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Swine Flu Impacting Surgical Resources

Mon, 10/12/2009 - 7:07am
The Centers for Disease Control and Prevention recently reported that 76 children have died of swine flu in U.S. this year, including 19 new reports in the past week. The regular flu kills between 46 and 88 children a year. That suggests deaths from the new H1N1 virus could dramatically outpace children's deaths from seasonal flu, if swine flu continues to spread as it has.

CDC officials say 10 more states, a total of 37, now have widespread swine flu. A week ago, reports suggested that cases might be leveling off and even falling in some areas of the country, but that did not turn out to be an enduring national trend.

The CDC doesn't have an exact count of all swine flu deaths and hospitalizations, but existing reports suggest more than 600 have died and more than 9,000 have been hospitalized. Most healthy children recover and often suffer only mild symptoms, but kids with asthma or chronic heart or respiratory conditions also are at greater risk for serious complications.

Vaccinations against swine flu began this week and so far, states have ordered 3.7 million doses. Demand is exceeding supply, and people seeking the vaccination should ask their state or local health department where to go. Health officials also said more data is trickling in from several clinical trials of the new vaccine, and so far no serious side effects have been reported.

Preliminary results from one study indicate that both a seasonal flu shot and a swine flu shot are effective when given during the same doctor's office visit. However, the government is not recommending that people get the nasal spray versions of the seasonal and swine flu vaccines at the same time.

However, as vaccinations progress, one-quarter of Americans sick enough to be hospitalized with swine flu last spring wound up needing intensive care, and seven percent of them died. That's a little higher than with ordinary seasonal flu. Results were published online Thursday by the New England Journal of Medicine.

A second study released by the journal revealed that swine flu had a profound effect on intensive care units in Australia and New Zealand from June through August — winter months and the normal flu season in the Southern Hemisphere.”They had a 15-fold increase in ICU care. That's a 1,500 percent increase,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“We're still heading into our flu season. Will we see this same big increase in cases over the next several months or will we have a peak in cases in October or November?”

In the U.S. study, researchers led by the CDC's Dr. Seema Jain identified 272 patients hospitalized for at least a day from April through mid-June, when the novel virus caused its first wave of cases. That's about one-fourth of the total hospitalizations for swine flu reported during that time, but researchers only studied lab-confirmed cases and patients who agreed to be part of the study.

Three-fourths of these patients had other health problems, such as diabetes — typical of seasonal flu, too. However, only 5 percent were 65 and older; ordinary seasonal flu usually hits hardest in the elderly.

This additional strain is obviously impacting hospitals and medical suppliers. While those providing masks and other prevention-focused items are seeing nice sales gains, one has to wonder how the onslaught of H1N1 will impact surgical purchases and other necessary hospital resources.

With facilities already taking a closer look at capital expenditures as they weather the current economic storm, especially in the OR suite, the additional burden caused by the swine flu could cause even deeper evaluations, especially as these cases demand longer-term care and greater doctor, nurse, ICU and overall patient needs.

Contributors: Mike Stobbe & Marilynn Marchione, AP Medical Writers

New England Journal: www.nejm.org

Swine flu information: www.flu.gov

Centers for Disease Control and Prevention: www.cdc.gov/h1n1flu/update.htm

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