USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 4 test positive for Seasonal Inf

[Laidback Al]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Update on Calvert County Respiratory Illness Investigation
Preliminary Testing Indicates Influenza

Dori Henry
Director of Communications
Maryland Department of Health and Mental Hygiene

BALTIMORE (March 6, 2012) ? The Maryland Department of Health and Mental Hygiene (DHMH) is working in conjunction with the Calvert County Health Department to investigate a cluster of respiratory illnesses in Calvert County. As the Calvert County Health Department has reported, DHMH is aware of four cases in adults from a single family with severe respiratory illness; three have died. At this time, no other similar clusters have been reported from Calvert County or elsewhere in the state.
The cause for these illnesses is under investigation and testing is being conducted by the DHMH Laboratories Administration. Preliminary testing at the DHMH Laboratories Administration indicates that two of the fatal cases had influenza, and these cases may have been complicated by bacterial co-infections. Bacterial co-infection is a known complication of influenza infection. Additional testing is being conducted for all cases.
DHMH recommends all individuals continue to take the following precautions during influenza season: hand washing, staying home if sick, and staying up to date with influenza vaccinations. DHMH also reminds Maryland residents with influenza-like illness (fever and sore throat or cough) to consult their healthcare providers for evaluation. DHMH is not recommending any additional measures at this time. The Department will provide additional updates as more information becomes available.
There have been no new cases reported as of 11:30 p.m. {EST}
For current info call 410-535-5400 x349

http://www.calverthealth.org/

 

[hawkeye]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland

From the article in post #1:

According to the health department, the 81-year-old died presented symptoms of respiratory illness on February 23, and died on March 1. The children showed symptoms around February 28, and were hospitalized in critical condition. Several days later, the 58-year-old son and the 56-year-old daughter died, and the third daughter remains hospitalized.

For me, the ages of the victims is standing out. Thanks everyone for continuing to track down information

 

[tetano]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

DHMH LABORATORIES ADMINISTRATION REPORTS

During week 7 of 2012, the DHMH Laboratories Administration received a total of 79 specimens for influenza testing by PCR. Two were positive for type A (H1N1), seven were positive for type A (H3), and three were positive for type B.

The table below shows the breakdown of positive tests by influenza strain for the 2011-12 influenza season to date. More information on the valuable work done by the DHMH Laboratories Administration is available at http://dhmh.maryland.gov/labs.

http://www.dhmh.maryland.gov/fluwatch/SitePages/weeklyreport.aspx

 

[hawkeye]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

News Video and photos (top left):

PRINCE FREDERICK, Md. - A deadly outbreak of flu appears to have killed three people in Calvert County, all from the same family. The Calvert County Health Department began investigating the cluster of deaths on Monday trying to find the source of this outbreak.

Read more: http://www.myfoxdc.com/dpp/news/mar...ckened-in-calvert-county-030612#ixzz1oR9QVw1h

 

[sharon sanders]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Does not say which strain of influenza


PRESS RELEASE
FROM: David L. Rogers, MD MPH
Health Officer
DATE: March 7, 2012, 8:45 am

Initial testing of two of four family members in Lusby, three of whom have died, suggests that that the serious lung infection suffered by all four was a complication of seasonal flu. A fourth family member remains hospitalized at Washington Hospital Center and is improving.

Samples have been sent to the Centers for Disease Control and Prevention in Atlanta for further testing.

These cases of serious lung infection were isolated to a single family and there are currently no other affected individuals. Local healthcare providers are not reporting any significant increase in patients with flu-like symptoms.

The illnesses in these family members began with an 81-year-old Lusby woman who developed respiratory symptoms at her home beginning on or about February 23, 2012. She was cared for at home by three of her children, a son and two daughters. The caregivers developed similar respiratory symptoms on or about February 28, 2012. The mother died at home on March 1, 2012. Following her death the three children were hospitalized. Subsequently the 58-year-old son and a 56-year-old daughter died.

As always, we recommend that everyone take routine precautions to prevent the spread of respiratory infections including hand washing and limiting contact with sick individuals. Those with flu-like symptoms, who develop cough, fever or sore throat, should be evaluated by their healthcare provider. Residents who have not received a seasonal flu vaccine are urged to get one from their healthcare provider or by calling Calvert County health department at 410-535-5400, ext. 349.
---end of press release---

http://www.calverthealth.org/

 

[Giuseppe]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Seasonal influenza: H1pdm, H3N2, B.

 

[James S]

Re: Discussion - Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland

Re: Discussion - Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland

5th Calvert family member at hospital


By Lena H. Sun, Wednesday, March 7, 11:00 AM

A fifth member of the Calvert County family stricken by serious lung infections and complications of flu is at MedStar Washington Hospital Center for evaluation, a spokeswoman said Wednesday. Three family members have died in the past week.

The newest person to come under medical attention is the sister of Lou Ruth Blake, 81. Blake died at her home in Lusby on March 1. The sister has a fever but does not appear to have other flulike symptoms, the spokeswoman said.

snip

http://www.washingtonpost.com/natio...-at-hospital/2012/03/07/gIQAYZYFxR_story.html

 

[sharon sanders]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

I called the public health department back and was told that the flu type was "seasonal flu A, H3 type". I specifically asked if it was swine flu type H3 and was told "No". I was told that it was not any kind of "swine" flu which also dismisses H1N1pdm09.

 

[sharon sanders]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

I would like to know if these patients received the seasonal flu shot, and when. Also, I wonder about the reported "coughing" blood symptom and if this could have been caused by the bacterial co-infection.

 

[curiosity]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Influenza A

I would like to know if any healthcare workers working with the family are reporting illness and/or are being treated with preventive measures i.e., oseltamivir.

Also, there was a brief mention that another death was being investigated - not related to the family? Any further information?

Finally, a previously healthy teenager (6'3" and over 300lbs) living forty miles away recently c/o of sudden onset "Influenza Like Illness" then died with a final dx of pulmonary thromboembolism - research on pH1N1 victims (particularly during initial wave) associated pulmonary thromboembolism secondary to pH1N1 infection -

"ILI" is typically defined as respiratory complaint (cough, SOB) WITH other symptoms - especially high fever, not just a respiratory complaint as a pulmonary thromboembolus would present. Is there more to the initial ILI report in this patient that would indicate a possible influenza infection, too?

 

[Giuseppe]

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A

Re: USA - 3 familial deaths, 1 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A

I would like to know if these patients received the seasonal flu shot, and when. Also, I wonder about the reported "coughing" blood symptom and if this could have been caused by the bacterial co-infection.

Any condition involving trachea epithelium may induce hemorrhages so that both primary viral pneumonia and secondary bacterial superinfection can cause blood sputum.

Seasonal vaccine effectiveness may be low in elderly people due to immune system condition, co-morbidity and mismatch between vaccine and circulating strains.

Also, I am sure that environmental factor such as carbon monoxyde was already excluded by health care providers.

In some cases, carbon monoxyde can simulate a severe infection with hemorrhages.

Anyway, the unusual feature of four people down with severe seasonal influenza infection needs to be investigared thoroughly to exclude any other factor, such as hypervirulent pathogens or toxic chemical, and every thing may cause harm to public health.

To note, finally, that some H3N2 human seasonal strain isolated here in Europe demonstrated to be antigenically drifted with respect the vaccine strain and possessed several amino acid substitution in the hemagglutinin.

A reduced oseltamivir sensitivity H3N2 was isolated in Italy, although the mutation is considered to hamper the transmissibility of the virus, which poses minimal risk to widespread diffusion.

 

[Giuseppe]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Here we repost my earlier update on virological surveillance in Italy.

Those interested may find useful to see how many HA aa mutations were detected for the H3N2 strain.

Phylogenetic relations between recent Italian isolates of influenza A(H3N2) virus, February 2012 (Min. of Health)

Source: Italian Ministry of Health, full PDF document: http://www.salute.gov.it/influenza/d...Vir15-2-12.pdf
Full text in this forum: http://www.flutrackers.com/forum/sho...2&postcount=13
GIF image: http://www.flutrackers.com/forum/att...6&d=1329337623

Text translation by the Mod.(IOH)

Phylogenetic analysis was performed by the National Institute of Health of Italy (Istituto Superiore di Sanit?) with the Neighbor-Joining Algorithm for phylogenetic trees construction.

The phylogenetic tree shows the genetic relations between some of the most recent isolates of Influenza A(H3N2) from 2011-2012 season and other reference strains.

Molecular analysis demonstrates that all isolates belong to the A/Victoria/208/2009 subgroup, genetically distinct from the A/Perth/16/2009 group, which related strain is contained in the 2011-2012 trivalent seasonal influenza vaccines for the norther hemisphere.

In this group, isolates are distinguishable in two main subgroups:

-- subgroup 1:
----- A/Stockholm/18/2011, most part of isolates are closely related and it is characterized by the amino acids substitutions V223I, N144D, N145S
-- subgroup 5:
---- A/Iowa/19/2010, at this group belongs A/Firenze/1/2011 and A/Firenze/3/2011 isolates, characterized by the aa substitutions D53N, Y94H, S199A, I230V, E280A.

Data obtained are similar to those reported by the ECDC regarding the most recent influenza virus isolated so far in the European Region during the 2011-2012 season.

Most part ot these isolates are closely related to the A/Stockholm/18/2011-like strains.

(...)
-
-----

 

[alert]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

http://www.promedmail.org/

Published Date: 2012-03-07 15:29:17
Subject: PRO/EDR> Respiratory illness - USA (02): (MD) fatal cluster
Archive Number: 20120307.1063821

RESPIRATORY ILLNESS - USA (02): (MARYLAND) FATAL CLUSTER
********************************************************
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 6 Mar 2012
From: The Washington Post [edited]
http://www.washingtonpost.com/natio...rt-county-md/2012/03/06/gIQAztDDvR_story.html


Three members of a Calvert County family died in the past week following respiratory illnesses, 2 from complications from the flu, according to the chief medical officer at MedStar Washington Hospital Center, where a 4th family member is being treated. The family was from the Lusby area, according to hospital and county officials, who on Tuesday [6 Mar 2012] issued a press release about the investigation into the deaths.

The 1st case involved an 81 year old woman who grew sick at home around 23 Feb 2012. Her son and 2 daughters took care of her there, and then developed similar upper respiratory symptoms 5 days later, on 28 Feb 2012, health officials said. The mother became sick with traditional flu symptoms and also had other underlying medical conditions, according to Janis Orlowski, chief medical officer at the hospital center, located in the District. The mother died at home 1 Mar 2012.

Her 58 year old son and a 56 year old daughter initially were hospitalized at Calvert Memorial Hospital. Both died Monday [5 Mar 2012] -- the daughter at Calvert and the son at the hospital center, where he had been transferred. The other daughter, 51, was transferred from Calvert to the hospital center Monday and is "doing better today," Orlowski said. That woman arrived with the same flu-like symptoms as her siblings, including fever, aches, cough, and shortness of breath, Orlowski said.

Tests confirmed the siblings who died had a strain of flu virus known as influenza A, and each also acquired a serious staph infection, according to Orlowski. She said it was unlikely the infection was acquired in the hospitals because the siblings arrived coughing blood. "It's likely they came to the hospital with the infection, which is what caused the cough and fever," Orlowski said. Tests are being conducted to determine whether the 2nd daughter has the same influenza virus and infection. Officials at the Centers for Disease Control and Prevention will determine what strain of the influenza A virus infected the family, Orlowski said.

This year's [2012] flu season has gotten off to a late start, but Orlowski said there has been an increase in the number of patients with flu-like symptoms in recent weeks. Hospital center officials are looking into at least one other recent death -- unrelated to the Calvert cluster -- to determine whether it was related to flu. The severity of illness and death due to flu varies widely from season to season. The very young, adults older than 65, and individuals with certain medical conditions are at higher risk for developing flu-related complications. The 2011-2012 flu vaccine will protect against the 3 viruses that research indicates will be most common during the season: 2 strains of the influenza A virus, H1N1 and H3N2, and an influenza B virus.

Health officials said the department is urging people who have not yet received a flu vaccine to get one. Local officials are also asking residents to take standard precautions to prevent the spread of illness, including hand washing and limiting contact with sick individuals. Anyone with flu-like symptoms should check with a health care provider.

Maryland's Office of Chief Medical Examiner also is conducting autopsies as part of the investigation. Medical examiner David Fowler said Calvert health officials contacted his office on Monday [5 Mar 2012] seeking assistance. One of the bodies was being transported to Baltimore on Tuesday [6 Mar 2012] for an autopsy. At least one of the bodies had already been embalmed and buried, local officials told him. The medical examiner's office will examine the respiratory organs in detail, Fowler said, and conduct blood cultures for bacteria and viruses.

--
communicated by:
Sara Volk de Garcia, PhD
Asst Professor of Biology
Dept of Math and Science
Our Lady of the Lake University
San Antonio, TX
USA


******
[2]
Date: Tue 6 Mar 2012
Source: Calvert County Health Department press release [edited]
http://www.calverthealth.org/


Update on Calvert County respiratory illness investigation
----------------------------------------------------------
The Maryland Department of Health and Mental Hygiene (DHMH) is working in conjunction with the Calvert County Health Department to investigate a cluster of respiratory illnesses in Calvert County. As the Calvert County Health Department has reported, DHMH is aware of 4 cases in adults from a single family with severe respiratory illness; 3 have died. At this time, no other similar clusters have been reported from Calvert County or elsewhere in the state.

The cause for these illnesses is under investigation and testing is being conducted by the DHMH Laboratories Administration. Preliminary testing at the DHMH Laboratories Administration indicates that 2 of the fatal cases had influenza, and these cases may have been complicated by bacterial coinfections. Bacterial coinfection is a known complication of influenza infection. Additional testing is being conducted for all cases.

DHMH recommends all individuals continue to take the following precautions during influenza season: hand washing, staying home if sick, and staying up to date with influenza vaccinations. DHMH also reminds Maryland residents with influenza-like illness (fever and sore throat or cough) to consult their healthcare providers for evaluation. DHMH is not recommending any additional measures at this time. The Department will provide additional updates as more information becomes available.

There have been no new cases reported as of 10:00 p.m.

--
communicated by:
Irene Lai MD
International SOS Sydney


[The provisional verdict appears to be that influenza A virus infection, in conjunction with bacterial coinfection, was responsible for this cluster of fatalities affecting a single family in Calvert County. The outcome of a postmortem examination in Baltimore is awaited, as is identification of the specific influenza A virus responsible for this outbreak and its relationship to the seasonal influenza viruses circulating in this area.

Calvert County can be located in the map of the counties of Maryland at http://www.digital-topo-maps.com/county-map/maryland.shtml. The HealthMap/ProMED-mail interactive map of Maryland can be seen at http://healthmap.org/r/1XhP. - Mod.CP]

 

[Shiloh]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Source: http://www.nbcwashington.com/news/h...ied-in-2-Calvert-County-Deaths-141794243.html

Flu Strain Identified in 2 Calvert County Deaths
Flu strain among those circulating this season
By Tim Persinko
| Wednesday, Mar 7, 2012 | Updated 3:43 PM EST

Lab testing identified the same strain of influenza in two of the three victims who died with respiratory sickness last week in Calvert County.

The county's health department has been investigating a cluster of illnesses that led to three deaths in Lusby, MD, near the Calvert Cliffs nuclear facility.

The Maryland Department of Health and Mental Health said on Wednesday afternoon that Influenza H3, a strain of Influenza A that has been circulating this season, was found in two of the cases.

The department said in both cases, bacterial co-infections, a known complication of flu infection, also contributed to the victims' deaths...

 

[tetano]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Update on Calvert County Respiratory Illness Investigation

BALTIMORE (March 7, 2012) ? The Maryland Department of Health and Mental Hygiene (DHMH) is working with the Calvert County Health Department to investigate four cases of severe respiratory illnesses in the same immediate family. Three have died. Testing by the DHMH Laboratories Administration has confirmed that two of the cases had Influenza H3, a strain of Influenza A that has been circulating this season. These cases were complicated by bacterial co-infections, a known complication of influenza infection.

Additional laboratory evaluation and investigation are ongoing. At this time, there is no indication of any other clusters of severe respiratory illness in the state. DHMH continues to coordinate with the Maryland Emergency Management Administration (MEMA) to update the Governor and local health and Emergency Medical Services (EMS) partners.

The 'flu' season typically can last as late as May. Vaccination is the best way to prevent influenza and its related complications that can lead to hospitalization and even death. DHMH recommends all individuals over the age of six months get vaccinated. In addition, DHMH reminds Marylanders to take other precautionary measures, such as hand washing and staying home if sick. Individuals with influenza-like illness (fever and sore throat or cough) should consult their healthcare providers for evaluation.

More information regarding the Calvert County investigation will be provided as it becomes available.

http://www.dhmh.maryland.gov/public...aspx&Web=3069d104-bcfc-4c0f-ae6f-ca28f24d570f

 

[sharon sanders]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

I believe that the sibling that is still hospitalized also has Seasonal A/H3. That would be a total of 3. The index case which is Ms. Blake, 81, is suspected influenza.

 

[Treyfish]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

..The health department will continue to work with the healthcare providers and others on this situation and will update county residents if new information important to their health become available, the press release states.
Sweeney said the hospital took normal precautions when the patients were admitted to the hospital, which included isolating the patients and telling all staff, family members and visitors to wear masks when in the same room as the patients. She said the illnesses were reported to the health department, per procedure.

?In abundance of precaution, we have put up signs asking people with respiratory illnesses or fever to refrain from visiting patients,? Sweeney said, but that is also standard procedure that should always be followed. Also, the hospital asks that children younger than 13 not be brought in as visitors to patients.
:tiphat:http://www.somdnews.com/article/201...respiratory-illness&template=southernMaryland

 

[alert]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/mar0712fatalflu-br.html

Maryland tests confirm flu, bacterial co-infections in family case cluster
Lisa Schnirring Staff Writer


Mar 7, 2012 (CIDRAP News) – Lab tests conducted by the Maryland Department of Health and Mental Hygiene (MDHMH) have revealed that two patients in a family cluster of four severe respiratory disease cases had the seasonal H3 influenza strain, complicated by bacterial co-infections, the department announced today.

State authorities and their colleagues in Calvert County have been investigating a cluster of severe respiratory illnesses that led to the deaths of an 81-year-old woman from Lusby and two adult children who cared for her after she got sick and until she died on Mar 1. Another of the woman's daughters is hospitalized with similar symptoms.

More lab testing and an investigation into the cases are ongoing, the MDHMH said in a press release. The release did not specify which two patients the flu confirmation pertained to.

The Calvert County Department of Health (CCDH) said in a statement today that initial tests on two of the four family members suggest that the serious respiratory infection suffered by all four is a complication of seasonal flu. It said a fourth family member is still hospitalized at MedStar Washington Hospital Center and is improving.

The elderly woman's 58-year-old son was treated at the same hospital, where he died on Mar 5, and his 51-year-old sister is receiving care, after first being treated at Calvert Memorial Hospital, the Washington Post reported yesterday. Their 56-year-old sister also died on Mar 5.

Janis Orlowski, MD, chief medical officer with MedStar Washington Hospital Center, told the Post yesterday that the siblings who died had influenza A infections, along with serious Staphylococcus (staph) infections that they likely acquired before they were hospitalized, given that they arrived with fever, aches, cough, and shortness of breath.

Health officials so far haven't released any information on what type of staph infection the patients had. Tom Skinner, a spokesman for the Centers for Disease Control and Prevention (CDC), told CIDRAP News that the CDC is expecting to receive some samples to test, and results will be shared with state and local officials first.

Healthy people can carry Staphylococcus aureus on their skin or in their noses, and the bacteria can cause non life-threatening skin infections. S aureus is also a common cause of pneumonia, particularly in older people and those with underlying medical conditions. Some S aureus pneumonia infections are caused by antibiotic-resistant strains such as methicillin-resistant S aureus (MRSA).

S aureus infections were cited in a number of pediatric flu-related deaths in the 2006-07 flu season. In January 2008 the CDC issued a health alert about a fivefold increase in pediatric flu deaths. At that time, the CDC had received reports of 73 pediatric flu deaths for the 2006-07 season. Of 69 cases with available information, 30 (44%) had bacterial coinfections, including 22 who were infected with S aureus; the 22 included 15 MRSA cases. The pattern was unusual, because some of the deaths occurred quickly in previously healthy children.

The CCHD said no other similar severe respiratory infections have been detected in the Lusby area recently, and local health officials are not reporting a significant increase in patients with flulike symptoms. They recommended that residents take standard precautions, such as observing good hand hygiene and limiting contact with sick people.

Officials urged residents who haven't been vaccinated against seasonal flu to be immunized by their providers or at local retail stores. The CCHD also said it would be administering the vaccine at the health department on a walk-in basis on weekdays.

 

[alert]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

I have to wonder about the timing here. If the sister didn't take ill until the 6th or so, she would have to be third-generation, infected by the children at the funeral, as any exposures to the index case would likely be too early.

http://thechart.blogs.cnn.com/2012/03/07/maryland-flu-deaths-mysterious/

[snip]

The sister of the deceased 81-year old woman is now also being treated for flu like symptoms at MedStar Washington Hospital Center.

Dr. Janis Orlowski, Senior Vice President and Chief Medical Officer at MedStar Washington Hospital Center, says the woman was admitted last night and is in fair condition.

"We don't yet know what this is about," Orlowski said. "She has a fever and a cough. They were all together at a funeral last week. Individuals could easily have caught the flu–a large gathering of people, hugging, consoling, possibly sharing a meal."

"If the individuals had the flu at that time it is quite likely that others are showing signs of the flu," says Orlowski. 'If I was in that family and felt ill, I would seek medical attention early."

Orlowski also treated the brother, who passed away at the hospital Monday night.

She says the bacterial infection they had was a staphylococcal (staph) infection, which she calls a super infection. Cultures on the surviving sister are not back yet. The source of the staph is still unknown, but Orlowski says the bacteria is naturally on the body. On skin, in the nose. Most people, she says, don't catch it from someone else.

"The question is did the mother have the staph where it went to the hands of the children and they got infected or did each end up becoming super infected with their own bacteria and we don't know the answer to that. It's likely we will never know."

[snip]

Orlowski says over the last several days the hospital emergency room filled with nearly 400 patients. Most had chronic illnesses like heart failure, chronic obstructive pulmonary disease (COPD) and liver disease made worse by a bout of flu.

"It's flu season in the mid-Atlantic area so I urge the public to get vaccinated if you have not been, wash your hands, and if you are ill, don't go to school or work. We don't want you to spread the illness."

 

[Readymom]

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

Re: USA - 3 familial deaths, 2 hospitalized due to respiratory illness confirmed by Calvert County Health Dept Maryland - 3 test positive for Seasonal Influenza A/H3

..... Sneaking in from my quiet lurking, I have a question:

So just how common is it, during a regular flu season to have this occur? And yes, I'm keeping in mind that they are mentioning the chronic illnesses playing a part in the near-400 patients. Still seems like a heck of a lot for just 'several days'. -k

Orlowski says over the last several days the hospital emergency room filled with nearly 400 patients. Most had chronic illnesses like heart failure, chronic obstructive pulmonary disease (COPD) and liver disease made worse by a bout of flu.