Two H1N1 Patients, Two Different Outcomes

[Shiloh]

Source: http://www.cbsnews.com/stories/2009/09/18/eveningnews/main5321795.shtml

OKLAHOMA CITY, Sept. 18, 2009
Two H1N1 Patients, Two Different Outcomes
Doctors Don?t Know Why Some Children with Flu Virus Get Much Sicker than Others

By Mark Strassmann

Video
(CBS) Hugh Estlinbaum sits for hours encouraging his very sick son.

"We're just floored by how well you're doing. How hard you're fighting," Estlinbaum said. "How hard you're fighting. We can see it, Tony, we can see it."

Above his sedated son Tony - photos of the all-American 10 year old. Tony got the H1N1 virus last Sunday, and began fighting for his life.

"You are strong. You are special, and you can do anything," his dad said.

Just outside, Tony's mother Lizzy Estlinbaum keeps a round-the-clock vigil.

"I'll go in and talk to him," Lizzy said. "But I cry so easy, and I don't want him to hear me cry."

Carolyn Howard's daughter Leteasha is another critically ill H1N1 patient in the intensive care unit of Oklahoma City's Children's Hospital, reports CBS News correspondent Mark Strassmann.

Heavily sedated, she's been clinging to life for the last three weeks.

"I rub her hand and tell her I love her," Howard said. "And we're ready for her to come home."

At home, this 10 year old loves to sing and dance. But in Oklahoma, one of America's hardest-hit states by H1N1, Leteasha got sick and never got better.

A machine called an ECMO may be her last hope. It oxygenates her blood, acting as her heart and lungs to give her sick body a fighting chance.

"I just want her to open her eyes, and let me know she's alright," Howard said.

Tony and Leteasha's rooms are 40 feet apart at the hospital. But doctors say their chances of recovery are miles apart.

Tony's improving slowly, day by day.

"It's like a little bit more weight is taken off every day," said Lizzy Estlinbaum.

But Leteasha Howard's family knows, she is not responding.

"What explains why one child is doing well and the other child is not doing well?" Strassmann asked.

"Great question. I wish we knew the answer to it," said Dr. Cameron Mantor. "This is something that's new to us."

CBSNews.com Special Report: The H1N1 Threat

Leteasha has weight issues and asthma. Not enough, doctors say, to explain why she's sinking as Tony improves.

Forty-three of America's 593 H1N1 deaths have been children under 18.So far, none of them in Oklahoma where two families are at the crossroads of this mystery virus.


For those wishing to help out the Estlinbaum family featured in the story, donations can be made through Citizens Bank of Edmond, routing number 103002251,
account number 5220874.

 

[Emily]

Re: Two H1N1 Patients, Two Different Outcomes

I hope they are researching why this is happening. The doctor in the video sounded pretty hopeless. We had money to fund adjuvant research for big pharma companies, why not why this? It is not just happening in Oklahoma.

http://www.npr.org/templates/story/story.php?storyId=112035625&ft=3&f=1007
August 19, 2009
Officials Find Swine Flu Hits Minorities Harder

by Richard Knox

Young people are more at risk of getting swine flu, and pregnant women, among others, have a higher chance of hospitalization from the new flu. Now public health officials are discovering that blacks and Latinos have a substantially higher risk of both.

It is apparently not because of race or ethnicity, per se; it's because of the social circumstances of many African-Americans and Hispanics.

The new data are from Boston health authorities. Federal health officials are studying flu disparities on a national basis but haven't released numbers yet.

Stark Disparities

In Boston, the disproportionate effect of swine flu on minorities is striking.

Blacks make up one-quarter of the city's population, but they were 37 percent of the swine flu cases. Latinos are 14 percent of the population, but more than one-third of those with confirmed cases of the new H1N1 virus this spring and summer were Latino.

Dr. Anita Barry of the Boston Public Health Commission says she and her colleagues didn't expect such large disparities.

"We really didn't know what the race-ethnicity breakdown would be," Barry says. "So, when we saw that this illness was disproportionately affecting black and Latino residents, that really did get our attention."

Barry says there is nothing about the new flu virus itself that makes minorities more likely to get sick from it; social factors ? especially the makeup of Boston public schools ? are key. Most Boston schoolchildren are minorities, though the general population isn't.

This, for starters, makes minorities more likely to get swine flu because it disproportionately strikes younger people who don't have decades of exposure to distantly related viruses, which grants some degree of immunity. The typical Boston swine flu victim between April and July was 13 years old.

Low-Income Parents

There are, however, other reasons why minorities seem to be more at risk of swine flu. Low-income parents have a harder time keeping their sick children home from school.

"For some parents in lower-wage jobs, if they don't show up at work, they don't get paid, and people may already be on the economic margins," Barry says. "So parents were desperate to get some of these children back in school."

As a result, there were many sick, contagious kids in Boston classrooms this spring. Because of the economic pressures and demographics of the Boston school system, most of them turned out to be black or Hispanic.

Barry says this abetted the spread of the new flu among those groups.

School officials documented the phenomenon.

"It was hard on the school nurses, who had parents on the phone saying, 'I can't come get my child,' or 'I don't have anybody to take care of my child,' " Barry says.

Impact On Local Clinics

The city's neighborhood health centers saw the disproportionate impact, too. Nurse Jan Smith of the Codman Square Health Center in Boston's Dorchester neighborhood, which treats a low-income population, says she was surprised by the volume of people who sought care for flu symptoms.

"Our waiting room was packed," Smith says. "It was as great or greater than late winter."

There is another troubling disparity in the new data. Blacks and Hispanics were also twice as likely to require hospitalization for the new H1N1 virus ? that is, their infections were more severe than those of nonminorities.

That reflects another kind of disparity. About half of the hospitalized cases of swine flu involved people with asthma, which is more prevalent among African-Americans and Latinos.

Boston officials have counted four deaths from swine flu so far: two blacks, one Latino and one white. That's too few to draw any conclusions about disparities in the risk of death.

Targeting Minorities

Given the new data, Boston officials plan to target minority neighborhoods in upcoming flu-vaccination campaigns. Like their counterparts across the country, they will probably have to persuade people to come in three times for flu shots: once, early in the season, to be vaccinated against regular seasonal flu; then, later, twice to get swine flu vaccine. Because it is a novel vaccine, it is assumed that people will need two shots to get adequate antibodies.

Dr. Steve Tringale of Codman Square Health Center says it is hard for low-income people to make time for flu shots.

"That's always a challenge, to come back a second time for full protection," Tringale says. "Taking the time off work or getting babysitters or whatever it takes is always going to be an effort for patients."

To address that problem, Boston Mayor Tom Menino is asking all businesses to give workers time off to get flu shots.

 

[mcphilbrick]

Re: Two H1N1 Patients, Two Different Outcomes

Blog - The ECMO Option

ECMO or Extracorporeal Membrane Oxygenation is a specialized heart-lung bypass machine used to take over the body?s heart and lung function ? for days or weeks if necessary ? while the body heals from injury or illness.



ECMO is a highly specialized, and technically demanding life support option which is not available a most hospitals around the globe. It is most commonly used in neonatal intensive care units for newborns in respiratory distress, although it is also used for pediatric and adult patients with severe heart or respiratory deficits.


One of the disturbing hallmarks of the novel H1N1 `swine? flu virus is that it produces ? in a very small percentage of victims ? severe lung damage resulting in ARDS (Acute Respiratory Distress Syndrome).

Follow link to read more! He has an explanation (complete with diagrams) of how ECMO works.

The ECMO Option

 

[andreabeth]

Re: Two H1N1 Patients, Two Different Outcomes

Here is some good news. It seems like so many of the critically ill young people that we hear about do not make it, so it is heartening to hear that Tony Estlinbaum seems to be on the way to recovery. Leteasha Howard, the other child mentioned in the initial report is still in critical condition in the ICU. I hope she will be able to pull through. She must be a real fighter to have hung on this long. My prayers go out to both families.

http://Edmond 10-year-old Recovering from H1N1 Virus

Posted: Oct 16, 2009 4:54 PM
Updated: Oct 16, 2009 7:17 PM
Featured Video
H1N1 Survivor and Father Discuss Recovery
10-Year-Old Tony Estlinbaum Discusses Battle with H1N1
News9.com

BETHANY, Oklahoma -- One of three children hospitalized from the H1N1 virus has been released from the hospital. Tony Estlinbaum spent over a month at Children's Hospital.

At one point, he was on life support, but last week, the 10-year-old was awake and telling jokes.

Now Tony is starting treatment at the Children's Center in Bethany and will spend the next week or so in rehabilitation to gain back his strength. Tony's dad said his son is very courageous.

“For somebody to be laying down for close to five weeks and then pushing me off to the side saying ‘Dad, I can stand up by myself. I'm ok.’ Yeah that's courage,” said father Hugh Estlinbaum.

Tony said he can't wait to get go back to school and play tackle football again.

Two other children, both girls, remain in critical condition at the Children's Hospital with H1N1. Lateasha Howard is one of those children. She's been in the hospital for more than a month.

http://www.news9.com/global/story.asp?s=11329453