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

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  • #46
    Re: Discussion thread: USA - Texas: Unknown ILI flu type illness December 17, 2013

    http://www.dshs.state.tx.us/idcu/dis...eillance/2013/



    Note: 1 Pediatric death with un-subtyped influenza virus reported in September

    The first round of H1N1pdm09 was significant for the pediatric population as well - three times as many deaths during that flu season compared to past seasons.
    Attached Files
    Last edited by sharon sanders; December 19th, 2013, 03:28 PM. Reason: edit last sentence out

    Comment


    • #47
      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

      A note:

      FluTrackers does not offer medical advice and our vaccine policy - for all vaccines - is for people to consult their medical practitioners.
      "May the long time sun
      Shine upon you,
      All love surround you,
      And the pure light within you
      Guide your way on."

      "Where your talents and the needs of the world cross, lies your calling."
      Aristotle

      “In a gentle way, you can shake the world.”
      Mohandas Gandhi

      Be the light that is within.

      Comment


      • #48
        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

        http://houston.culturemap.com/news/c...y-encouraging/

        [snip]

        Derrick Goodwill, a physician assistant at the Conroe Urgent Care Clinic, tells KHOU Ch. 11 his team sees at least five to seven people testing positive for H1N1 each day, a huge spike since the start of the Texas flu season in October. All patients are recommended to take the Tamiflu antiviral, even if they test negative for the strain.

        [snip]

        (So did the "mystery illness" patients get Tamiflu?)

        Comment


        • #49
          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

          Montgomery County Public Health

          <A class=uiLinkSubtle href="https://www.facebook.com/mctxpublichealth/posts/10150349054219970"><ABBR class="timestamp livetimestamp" title="Thursday, December 19, 2013 at 2:58pm" data-utime="1387493929">8 minutes ago</ABBR>

          Contact: Jennifer Nichols-Contella FOR IMMEDIATE RELEASE
          Cell: (936) 444-9724 12/19/13
          Email: jnichols@mchd-tx.org

          UPDATE - INFLUENZA LIKE ILLNESS ARISES IN MONTGOMERY COUNTY

          As of Thursday afternoon, one additional case of H1N1 has been confirmed in Montgomery County. This patient is currently in an area hospital receiving treatment. Labs are being repeated on all remaining cases by the CDC. There are currently two confirmed H1N1 cases in Montgomery County.

          The Montgomery County Public Health District is coordinating with regional and state resources to manage the case investigations. Health officials continue to encourage the public to be vaccinated for the flu, especially those who are at high risk.

          Montgomery County Public Health District is monitoring the situation closely and will provide more information as it arises.
          ###

          https://www.facebook.com/mctxpublich...ation=timeline
          "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


          • #50
            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 - 2 cases confirmed H1N1pdm09

            All four fatalities confirmed H1N1:

            http://www.khou.com/news/local/BREAK...236620791.html

            HOUSTON – Health officials say there have been six confirmed deaths from H1N1 in the Houston area recently, KHOU 11 News confirmed Thursday afternoon. That includes the four deaths at Conroe Regional Medical Center.

            At least 14 people have become critically ill in Harris, Montgomery and Jefferson counties, including the four patients at Conroe Regional Medical Center.

            This is the same strain of H1N1 that caused a pandemic in 2009. Doctors have been seeing hundreds of new cases recently in Texas and nationwide. In fact, H1N1 is one of the viruses included in this year’s flu shot.

            Health officials from all over the region spent Thursday afternoon in a conference call comparing notes about all the cases. They suspect that all of the cases at the Conroe Regional Medical Center are H1N1, or what used to be called the “swine flu.”

            [snip]

            Comment


            • #51
              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

              Originally posted by Pathfinder View Post
              Montgomery County Public Health

              <A class=uiLinkSubtle href="https://www.facebook.com/mctxpublichealth/posts/10150349054219970"><ABBR class="timestamp livetimestamp" title="Thursday, December 19, 2013 at 2:58pm" data-utime="1387493929">8 minutes ago</ABBR>

              Contact: Jennifer Nichols-Contella FOR IMMEDIATE RELEASE
              Cell: (936) 444-9724 12/19/13
              Email: jnichols@mchd-tx.org

              UPDATE - INFLUENZA LIKE ILLNESS ARISES IN MONTGOMERY COUNTY

              As of Thursday afternoon, one additional case of H1N1 has been confirmed in Montgomery County. This patient is currently in an area hospital receiving treatment. Labs are being repeated on all remaining cases by the CDC. There are currently two confirmed H1N1 cases in Montgomery County.

              The Montgomery County Public Health District is coordinating with regional and state resources to manage the case investigations. Health officials continue to encourage the public to be vaccinated for the flu, especially those who are at high risk.

              Montgomery County Public Health District is monitoring the situation closely and will provide more information as it arises.
              ###

              https://www.facebook.com/mctxpublich...ation=timeline
              more....

              Montgomery County Public Health: There have only been two confirmed cases of H1N1 in Montgomery County Amber Wittnebert
              "May the long time sun
              Shine upon you,
              All love surround you,
              And the pure light within you
              Guide your way on."

              "Where your talents and the needs of the world cross, lies your calling."
              Aristotle

              “In a gentle way, you can shake the world.”
              Mohandas Gandhi

              Be the light that is within.

              Comment


              • #52
                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 - 2 cases confirmed H1N1pdm09

                Originally posted by alert View Post
                All four fatalities confirmed H1N1:

                http://www.khou.com/news/local/BREAK...236620791.html

                HOUSTON – Health officials say there have been six confirmed deaths from H1N1 in the Houston area recently, KHOU 11 News confirmed Thursday afternoon. That includes the four deaths at Conroe Regional Medical Center.

                At least 14 people have become critically ill in Harris, Montgomery and Jefferson counties, including the four patients at Conroe Regional Medical Center.

                This is the same strain of H1N1 that caused a pandemic in 2009. Doctors have been seeing hundreds of new cases recently in Texas and nationwide. In fact, H1N1 is one of the viruses included in this year’s flu shot.

                Health officials from all over the region spent Thursday afternoon in a conference call comparing notes about all the cases. They suspect that all of the cases at the Conroe Regional Medical Center are H1N1, or what used to be called the “swine flu.”

                [snip]

                This media report conflicts with the above public health statement. The Montgomery county health department does not mention anything about the deaths.

                So....??
                "May the long time sun
                Shine upon you,
                All love surround you,
                And the pure light within you
                Guide your way on."

                "Where your talents and the needs of the world cross, lies your calling."
                Aristotle

                “In a gentle way, you can shake the world.”
                Mohandas Gandhi

                Be the light that is within.

                Comment


                • #53
                  Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                  It is disconcerting that the initial test results were unreliable - at least in 2 cases that have now tested positive.

                  H1N1pdm09 has been around for 4+ years. Why are the rapid tests not more accurate at this time?

                  And if there is a discrepancy between media, health officials, health departments when talking about such tiny numbers such as 4, 6, 8, what would happen in a really large outbreak?
                  "May the long time sun
                  Shine upon you,
                  All love surround you,
                  And the pure light within you
                  Guide your way on."

                  "Where your talents and the needs of the world cross, lies your calling."
                  Aristotle

                  “In a gentle way, you can shake the world.”
                  Mohandas Gandhi

                  Be the light that is within.

                  Comment


                  • #54
                    Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                    I wonder to what effect the false negatives were due more to poor sample collection or sloppy handling of samples rather than due to inaccurate testing. I can't imagine much priority was placed on these ILI samples until patients started dying. As has been noted repeatedly both here and elsewhere, most ILI in the US simply doesn't get a diagnosis.

                    I think journalists do need to be careful now as to precisely what they report. There are two ways of counting cases. We can count them based on thier outcome (deceased, critically ill, recovered) or based on laboratory testing (confirmed, probable, suspected, excluded). So the above KHOU report of 6 confirmed fatalities actually states two things: 6 people have tested positive for H1N1, AND all 6 have died. Is that true? No other source has reported that.

                    Might the correct statement be that there are 6 probable fatalites, 2 of whom are confirmed and 2 confirmed critically ill cases in Conroe?

                    It does appear that the number of confirmed severe H1N1 cases in the Houston area is at least 16 (14 critically ill plus 2 confirmed dead OUTSIDE of Conroe). It also appears that the Conroe Regional Medical is confirming 5-7 new H1N1 cases daily.

                    It also seems evident this entire outbreak is due to H1N1pdm09.

                    Comment


                    • #55
                      Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                      Here's another likely H1N1 death. Since this one is female, it's not one of the four in question so far, which are all male.

                      http://www.khou.com/news/health/Fami...236672991.html

                      Comment


                      • #56
                        Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                        We have a thread started for the Texas: Houston area flu articles that are separate from the flu event in Montgomery county:

                        http://www.flutrackers.com/forum/sho...310#post517310
                        "May the long time sun
                        Shine upon you,
                        All love surround you,
                        And the pure light within you
                        Guide your way on."

                        "Where your talents and the needs of the world cross, lies your calling."
                        Aristotle

                        “In a gentle way, you can shake the world.”
                        Mohandas Gandhi

                        Be the light that is within.

                        Comment


                        • #57
                          Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                          Here's a video of a ninth suspected case in Montgomery County:

                          http://www.click2houston.com/lifesty...z/-/index.html

                          Comment


                          • #58
                            Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                            Doctor: Specificity lacking in flu tests

                            Posted: Dec 20, 2013 5:08 PM CST Updated: Dec 20, 2013 5:30 PM CST
                            By Shaley Sanders - bio | email
                            ...
                            "Interestingly, most of the regular test that you do for influenza, it's showing negative and that's the problem. This test does not have really good sensitivity," said Dr. Shabaz Ahmad, an infectious disease expert at Good Shepherd Medical Center in Longview.
                            ...
                            "What I'm finding is that it is not really sensitive for H1N1 somehow," Dr. Ahmad said.

                            "I have even a few cases where their tests were twice negative, so we have to do specific testing," Dr. Ahmad said.

                            So why do doctors not start with those tests that have more specific results?

                            "Most of the time it is not cost effective to do a PCR test at the get go, most of the time we do the regular testing," Dr. Ahmad said.

                            In fact, Dr. Ahmad believes the mysterious illnesses in Montgomery County may be still be attributed to the flu, despite the negatives results.

                            "The mysterious kind of deaths coming, like influenza-like illness with mysterious death, and the test is negative for flu and you think, 'Oh, there's no flu," but still flu could be hiding there and you need to do specific testing to find out," Dr. Ahmad said.
                            ...
                            "What we are seeing in the hospitals and mysterious death, this is basically the iceberg," Dr. Ahmad said.

                            The peak of flu season is typically in January or February.

                            Full text:
                            http://www.kplctv.com/story/24276149...ular-flu-tests
                            "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


                            • #59
                              Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                              I've seen no evidence for this conclusion...

                              Published Date: 2013-12-21 19:32:56
                              Subject: PRO/EDR> Influenza (67): USA (TX) H1N1
                              Archive Number: 20131221.2129781

                              INFLUENZA (67): USA (TEXAS) H1N1
                              ********************************
                              A ProMED-mail post
                              http://www.promedmail.org
                              ProMED-mail is a program of the
                              International Society for Infectious Diseases
                              http://www.isid.org

                              Date: Fri 20 Dec 2013
                              Source: Texas Department of State Health Services (DSHS) [summ., edited]
                              http://www.dshs.state.tx.us/news/rel...ert-122013.pdf


                              Influenza health alert
                              ----------------------
                              Statewide influenza-like illness (ILI) activity continues to increase and is above baseline levels. ILI intensity is high in Texas, and influenza is now widespread. All Texas regions have reported laboratory confirmed influenza. Over 90 per cent of positive influenza tests reported from Texas laboratories have been typed as influenza A. Of those influenza A viruses that have been subtyped, 90 per cent have been the 2009 pandemic H1N1 subtype. This subtype of influenza is included in this season's [2013-14] influenza vaccine. No novel influenza cases have been reported in Texas. No antiviral resistant influenza strains have been reported in Texas.

                              Background
                              ----------
                              Influenza viruses can be spread by large respiratory droplets generated when an infected person coughs or sneezes in close proximity to an uninfected person. Symptoms can include fever, dry cough, sore throat, headache, body aches, fatigue, and nasal congestion. Among children, otitis media, nausea, vomiting, and diarrhea are common. Most people generally recover from illness in 1-2 weeks, but some people develop complications and may die from influenza. The highest rates of influenza infection occur among children; however, the risks for serious health problems, hospitalizations, and deaths from influenza are higher among people 65 years of age or older, very young children, and people of any age who have medical conditions that place them at increased risk for complications from influenza.

                              Vaccination
                              -----------
                              Everyone who is at least 6 months of age should get a flu vaccine this season [2013-14]. It is not too late for vaccination. There are several flu vaccine options available for the 2013-2014 flu season. All these vaccines contain the currently circulating H1N1 strain. DSHS [Department of State Health Services] does not recommend one flu vaccine over another, although there are special indications for some (such as a high-dose inactivated trivalent vaccine approved for persons age 65 years and older).

                              Rapid Lab Test
                              --------------
                              Rapid influenza diagnostic tests (RIDTs) can be useful to identify influenza virus infection, but false negative test results are common during influenza season. Clinicians should be aware that a negative RIDT result does NOT exclude a diagnosis of influenza in a patient with suspected influenza. When there is clinical suspicion of influenza and antiviral treatment is indicated, antiviral treatment should be started as soon as possible, even if the result of the RIDT is negative, without waiting for results of additional influenza testing.

                              Treatment: oseltamivir and zanamivir are chemically related antiviral medications known as neuraminidase inhibitors that have activity against both influenza A and B viruses. Early antiviral treatment can shorten the duration of fever and illness symptoms, may reduce the risk of complications and death, and may shorten the duration of hospitalization. Clinical benefit is greatest when antiviral treatment is administered early, especially within 48 hours of influenza illness onset. Decisions about starting antiviral treatment should not wait for laboratory confirmation of influenza.

                              Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who
                              - is hospitalized,
                              - has severe, complicated, or progressive illness,
                              - is at higher risk for influenza complications.

                              Persons at higher risk for influenza complications recommended for antiviral treatment include:
                              - children aged younger than 2 years,
                              - adults aged 65 years and older,
                              - persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, or hematological disease (including sickle cell disease); metabolic disorders (including diabetes mellitus); or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury),
                              - persons with immunosuppression, including that caused by medications or by HIV infection,
                              - women who are pregnant or postpartum (within 2 weeks after delivery),
                              - persons aged younger than 19 years who are receiving long-term aspirin therapy.
                              - American Indians/Alaska Natives.
                              - persons who are morbidly obese (that is, body-mass index is equal to or greater than 40).
                              - residents of nursing homes and other chronic-care facilities.

                              Clinical judgment, on the basis of the patient's disease severity and progression, age, underlying medical conditions, likelihood of influenza, and time since onset of symptoms, is important when making antiviral treatment decisions for high-risk outpatients.

                              Additional details regarding antiviral treatment can be found at http://www.cdc.gov/flu/professionals...clinicians.htm.

                              In Texas, influenza-associated pediatric mortality is required to be reported within one work day. Clusters or outbreaks of any disease, including influenza, should be reported immediately. Reports of influenza-associated pediatric mortality and influenza or influenza-like illness outbreak should be made to your local health department or to 1-800-705-8868.

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

                              [The correspondent has added the following commentary in relation to the information above. "This outbreak now appears to involve an H1N1 virus. The vaccine inefficacy statement from the County health authorities press release highlights, coupled with the apparent unreliability of rapid diagnostic tests cited in media reports, suggests to me that H1N1 virus circulating in Texas may be a new [more virulent ?] drifted or reasserted strain. The current Texas state flu bulletin for week of 7-14 Dec 2013 issued today (20 Dec 2013) does not seem to discuss this issue http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2014/."

                              It seems likely that the fatalities observed in Texas are due to a possibly more virulent strain of the seasonal H1N1 influenza virus, rather than a novel pathogenic agent. Further information is awaited to substantiate this conclusion. - Mod.CP]

                              Comment


                              • #60
                                Re: USA - Texas: Public Health department confirmed H1N1pdm09 outbreak - in Houston area media report of 6 fatalities, 14 more critically ill - Montgomery county health says 2 confirmed H1N1pdm09

                                On a ProMED post on the H1N1 outbreak in Alberta, the same ProMED moderator comments:

                                http://www.promedmail.org/direct.php?id=2131051

                                [This hospital outbreak would have been preventable if there had been adequate acceptance of the current Northern hemisphere seasonal influenza vaccine. It is not justifiable at this stage to hypothesise an increased virulence of the newly appearing H1N1 seasonal influenza virus.

                                Comment

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