Alexandre Meneghini/AP

Who Is Most Susceptible to Swine Flu?

May 29, 2009 04:00 PM
by Cara McDonough
At first, the H1N1 virus was affecting healthy people in Mexico, authorities said. But in the United States, “underlying health conditions” have been implicated in the deaths of swine flu victims.

Swine Flu: Many Questions Remain Unanswered

The fervor over swine flu may have died down in the media, but it certainly hasn’t gone away completely. Following the deaths of two more New Yorkers from the virus, new questions emerge, including: Who is most susceptible to the H1N1 virus, and why?

The New York Times observed that when the two latest swine flue deaths were announced—the most recent, a woman in her 50s who died last week—New York City’s health commissioner, Dr. Thomas R. Frieden, “added a by-now familiar caveat: Both of them, he said, had ‘underlying conditions.’”

Mitchell Wiener, 55, the first New Yorker to die of swine flu, was overweight and taking medicine for high blood pressure, his widow, Bonnie Wiener, told The Times. “How many people 50 and above don’t?” she asked. She takes issue with the city’s explanation that her husband’s health conditions were a contributing factor in his death.

The notion that an underlying health condition puts someone at greater risk is worrisome, according to The Times, because in New York City alone, health conditions like Wiener's are common and “statistics suggest that the city’s long list of red flags may encompass as many as one in three people.” Asthma, obesity and heart disease are just some of the health conditions that could put people at higher risk.

Opinion & Analysis: Who is most at risk?

When officials were first observing the swine flu outbreak in Mexico, they noted that cases were mostly reported in healthy adults—scarily similar to the 1918 Spanish flu. So why have those who suffered the most serious complications from the H1N1 virus in the U.S. had underlying health conditions?

It may be too soon to tell. Dr. Michael W. Smith, medical editor-in-chief of WebMD, wrote for that certain people are simply more likely to suffer complications from swine flu—or any flu—and therefore are “more likely to get very ill, require hospitalization, and more likely to die.” Those people include children, pregnant women, people 50 years old and older, and people with certain medical conditions, such as lung or heart disease or those with weak immune systems.

Still, even common sense advisories like Smith’s don’t totally jibe with the many confusing aspects of the H1N1 virus. The Economist reports that a study by the Centers of Disease Control and Prevention found that the seasonal flu kills thousands of elderly people in the U.S. every year, yet with swine flu, a mere 1 percent of cases have been in people over 65. Anne Schuchat of the CDC was quoted as saying by The Economist that “older adults might have been in contact a long time ago with a virus similar to the one we see now.” Therefore, they might have immunity to swine flu that younger people don’t.

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Background: Swine flu panic

Although swine flu stormed into the media when cases began to spread in Mexico, the U.S. and around the world, many experts said, and continue to say, that panic is premature and unnecessary.

The regular flu—whatever strain is prevalent that year—affects between 5 and 20 percent of the U.S. population each year, and about 36,000 people die. So far, the H1N1 virus hasn’t even come close to approaching those numbers.

"Let's not lose track of the fact that the normal seasonal influenza is a huge public health problem that kills tens of thousands of people in the U.S. alone and hundreds of thousands around the world," Dr. Christopher Olsen, a molecular virologist who studies swine flu at the University of Wisconsin School of Veterinary Medicine, told the Los Angeles Times in April. He added that any death is “heartbreaking,” but that we “do need to keep this in perspective.”

Reference: 5 sites for understanding swine flu (H1N1 Influenza A)


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