Oct 16, 2009 (CIDRAP News) – The susceptibility of some young, healthy people to severe illness with pandemic H1N1 influenza marks a striking difference from the pattern of disease seen in seasonal flu epidemics, the World Health Organization (WHO) said today.The factors that increase the risk of severe illness in previously healthy people remain unknown, the WHO said in reporting on the results of a 3-day conference on the features of severe H1N1 cases. The meeting involved about 100 clinicians, virologists, and other experts at the Pan American Health Organization headquarters in Washington, DC.The ability of the virus to make young, healthy people dangerously sick has been noted for months, but the WHO put new emphasis on the phenomenon today. At the same time, the agency said pregnant women, children younger than 2 years, and people with chronic lung disease face the greatest risk of severe illness.In a statement, the WHO said the experts confirmed that the vast majority of patients around the world experience an uncomplicated flu-like illness and recover within a week, even without treatment.Patients hard to treat But concern now focuses on “small subsets of patients who rapidly develop very severe progressive pneumonia,” the agency said. “In these patients, severe pneumonia is often associated with failure of other organs, or marked worsening of underlying asthma or chronic obstructive airway disease.”These patients are hard to treat, which suggests that emergency rooms and intensive care units will bear the heaviest burden during the pandemic, the statement said. That conclusion matched the message from several medical journal reports published in the past week on hospitalized H1N1 cases.Primary viral pneumonia is the most common finding in severe cases and often causes death, the WHO said. However, bacterial infections have been found in about 30% of fatal cases—more common than previously recognized.Data from animal studies also show the virus’s ability to cause severe pneumonia. “This virus really likes the lower respiratory tract,” said the WHO’s Dr.Nikki Shindo at a press teleconference today. “That means this virus is likely to cause viral pneumonia.”Physicians who have managed severe cases “agreed that the clinical picture in severe cases is strikingly different from the disease pattern seen during epidemics of seasonal influenza,” the WHO statement said. “While people with certain underlying medical conditions, including pregnancy, are known to be at increased risk, many severe cases occur in previously healthy young people. In these patients, predisposing factors that increase the risk of severe illness are not presently understood, though research is under way.”In a separate pandemic update today, the WHO noted that about a third of intensive care unit patients with H1N1 in Australia and New Zealand had no predisposing conditions. Likewise, Canadian and Mexican researchers who recently reported on severe cases were “impressed” by the number that occurred in previously healthy people, the agency said.The latest US figures suggest that an even higher proportion of patients hit hardest by the virus were previously healthy. The Centers for Disease Control and Prevention reported this week that 45% of about 1,400 adult H1N1 patients who were hospitalized had no preexisting health problems.In severe cases, patients usually begin deteriorating about 3 to 5 days after their first symptoms, the WHO statement said. Many of them then slip into respiratory failure, requiring admission to an ICU and ventilatory support. Some patients don’t respond well to conventional ventilatory support, making treatment even harder.Known at-risk groupsOf groups with conditions that raise the risk of severe illness, conference participants agreed that three lead the list: pregnant women, especially in the third trimester; children under the age of 2 years, and people with chronic lung disease, including asthma, the WHO reported.Disadvantaged populations, such as minority groups and indigenous people, also are disproportionately subject to severe disease, the WHO said. The reasons are not clear, but possibilities include lack of access to care and an increased prevalence of conditions like asthma and diabetes.The statement also noted that obesity—especially morbid obesity—has been present in many of the severe H1N1 cases, but its role remains poorly understood.More support for antiviralsOn the brighter side, the meeting pointed up a growing body of evidence that prompt treatment with the antiviral drugs oseltamivir and zanamivir is helpful, the WHO said.”We have increased evidence that timely antiviral treatment really helps to decrease the severe disease,” said Shindo at the press conference.Where the virus is circulating, clinicians should base antiviral treatment decisions on epidemiologic and clinical findings and not wait for lab test results, she said. “The message for clinicians is, don’t miss this opportunity for early treatment.”Shindo said the WHO has shipped antivirals from its stockpile to 72 countries so far.See also: Oct 16 WHO report on clinical consultationhttp://www.who.int/csr/disease/swineflu/notes/h1n1_clinical_features_20091016/en/index.htmlOct 16 WHO weekly update on pandemichttp://www.who.int/csr/don/2009_10_16/en/index.htmlAug 28 WHO briefing note on lessons from recent outbreakshttp://www.who.int/csr/disease/swineflu/notes/h1n1_second_wave_20090828/en/index.html
Saturday was finally an almost perfect day to watch and participate in a track meet. Many members of the Batesville High School men and women’s track and field team traveled to Indianapolis to Lawrence Central High School to compete in the Midwest Prepmeet.This meet is a little unique, as competitors need to qualify at certain times and distances to be invited to compete. This year, Batesville had the most number of events and athletes competing here than they ever have in the past. Having to meet the qualifying standards, makes this meet highly competitive…the best competition we have seen thus far. It is also great experience for these athletes to help prepare them for the big meets at the end for the year.Medal awards were given to the top 8 athletes in each event and the Bulldogs were able to bring several of these home. The first medal winners were the girls 4 x 800m relay team. The relay placed 6th overall, running over 20 seconds faster than they have this year, which also ended up being a new school record!!! The old record set at this meet last year was 10:14. This year’s squad cut almost 4 second from that clocking in at 10:10.83. Member’s for the team were Mary Poltrack, Maria Wessel, SarahPoltrack and Kelsey Gausman.Also bringing home a medal were: Peter Heil in the 300m hurdles, coming in at 7th place (41.17), Connor Bell in the 800m run- running a 6 second personal best and placing 5th at 2:00.27 and Michael Tunny in the 200m dash, coming through the line 6th, at 23.55.Others competing but coming a little short of a medal, but running great were:100m dash-Sophie Meadows (17th), Tanner Ayette (13th) and Jacob Koehne (18th).200m dash-Sophie Meadows (13th), Jacob Koehne (13th).400m dash-Audrey Hall (14th) and John Moody (26th).800m run-Kelsey Gausman (13th).3200m run-Mary Poltrack (10th) , Sarah Poltrack (16th) and Caleb Moster (17th).High Jump-Kim Tidman (9th).Long Jump-Kim Tidman (11th), Mary Elizabeth Elkins (20th) and Garrett Yorn (22md).Shot put-Samathna Heidlage (9th).4 x 100 relay team-Jacob Koehne, Peter Heil, Garrett Yorn, Tanner Ayette (14th).4 x 400 relay teams of: Madelein Robben, Haylee Harmeyer, Mary Elizabeth Elkins and Sophie Meadows (12th) and Garrett Yorn, John Moody, Peter Heil and Michael Tunny (15th).Congratulations to all of the competitors!Next meet is Tuesday. It will be a two in one meet as we will be making up the meet from a couple of weeks ago against East Central, combined with an already scheduled meet with EC with our JV team. So this will be a ribbon awarded Varsity and JV meet.Action will begin at 5:15 at East Central.Courtesy of Bulldogs Coach Lisa Gausman.
He added: “But just being involved with a Premier League team, living the experience of first-team football and learning from other players and other teams has been very good. “You always improve and pick up new things from new managers and new players. “That was the point of the whole exercise, and I hope to show what I’ve learned when I return to Old Trafford.” Press Association Manchester United striker Angelo Henriquez has not ruled out a return to Wigan next season even though they have been relegated. The 19-year-old Chilean joined the Latics on loan in January but made just eight appearances – which included only four in the Premier League as substitute – with his only goal coming in the 3-2 defeat at Sunderland. “I didn’t play a lot of football, which was obviously the target when I arrived in January,” Henriquez told the Wigan Evening Post. “I have enjoyed my time here (Wigan) and I wouldn’t rule out coming here again if that is a possibility. Who knows?”