Nebraska reporting 1 dead

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Nebraska officials say one dead from swine flu

By the Lincoln Journal Star
Wednesday, Jul 15, 2009 - 11:11:58 am CDT

State health officials say the death of a Custer County woman in her 50s last week is Nebraska?s first death from the H1N1 flu.

?Her loss is a tragedy, and my condolences go out to her loved ones. Any death from influenza is profoundly sad,? said Dr. Joann Schaefer, the state?s chief medical officer Wednesday.

Schaefer didn?t give the woman?s name, citing state privacy laws.

The woman had several chronic, underlying health conditions, such as heart disease and chronic obstructive pulmonary disease, according to the Nebraska Department of Health and Human Services.

?H1N1 can be a very serious illness, especially for those who have chronic health conditions, such as heart disease and asthma, or who have compromised immune systems,? Schaefer said.

Those who are pregnant or obese also face increased risks from the virus.

DHHS has had 264 cases of H1N1 reported in Nebraska. Thirteen people have been hospitalized.

H1N1 seems to be affecting younger people in the U.S. and Nebraska, particularly those 5 to 24. In Nebraska, the average age is 20. Only 17 cases have been over 50.

DHHS is working with local health departments to investigate cases and contacts of people with the virus.

A health alert will be issued to physicians and other providers reminding them that all influenza being seen at this time is novel H1N1 and providing them with important information regarding the statistics, treatment and prevention.


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Re: Nebraska reporting 1 dead

http://www.omaha.com/article/20090716/NEWS01/707169944/-1/FRONTPAGE

H1N1 isn't an obvious diagnosis
By Rick Ruggles
WORLD-HERALD STAFF WRITER

For all the attention it has received, H1N1 flu isn't an obvious diagnosis when a patient arrives at the hospital with chronic heart and lung problems, flu experts in Omaha said Wednesday.

Even if the virus is diagnosed promptly, the window of opportunity to treat a patient with anti-viral medicine is narrow ? generally a mere 48 hours from the onset of symptoms ? if the medicine is to work well.

Nevertheless, the experts said, physicians and other medical providers must be alert to the possibility that it's H1N1 flu that has sickened a feverish patient with a cough or sore throat.

The Nebraska Department of Health and Human Services on Wednesday reported the state's first H1N1 flu death since that strain began traveling around the globe in the spring.

Based on death notices and other information, The World-Herald learned that the victim was Deb Smith, 56, of Broken Bow. Smith, who worked during the day at a Broken Bow bank and in the evening as a bartender at the Broken Bow Country Club, died Saturday. Her funeral is today.

Dr. Joann Schaefer, the state's chief medical officer, said the Custer County woman, whom Schaefer and other authorities declined to name, had heart disease and chronic lung disease. Schaefer said H1N1 worsened her underlying medical conditions.

State health officials said the lab confirmation of H1N1 came after the woman's death.

Dr. Tom Safranek, the state's epidemiologist, said the patient was first in the Broken Bow hospital, then taken to a Lincoln hospital and moved to a second Lincoln hospital.

Steve Osborn, the infection control practitioner at Broken Bow's only hospital, referred questions to the State Health Department.

The victim is only the second patient from Custer County, in the middle of Nebraska, with a confirmed case of H1N1. There are 264 confirmed cases statewide. Iowa, which has reported no deaths, has 155 confirmed cases.

In a community with almost no cases of H1N1, a physician wouldn't necessarily immediately think of it as the cause of a patient's distress, especially if heart and lung problems had flared up, said Dr. Phil Smith, chief of infectious diseases at the University of Nebraska Medical Center.

Most hospitals have a rapid flu test that promptly indicates whether a person has the flu. H1N1 confirmation is provided within hours or the next day by the Nebraska Public Health Laboratory at UNMC.

After the window to treat with anti-virals has closed, a physician must treat the patient in serious distress with oxygen, antibiotics and other therapies.

Dr. Robert Penn, Methodist Hospital's medical director of epidemiology, said his hospital has emphasized to its doctors that testing and treatment for H1N1 should be done on any patient with a fever of 100 or higher and a cough or sore throat.

The Nebraska death ?should bring to everyone's attention that you should still consider H1N1,? Penn said.

Dr. Kari Simonsen, medical adviser to the Douglas County Health Department, said people who are quite ill with flu symptoms should see a doctor quickly.

But there is no guarantee that anti-viral medicine promptly administered would help a person who is sick and has serious underlying conditions, said Dr. Marvin Bittner, associate professor of medicine at Creighton University.

Clinical tests of such medicine tend to be done on people without such serious conditions, Bittner said.

One death is tragic, he said, but society neglects many tragedies to come by not emphasizing the importance of treating high blood pressure, high cholesterol and other health problems that many Americans face. There are, he said, ?hundreds and hundreds of opportunities for prevention.?

Meanwhile, more than 150 state and local health officials, along with representatives from education and other fields, gathered Wednesday in Lincoln to plan for the possibility of larger H1N1 outbreaks this fall and winter. Federal and state officials plan to offer the vaccine this fall.

Schaefer said the goal is to reduce the number and severity of cases by limiting chances for the virus to spread. Staying home if sick and sending sick children home from school or day care can help diminish the effect of a disease outbreak, she said.

?Our motto is plan for the worst, hope for the best and see what Mother Nature tosses us,? she said.

World-Herald staff writer Martha Stoddard contributed to this report.

Contact the writer:

444-1123, rick.ruggles@owh.com