http://www.ottawacitizen.com/health/Ottawa+records+fifth+confirmed+H1N1+death/2004054/story.html
Ottawa records fifth confirmed H1N1 death
Public Health officials urge those at greater risk to talk to their doctors
OTTAWA ?Public health officials in Ottawa are urging parents of young children, people with certain chronic diseases and pregnant women to talk to their family doctors about getting the vaccine that prevents pneumonia as a way of limiting complications from the H1N1 swine flu.
?I would encourage those people to actually consult with their health-care provider,? said Dr. Nadine Sicard, the city?s associate medical officer of health. ?This is a good opportunity, as part of pandemic preparedness, to ensure that if you are eligible for the vaccine and you?re more at risk ... that you make sure that you have all your shots.?
But some doctors question the wisdom of recommending the pneumococcal vaccine as a secondary line of defence, saying patients who have developed life-threatening complications from the H1N1 virus are not suffering from difficulties related to pneumonia.
The call for more people to consider the pneumococcal vaccine came as Ottawa recorded its fifth H1N1-related death on Thursday. The latest person to die was a man under the age of 65 who had an underlying medical condition before he was hospitalized last week, said Dr. Isra Levy, the city?s medical officer of health.
In addition, four new lab-confirmed cases of H1N1 flu have been reported in the city, although not all of them may turn out to be Ottawa residents, Levy said Thursday after briefing the city?s community and protective services committee on local preparations for an expected fall pandemic. The new cases brings the total number of lab-confirmed cases to date to 364.
Pneumonia is an infection of the lungs, which can arise as a complication of seasonal flu. Some forms of pneumonia can be prevented by the pneumococcal vaccine. The vaccine is free for Ontarians older than 65, children under two and people with underlying health problems such as diabetes or heart disease. But unlike seasonal flu vaccines, which are offered by public-health departments, pneumococcal vaccines are only available through family doctors and community health centres.
Health officials say the pneumococcal vaccine, unlike the H1N1 vaccine being developed, has the benefit of having been tested for safety and effectiveness and is already in use. In contrast, the H1N1 vaccine may not be available until November, well after the flu season has started. While officials cautioned that the pneumococcal vaccine does not prevent swine flu and is not a substitute for the H1N1 vaccine, they maintained it can be effective in reducing the severity of illness in some people who get H1N1. As a result, they say, it has the potential to limit the number of hospitalizations and deaths.
?It?s more about preventing a frequent complication of influenza,? said Sicard. ?When you have a viral infection such as influenza, it decreases your body?s defence. It decreases your ability to fight off disease, and it also makes it easier for bacteria to ... invade the pulmonary system. So the idea is to prevent this complication.?
The strategy has been endorsed by the U.S. Centers for Disease Control and Prevention and Ontario?s health ministry, which has issued a letter to the province?s family doctors, urging them to discuss the pneumococcal vaccine with those patients who are eligible for it. Sicard said the public-health department has already seen an increase in orders for the vaccine over the past month. ?It seems like the message is getting out there.?
Even so, questions about the pneumococcal vaccine?s effectiveness persist. A recent review of 22 clinical trials, involving more than 100,000 participants, found the vaccine did not appear to be effective in preventing pneumonia, even in high-risk groups. The analysis was done by researchers at the University of Bern and published in the Canadian Medical Association Journal.
Dr. Paul H?bert, the journal?s editor-in-chief and a critical-care physician at The Ottawa Hospital, is among those who are not convinced that the pneumococcal vaccine is an effective way to limit complications from H1N1. To date, there are no known cases in Canada of H1N1 patients who have developed complications from pneumonia, said H?bert. ?It?s the virus itself that?s doing the damage, not pneumococcus from a secondary infection. What we?re not seeing is overwhelming pneumococcal pneumonia.?
His observations are supported by new research from the U.S. Centers for Disease Control and Prevention, which earlier this week reported that the H1N1 virus doesn?t appear to kill in the same way as seasonal flu. Based on autopsies, researchers found that the H1N1 infection burrows deep into the victims? lungs, doing damage to the alveoli ? the structures in the lung that deliver oxygen to the blood. This in turn causes acute respiratory distress syndrome, an often fatal condition that leaves patients gasping for breath. In contrast, seasonal flu causes bronchitis and other upper respiratory disease, with more serious cases leading to bacterial ?co-infections? such as pneumonia.
Meanwhile, Levy said he is working with city officials to have more hand sanitizers installed in public buildings, such as recreation facilities, in anticipation of a need for better infection control during a pandemic. Unlike hospitals, universities and most workplaces, the City of Ottawa has been slow to install hand sanitizers at its 350 facilities.
?We?ll be placing hand sanitizers in some key areas, particularly in buildings where there are eating facilities or buildings where large numbers of people congregate,? said Levy. He indicated that OC Transpo is also looking at ?the best places to facilitate hand hygiene? for transit riders.
Ottawa records fifth confirmed H1N1 death
Public Health officials urge those at greater risk to talk to their doctors
OTTAWA ?Public health officials in Ottawa are urging parents of young children, people with certain chronic diseases and pregnant women to talk to their family doctors about getting the vaccine that prevents pneumonia as a way of limiting complications from the H1N1 swine flu.
?I would encourage those people to actually consult with their health-care provider,? said Dr. Nadine Sicard, the city?s associate medical officer of health. ?This is a good opportunity, as part of pandemic preparedness, to ensure that if you are eligible for the vaccine and you?re more at risk ... that you make sure that you have all your shots.?
But some doctors question the wisdom of recommending the pneumococcal vaccine as a secondary line of defence, saying patients who have developed life-threatening complications from the H1N1 virus are not suffering from difficulties related to pneumonia.
The call for more people to consider the pneumococcal vaccine came as Ottawa recorded its fifth H1N1-related death on Thursday. The latest person to die was a man under the age of 65 who had an underlying medical condition before he was hospitalized last week, said Dr. Isra Levy, the city?s medical officer of health.
In addition, four new lab-confirmed cases of H1N1 flu have been reported in the city, although not all of them may turn out to be Ottawa residents, Levy said Thursday after briefing the city?s community and protective services committee on local preparations for an expected fall pandemic. The new cases brings the total number of lab-confirmed cases to date to 364.
Pneumonia is an infection of the lungs, which can arise as a complication of seasonal flu. Some forms of pneumonia can be prevented by the pneumococcal vaccine. The vaccine is free for Ontarians older than 65, children under two and people with underlying health problems such as diabetes or heart disease. But unlike seasonal flu vaccines, which are offered by public-health departments, pneumococcal vaccines are only available through family doctors and community health centres.
Health officials say the pneumococcal vaccine, unlike the H1N1 vaccine being developed, has the benefit of having been tested for safety and effectiveness and is already in use. In contrast, the H1N1 vaccine may not be available until November, well after the flu season has started. While officials cautioned that the pneumococcal vaccine does not prevent swine flu and is not a substitute for the H1N1 vaccine, they maintained it can be effective in reducing the severity of illness in some people who get H1N1. As a result, they say, it has the potential to limit the number of hospitalizations and deaths.
?It?s more about preventing a frequent complication of influenza,? said Sicard. ?When you have a viral infection such as influenza, it decreases your body?s defence. It decreases your ability to fight off disease, and it also makes it easier for bacteria to ... invade the pulmonary system. So the idea is to prevent this complication.?
The strategy has been endorsed by the U.S. Centers for Disease Control and Prevention and Ontario?s health ministry, which has issued a letter to the province?s family doctors, urging them to discuss the pneumococcal vaccine with those patients who are eligible for it. Sicard said the public-health department has already seen an increase in orders for the vaccine over the past month. ?It seems like the message is getting out there.?
Even so, questions about the pneumococcal vaccine?s effectiveness persist. A recent review of 22 clinical trials, involving more than 100,000 participants, found the vaccine did not appear to be effective in preventing pneumonia, even in high-risk groups. The analysis was done by researchers at the University of Bern and published in the Canadian Medical Association Journal.
Dr. Paul H?bert, the journal?s editor-in-chief and a critical-care physician at The Ottawa Hospital, is among those who are not convinced that the pneumococcal vaccine is an effective way to limit complications from H1N1. To date, there are no known cases in Canada of H1N1 patients who have developed complications from pneumonia, said H?bert. ?It?s the virus itself that?s doing the damage, not pneumococcus from a secondary infection. What we?re not seeing is overwhelming pneumococcal pneumonia.?
His observations are supported by new research from the U.S. Centers for Disease Control and Prevention, which earlier this week reported that the H1N1 virus doesn?t appear to kill in the same way as seasonal flu. Based on autopsies, researchers found that the H1N1 infection burrows deep into the victims? lungs, doing damage to the alveoli ? the structures in the lung that deliver oxygen to the blood. This in turn causes acute respiratory distress syndrome, an often fatal condition that leaves patients gasping for breath. In contrast, seasonal flu causes bronchitis and other upper respiratory disease, with more serious cases leading to bacterial ?co-infections? such as pneumonia.
Meanwhile, Levy said he is working with city officials to have more hand sanitizers installed in public buildings, such as recreation facilities, in anticipation of a need for better infection control during a pandemic. Unlike hospitals, universities and most workplaces, the City of Ottawa has been slow to install hand sanitizers at its 350 facilities.
?We?ll be placing hand sanitizers in some key areas, particularly in buildings where there are eating facilities or buildings where large numbers of people congregate,? said Levy. He indicated that OC Transpo is also looking at ?the best places to facilitate hand hygiene? for transit riders.