgomery County Public Health
(Facebook)
...
Mary Alred This news is here in California. Has your lab done a PCR test for H1N1? Rapid tests, if that is what was done cause false positives. This is very scary as we have relatives that live in Conroe. Also, I am hoping you are checking for the MERS Virus, too. I hope you will be able to post some info soon. Thank you.
27 minutes ago..

Montgomery County Public Health Mary Alred We have included every possible test in the labs to reach a proper diagnosis. More information to follow soon.
1 ? 16 minutes ago
...

https://www.facebook.com/mctxpublichealth

[alert]

Re: USA - Texas: Media report: Unidentified illness - 4 died out of 8 hospitalized including 2 "very sick"

http://abcnews.go.com/Health/mysterious-illness-texas-kills/story?id=21261390

A mysterious illness has Texas health officials worried after half of those infected died from the unidentified disease.

The Montgomery County Health Department said eight patients had presented with flu-like symptoms or pneumonia-like symptoms. Of the eight infected, four have died. Despite their symptoms, none have yet tested positive for the flu, officials said in a statement Tuesday.

However, the early rapid flu test does not test for all different flu strains and a state official said flu could not be fully ruled out yet.

Officials at the Conroe Regional Medical Center in Conroe, Texas, said that more definitive test results were still pending.

The patients range in age from 41 to 68 and it was unclear if any had underlying health issues that could have adversely affected their health.

[snip]

[sharon sanders]

Re: USA - Texas: Media report: Unidentified illness - 4 died out of 8 hospitalized including 2 "very sick"

This message is on their facebook page now:

For questions regarding the ILI cases in Montgomery County, please call the Public Health hotline at 936-523-5050. Thank you.

The line will be staffed Monday-Friday from 8am-5pm.

https://www.facebook.com/mctxpublichealth

-----------------------------

I called the number. It is for the general public to ask questions.

The health department does not have any additional test results back today yet but hopes to issue a new press release this afternoon with an update.

[Emily]

Re: USA - Texas: Media report: Unidentified illness - 4 died out of 8 hospitalized including 2 "very sick"

Golden Corral is a nationwide chain of restaurants, so there isn't likely much occupational exposure in this case. I wonder if the outpatient drugs included Tamiflu.

http://www.kens5.com/news/texas-news/Mother-says-mystery-illness-transformed-son-into-dying-patient-in-days-236360341.html

Mother says mystery illness transformed son into dying patient in days

CONROE, Texas ? The mother of the youngest of eight confirmed cases of a mystery illness in Montgomery County is sharing her son?s story.

Dathany Reed, 41, wasn?t feeling well on Thanksgiving. He called out sick from his job at the Golden Corral and went to see doctors at Conroe Regional Medical Center.

Odessa Reed says doctors sent her son home with several prescriptions.

She said her son was admitted to the hospital?s emergency room the next day and ended up on life support.

?It doesn?t make sense,? said Odessa Reed. ?How can you talk to a person one day, and they say, I?m not feeling good, and the next day, that person is on life support.?

Dathany?s 41st birthday came and went on November 30 while his kidneys and other organs deteriorated.

Family members said goodbye to the father of three on December 5.

more at above link...

Screen caps from the KEN5 video:

Youngest victim, Dathany Reed, is described by his mother as a healthy go-getter prior to his sudden illness:


Dr. Mark Escott:

[alert]

Re: USA - Texas: Public Health department confirmed unidentified ILI flu influenza type illness - 4 died out of 8 hospitalized including 2 "very sick" in Montgomery county - more tests pending

There is going to be an announcement at 4:30PM Central time (that's about 90 minutes away):

http://www.mchd-tx.org/

Updated information regarding the Influenza like illness in Montgomery County will be posted to our website and Montgomery County Public Health & Montgomery County Hospital District’s Facebook page at approximately

4:30 PM, Wednesday, December 18, 2013

[alert]

Re: USA - Texas: Public Health department confirmed unidentified ILI flu influenza type illness - 4 died out of 8 hospitalized including 2 "very sick" in Montgomery county - more tests pending

12/18/2013

UPDATE: INFLUENZA LIKE ILLNESS ARISES IN MONTGOMERY COUNTY

https://www.facebook.com/mctxpublichealth

As of Wednesday afternoon, there has been one confirmed case of H1N1 virus. Of the eight reported cases, four patients have deceased. Of the remaining four cases in an area hospital, one case has tested positive for the H1N1 virus. Two of the patients tested negative for all flu viruses. Montgomery County Public Health District is awaiting test results for the remaining patient. The 2013 Influenza vaccine does protect against the H1N1 virus. At this time no known deaths received the vaccine.

Based on CDC data, the H1N1 virus is nationally on the rise. It can reasonably be expected that the occurrence of more H1N1 cases will be reported. Public Health Officials will continue to monitor the situation diligently and will provide more information as it is received.

The Montgomery County Public Health District is grateful for Conroe Regional Hospital’s astute physicians who recognized the unusual nature of the illness and began the appropriate testing to reach a diagnosis.

Montgomery County Public Health District has been in discussion with the Texas Department of State Health Services along with the CDC to coordinate investigation efforts. Despite ongoing investigations, it cannot be emphasized enough that common infection control practices should be followed to prevent the spread of infection. As with common flu strains, some people are more likely to develop flu complications than others. Please reference the CDC’s website, http://www.cdc.gov/flu/about/disease/high_risk.htm, which further explains the high risk population, including children under the age of 5, adults over the age of 65, and people with certain medical conditions.

It is also recommended that you receive your flu shot. Montgomery County Public Health Clinic is offering the vaccination by appointment, while supplies last. Call (936) 523-5020 to set up an appointment. For any other questions or concerns, please contact the Public Health hotline at (936) 523-5050. The line will be staffed Monday thru Friday from 8AM-5PM, it is for non-media inquiries only.
_________________

[alert]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 "very sick" in Montgomery county - more tests pending - one case confirmed H1N1pdm09

comment by alert on above post:

(Are there any samples from the deceased cases? How long after onset were these samples taken? Is it possible that the two negative cases have already cleared the virus? Or is there some non-flu agent under investigation? - alert)

http://www.khou.com/news/local/Health-officials-Conroe-patient-with-mystery-illness-diagnosed-with-H1N1--236459811.html

HOUSTON – At least one of the eight patients being treated for a mysterious illness at Conroe Regional Medical Center has tested positive for H1N1, according to Montgomery County health officials.

The CDC is now monitoring the illness that has claimed at least four lives in Montgomery County.

Montgomery County health officials met again Wednesday afternoon to go over the latest test results from eight patients at Conroe Regional Medical Center. Four of those patients died and four others are still sick.

The patient diagnosed with H1N1 is still alive. The others will be retested.

Their illnesses started with flu-like symptoms, then progressed to pneumonia and, in some cases, organ failure. They all initially tested negative for the flu.

Other area hospitals are looking at a possible connection to similar cases they’ve seen.

"Right now in Houston, there are two outbreaks of respiratory illness and both can cause death," said Dr. Pedro Piedra, an internationally known flu researcher at Baylor College of Medicine.

One of those illnesses is the flu. The other is flu-like.

"Deaths will always occur with influenza. Sometimes more and sometimes less," Dr. Piedra said.

And just because the eight Conroe patients tested negative for the flu, doesn’t mean they didn’t have it.

"You can have influenza infection and not be able to detect it," Dr. Piedra explained. "Our rapid test that we use to say whether it is flu or RSV is not so good in adults."

That’s because adults normally have lower levels of the virus even when they are sick.

[snip]

-----------

There is also a report here:

http://www.chron.com/news/houston-texas/houston/article/Montgomery-Co-mystery-illness-likely-H1N1-virus-5076406.php?cmpid=houtexhcat

that claims one of the fatal cases has tested positive for H1N1, but that may be a reporting error based on the press release above. The one confirmed case appears to be alive.

[alert]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 "very sick" in Montgomery county - more tests pending - one case confirmed H1N1pdm09

Published Date: 2013-12-18 17:46:01
Subject: PRO/EDR> Undiagnosed respiratory illness - USA: (TX) fatal
Archive Number: 20131218.2124064

UNDIAGNOSED RESPIRATORY ILLNESS - USA: (TEXAS) FATAL
************************************************** **
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: Tue 17 Dec 2013
Source: KHOU 11 News [abridged & edited]

http://www.khou.com/news/health/Still-no-answers-for-mysterious-illness-that-has-killed-4-people-in-Conroe--236287281.html

The investigation into a mysterious illness in Montgomery County is expanding, as other hospitals and doctors report similar cases. The new case files are being reviewed for similarity to the 8 at Conroe Regional Medical Center that prompted a Montgomery County Health Department investigation.

Four of those 8 patients died, and 2 are still fighting for their lives. "We don't currently have a diagnosis for what has caused those illnesses," Montgomery County medical director Dr Mark Escott said. State and regional health departments have already been notified and are also looking for reports of new cases. "Other health departments will need to be looking for cases like this to make sure that we haven't missed cases," Dr Escott said.

Technically, the illness is classified as an influenza-like illness or ILI. There have been nearly 2000 ILI cases in Montgomery County this year [2013], but these 8 are different. "[There have been] 8 serious cases at a local hospital that developed with influenza-like symptoms that developed serious complications, including death for 4 of those 8 patients," said Dr Escott. At least some of these patients, all between the ages of 41 and 65, developed pneumonia. They all tested negative for standard strains of [seasonal] flu, and that is part of the problem. "The big worry about a situation like this is, 'Could this be a novel flu of some sort?'" Escott explained. "It could certainly be lots of other viruses or other diseases, but that is the big concern."

A 50 year old woman died last week at a hospital in North Harris County. She was perfectly healthy until she came down with flu-like symptoms about 3 weeks ago and ended up in the ICU.

The health department in Montgomery County is urging everyone to do their part to prevent any illness from spreading: Wash hands frequently; cover your cough but don't cough into your hands; stay home if you're sick; and get to the doctor within the 1st 48 hours of illness.

[byline: Jeremy Desel]

--
communicated by:
Jason Kaelber
Baylor College of Medicine
<jtk52@cornell.edu>

******
[2]
Date: Tue 17 Dec 2013
Source: Eastex Advocate [abridged & edited]

http://www.yourhoustonnews.com/eastex/news/no-diagnosis-made-in-mysterious-illness-four-dead/article_f876f117-98aa-5829-9b6b-a04ed1ab2a7a.html

Local and state medical officials are investigating an illness that has claimed the lives of 4 people in Montgomery County and hospitalized 4 more. The Montgomery County Public Health District was alerted of 8 cases at Conroe Regional Medical Center due to the severity of the cases. Of the 8 reported, 4 patients have died.

According to information from the Montgomery County Public Health District, officials learned of the cases within the last few weeks. All 4 deaths have been males ages 41-68, said Jennifer L Nichols-Contella, public information officer/administrative coordinator with the Montgomery County Hospital District and Public Health District. In a press release from the Health District, officials state no diagnosis has been made.

"Those affected are experiencing flu-like symptoms but have tested negative for common flu strains," the release states. "The patients are currently housed at an area hospital awaiting further laboratory test results in an effort to determine the nature of the illness. Montgomery County Public Health District officials are monitoring the situation closely and will provide more information as it arises." Nichols-Contella said there was little additional information about the patients including whether there was any connection in the deaths, whether they had been vaccinated for the flu, and whether autopsies would be performed. She added no other hospitals in Montgomery County have reported similar illnesses or deaths.

Health officials, according to Nichols-Contella, are not calling the illness an epidemic. Lindsay Duncan, spokesperson for Conroe Regional Medical Center (CRMC), confirmed the patients were at CRMC. "Conroe Regional Medical Center recently had 8 patients who presented to the hospital with similar flu-like symptoms," she said. "Initial rapid screening tests of these patients were negative for the flu; however, more definitive test results are pending. We are working closely with the Texas Department of State Health Services."

An official with the Texas Department of State Health Services said her office has been contacted by Montgomery County health officials. "We are aware of the illnesses and deaths in Montgomery County and have requested specimens be sent to our state lab for testing."

[byline: Catherine Domingez]

--
communicated by:
Jason Kaelber
Baylor College of Medicine
<jtk52@cornell.edu>

******
[3]
Date: Wed 18 Dec 2013
Source: Chron [edited]

http://www.chron.com/neighborhood/spring/health/article/Mystery-illness-claims-4-lives-in-Montgomery-5071680.php?cmpid=hpts

Four of 8 patients admitted recently to Montgomery County hospitals have died of a mysterious flu-like illness, officials said. The patients, ranging in age from 41 to 68, were admitted to the hospital with flu symptoms, but tests for influenza were negative, said Jennifer Nichols-Contella, spokeswoman for the Montgomery County Public Health District. "We're monitoring the situation and waiting on further lab results," Nichols-Contella said Tuesday [17 Dec 2013]. No details were available Tuesday on the dates of the deaths or hospitalizations, she said.

Although the Montgomery County patients did not test positive for influenza, this is the heart of the US flu season, which typically peaks in January or February, according to the federal Centers for Disease Control and Prevention (CDC). During the week ending 7 Dec 2013, 4 states -- Texas, Louisiana, Alabama and Mississippi -- reported high levels of influenza-like illness, CDC reported. The levels of activity are based upon the percentage of outpatient doctor visits that are due to influenza-like illness, according to the CDC website.

Flu symptoms can include some or all of these conditions: fever or feeling feverish; chills; cough; sore throat; runny or stuffy nose; muscle or body aches; headaches; fatigue. Some people may have vomiting and diarrhea, although this is more common in children than adults.

--
communicated by:
ProMED-mail rapporteur Mary Marshall

[Montgomery County is a county in the US state of Texas, within the Houston-The Woodlands-Sugar Land metropolitan area. As of the 2010 census, its population was 455 746. A 55 per cent growth rate in the 10 years from the last US census make the county the 24th fastest-growing county in the United States. The seat of the county is Conroe. A map showing the location of Montgomery County can be accessed at http://en.wikipedia.org/wiki/Montgomery_County,_Texas.

None of the above press reports provides sufficient information to identify the cause of this localised outbreak and its severity. Initial tests have not identified a cause, and [seasonal?] influenza appears to have been excluded, although the specific nature of the tests are not revealed. There are many respiratory viruses, other than influenza virus, associated with high mortality. An avian influenza might be a candidate, but at this stage, it cannot be assumed that the infection is viral. Further information is awaited. - Mod.CP

[Pathfinder]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 &quot;very sick&quot; in Montgomery county - more tests pending - one case confirmed H1N1pdm09

Husband?s sudden decline and death leaves unanswered questions

Posted: Wednesday, December 18, 2013 7:47 pm | Updated: 7:50 pm, Wed Dec 18, 2013.
By Catherine Dominguez

Donna Kinser felt helpless as she watched her husband go from ?bad to worse? following his recovery from heart surgery at Conroe Regional Medical Center Dec. 3.

Gregory Allen Kinser, 61, died Sunday after being in intensive care for a week. Kinser said when her husband died, his lungs had filled with fluid and he suffered from kidney failure.

Kinser said she hasn?t spoken with doctors about why her husband?s condition deteriorated so quickly. However, she said she became concerned after seeing media reports about the ?mysterious illness? in the county, particularly with patients that have been treated at CRMC.
...
The MRSA question

While Kinser was with Gregory in the hospital, she was taken aback when she asked what the ointment was nurses put in Gregory?s nose.

?They said it was some kind of an ointment to prevent MRSA, something they were trying,? she said.
...
Duncan declined to comment on MRSA and if it was a factor at the hospital.

Full text:

http://www.yourhoustonnews.com/courier/news/husband-s-sudden-decline-and-death-leaves-unanswered-questions/article_22bdbb26-245e-501d-b69a-61301a938e93.html

[sharon sanders]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 &quot;very sick&quot; in Montgomery county - more tests pending - one case confirmed H1N1pdm09

The Montgomery health department indicated that none of the dead patients had received the flu vaccine so I am not sure if the man in the previous post is counted as one of the four that died. From post #36 above:

"At this time no known deaths received the vaccine."


?

[sharon sanders]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 &quot;very sick&quot; in Montgomery county - more tests pending - one case confirmed H1N1pdm09

Texan flu step: flu-like illness outbreak in Montgomnery County


While 1,920 influenza-like illnesses (briefly that's measurable fever plus one or more particular symptom usually; includes sore throat, fatigue, body aches and complications including pneumonia) have occurred in this county since the start of the local influenza season, 8 severe infections (all with pneumonia) in adults (41-years to 65-years old) have been admitted to 1 (?) facility. These 8 cases are not all testing positive for the "common" influenza virus types.


According to the US Centers for Disease Control and Prevention website, seasonal influenza's populations at greatest risk of severe disease usually include the very young(under 5-years) and older adults (>65-years), pregnant women and indigenous populations, and those with a range of pre-existing medical conditions.

4/8 cases died and none of the fatal cases were vaccinated against influenza (?survivors were vaccinated)

1/4 surviving case has tested positive for influenza A(H1N1)pdm09 virus, which is circulating locally as the annual flu season is well engaged in the region. 2 other survivors have tested NEG for all influenza viruses. Test results are outstanding on the other survivor.

Management steps include staying away from ill people, hand-washing using soap and water/alcohol-based hand rubs, covering coughs and sneezes, staying at home when ill, cleaning linens, eating utensils and dishes used by ill people, and wiping down frequently touched surfaces if likely to be a landing spot for virus from an ill co-habitant/co-worker/school or daycare child.

It would be interesting to know what other respiratory viruses, and bacteria, have been tested for and excluded already.

References...

• CIDRAP story. http://www.cidrap.umn.edu/news-persp...llness-cluster
• Montgomery County Public Health on Facebook page. https://www.facebook.com/mctxpublichealth
• FluTrackers page. http://www.flutrackers.com/forum/sho...d.php?t=214964

Posted by Ian M Mackay

[Giuseppe]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 &quot;very sick&quot; in Montgomery county - more tests pending - one case confirmed H1N1pdm09

Are they saying that this is an Alabama cluster rerun?

I find that communication at this joint is very despicable: for many reason, mainly that it would be much more simple to explain the clinical course, basic laboratory test results, x-ray findings and close contacts situation, as seen elsewhere in similar circumstances.

This to avoid speculations, rumors and wild scaremongering around the web.

For the surviving relatives this would be at least a respectful move. GM

[Shiloh]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 &quot;very sick&quot; in Montgomery county - more tests pending - one case confirmed H1N1pdm09

Source: http://www.khou.com/news/texas-news/...236558201.html


North Texas man dies of swine flu; could be 'mystery illness' from Houston
by JANET ST. JAMES / WFAA
WFAA
Posted on December 19, 2013 at 9:16 AM

EULESS, Texas -- Looking at photographs shown at her husband's funeral is so very hard for Ashley Wright.

"He was too young,? she said. "I should not be a widow at 30... So it's pretty devastating."

Dustin Wright, 30, came down with flu-like symptoms just before Thanksgiving. Ashley said he seemed to be getting better, before taking a sudden turn for the worse...

...At first, flu tests were inconclusive.

"The second time they checked him, he came back positive for Influenza A, Influenza B,? Wright said.

Dustin suffered kidney failure, which has been associated with severe cases of H1N1 Type A, or swine flu. He had no known underlying medical conditions.

His case has many similarities to cases in Montgomery County that puzzled doctors this week. Of eight cases in that county, four patients have died...

[Giuseppe]

Re: USA - Texas: Public Health department confirmed unidentified ILI illness - 4 died out of 8 hospitalized including 2 &quot;very sick&quot; in Montgomery county - more tests pending - one case confirmed H1N1pdm09

Unfortunately, we know well as H1N1pdm09 likes Young and health people.

Since the investigation is ongoing, further details will be available to draw a conclusive diagnosis by health authorities. gm