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
Precautionary quarantine at Belmont Park barn is liftedNEW YORK (AP) — Officials have lifted a precautionary quarantine on a barn at Belmont Park after test results for a horse suspected of having equine herpesvirus Type 1 were negative.The New York Racing Association said Sunday all horses in Barn 37 were found to not have fever and were asymptomatic. As a result, they can enter races and train among the general population.The precautionary quarantine had been put in place a day earlier after a 4-year-old colt exhibited fever and neurological symptoms. Freudnme is being monitored by a private veterinarian. The colt last raced at Finger Lakes in upstate New York in June 2019.EHV-1 can cause an upper respiratory infection in young horses. If a number of horses are housed together, they can become sick and then recover uneventfully. However, equine herpesvirus-1 can also cause a severe neurological disease that affects a horse’s brain and spinal cord, and may result in paralysis and death. K-State players announce boycott after student’s Floyd tweetMANHATTAN, Kan. (AP) — Kansas State football players say they will boycott all team activities until administrators create a policy that would allow a student to be expelled for “openly racist, threatening or disrespectful actions.” The move that most players announced Saturday on social media follows a tweet by a student about the death of George Floyd that prompted outrage on campus. Jaden McNeil mocked Floyd’s death in a tweet Thursday, one month after the Black man died after a white Minneapolis police officer pressed his knee on his neck for nearly eight minutes. McNeil is the founder of a conservative group called America First Students and has been criticized for his past comments on the Black Lives Matter movement. University officials have said they are exploring their options for action.VIRUS OUTBREAK-SPORTS Jones won the first of three races Sunday at the Pennsylvania track with a two-lap sprint to the finish in a wreck-filled Truck Series race. He followed that by wrecking on the first lap of the Xfinity Series race.Chase Briscoe held off Ross Chastain in overtime to win the crash-filled Xfinity race. Briscoe won his fourth Xfinity race of the season. Chastain won $100,000 in a prize awarded to the highest finisher among four eligible drivers. The day’s third event is a Cup Series race. Kevin Harvick is trying for his second Cup victory in two days.Pocono became the first track to hold a Truck, Xfinity and Cup race on the same day. SPEEDWAY OWNER-ROPE AD Associated Press In addition to his two stints as an assistant with Washington, he was also a head coach of the Phoenix Cardinals and Oakland Raiders and an assistant with the Chargers. The Redskins announced that Bugel died Sunday at age 80. No cause of death was given. Johnson finished at 29-under par, good enough for a one-shot win over Kevin Streelman. Canadian Mackenzie Hughes and Will Gordon finished tied for third. Johnson’s round included an up and down par from a ball that lodged inches above a water hazard. It required him to stand in the hazard. Johnson now has 21 tour wins. NASCAR-POCONOJones, Briscoe win first two Sunday racesLONG POND, Pa. (AP) — Brandon Jones took home a trophy and sent a car to the scrap heap in about an hour at Pocono Raceway. Share This StoryFacebookTwitteremailPrintLinkedinRedditTRAVELERS-CHAMPIONSHIPDustin Johnson wins Travelers Championship despite late miscuesCROMWELL, Conn. (AP)— Despite a couple of late miscues, including a drive out of bounds, Dustin Johnson has won the Travelers Championship. Update on the latest sports Speedway owner loses staff, ‘all but 2’ sponsors after postPINE HALL, N.C. (AP) — The owner of a North Carolina racetrack said he has faced death threats, lost employees and seen “all but two” of his sponsors evaporate amid the backlash over his social media post invoking the noose found in the garage stall of Black NASCAR driver Bubba Wallace Mike Fulp, who owns the half-mile, dirt track 311 Speedway in Stokes County, told the News & Record he knew his troubles from what he described as a joke were self-inflicted. Fulp’s post advertised “Bubba Rope” for sale on Facebook Marketplace the day after an FBI investigation determined the noose found at the Talladega Superspeedway garage had been there since at least October and was a coincidence, not a hate crime. Fulps told the newspaper he’s responsible “for trying to make some jokes and said he is not a racist. Fulp said he’s been getting death threats and received messages threatening his family. He said seven workers quit.RACIAL INJUSTICE-KANSAS STATE TWEET Belmont’s current meet ends July 12. It is racing without spectators because of the coronavirus pandemic.NFL-OBIT-BUGELFormer Redskins assistant, “Hogs” creator Joe Bugel dies at 80UNDATED (AP) — Former Washington Redskins assistant coach Joe Bugel (BYOO’-gul) has died.Bugel was the architect of “The Hogs,” the dominant offensive lines that helped lead the team to three Super Bowls under Hall of Fame head coach Joe Gibbs. He was regarded as one of the best offensive line coaches in NFL history. June 28, 2020 Italy’s women’s ski team reports 3 positivesUNDATED (AP) — The Italian Winter Sports federation says three members of the women’s ski team — two coaches and one athlete — have tested positive for the coronavirus while training.The federation says that one of the coaches has been hospitalized with a mild fever. The others have no symptoms but are being quarantined. The federation did not name those who tested positive. While other sections of the national team will continue training, the World Cup team will return home. Italy’s team features reigning overall World Cup champion Federica Brignone (feh-deh-REE’-kah breen-YOH’-nay), whose mother recovered after being hospitalized with the virus, and Olympic downhill gold medalist Sofia Goggia (GOH’-jah).HORSE RACING-BELMONT-BARN QUARANTINE
NBA trade rumors: Pelicans unlikely to deal forward Julius Randle He has averaged 8.2 points, 3.7 rebounds and 3.1 assists in his 19 appearances in 2018-19.Fultz was the top pick in the 2017 draft and began his career with high expectations. But he also dealt with injuries as well as a hitch in his jump shot during his rookie season, which limited him to 14 games. Related News Markelle Fultz is drawing interest ahead of the Feb. 7 trade deadline.The Hawks and Magic have both spoken to the 76ers about dealing for the 6-4 guard, ESPN’s Zach Lowe reported on the Woj & Lowe show Wednesday. NBA trade rumors: Thunder, Rockets interested in Cavaliers guard Alec Burks Philadelphia acquired Tobias Harris from the Clippers in a blockbuster trade Wednesday. But it may still be looking to build its bench depth.Fultz was diagnosed with thoracic outlet syndrome in December and hasn’t played since Nov. 19. There is no timetable for his return to the court.