Font ResizeSix Salt Lake County residents now have died after testing positive for H1N1 swine flu and nearly 100 have been hospitalized with the novel strain.
The past four deaths have occurred in the past week, as hospitals in the valley report being inundated with patients with flu-like symptoms and doctors race to understand more about the new virus.
Nathan Dean, chief of pulmonary critical care at Intermountain Medical Center in Murray and LDS Hospital in Salt Lake City, said about one patient a day has been admitted to the intensive care unit for the past three weeks.
Most ICU patients have been overweight, he said, which is puzzling: Their weight isn't causing other health conditions that the federal government says puts people at higher risk of severe influenza complications, such as cardiovascular disease or diabetes, he said.
"I really don't consider being overweight a disease, at least in the patients we're seeing," Dean said. "It's not like they're so [obese] they've gone into heart failure. Somehow, the disease is striking them."
About a fourth of the ICU flu patients have suffered from an inflamed airway, exacerbated by conditions like asthma or emphysema. Nationally, asthma is the most common condition causing hospitalizations.
Other patients end up in the ICU suffering from adult respiratory distress syndrome (ARDS) or septic shock, he said. ARDS is a lung condition that leads to low oxygen levels in the blood,
And while septic shock, which can lead to low blood pressure and organ failure, is normally associated with bacterial infections, doctors aren't seeing such infections with flu patients.
"The virus itself seems to be initiating the septic shock cascade," said Dean, who said the virus reminds him of hantavirus, which is transmitted through rodent urine, droppings or saliva, and can cause acute respiratory distress.
The latest reported Salt Lake County deaths were a man between the ages of 25 and 50 who died Saturday and a woman who was 25 to 60 years old who died Monday. All six of the patients who have died had underlying health conditions that "may have put them at higher risk of complications or death, according to Salt Lake Valley Health Department spokeswoman Pam Davenport.
In two cases, those conditions have included obesity and sleep apnea and a liver condition, according to hospital officials or family members.
Additional deaths "are not unexpected," Gary Edwards, the department's executive director, said in a statement.
The continuing illnesses are surprising, since it was believed that the flu would take a summertime lull.
"Utah seems to be having a lot more of this than the rest of the country, in terms of severity of disease," Dean said. "It's partly because we have larger numbers of influenza than surrounding states. ... We're just trying to figure this out."
The Utah Department of Health will release statewide hospitalization numbers Wednesday. The average age of the most sick in the county is 21 years, with a range of 10 days old to 76 years old. Nationally, 1,621 people have been hospitalized as of Friday.
The Centers for Disease Control and Prevention recommend giving antiviral medications only to hospitalized patients and patients with underlying health conditions that put them at higher risk of complications. Doctors should also consider prophylactically treating people who live with flu patients and are at high risk of complications, the CDC says.
But Dean and others say people who have had symptoms of the flu, including a fever, cough, body aches and fatigue, for less than 48 hours should seek medications. "Why not use something you know works?" Dean said.
Antiviral wholesalers have reported to the state health department that there is an adequate private supply of Tamiflu and Relenza, but individual pharmacies may not have enough. A Sugarhouse Walgreen's pharmacist said Tamiflu is sold as quickly as it is stocked.
Tribune reporters Brooke Adams and Andrew Maddocks contributed to this story.
For adults:
Difficulty breathing
Purple or blue discoloration of the lips
Vomiting and unable to keep liquids down
Signs of dehydration such as dizziness when standing, absence of urination
Seizures or uncontrolled convulsions
Loss of consciousness
Alteration in thinking
For children:
Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms that improve then return with fever and worse cough
Fever with a rash
If severe symptoms develop, call your health care provider. If he or she is not available, go to the emergency room.
Source » Salt Lake Valley Health Department
Children younger than 5, with the highest risk for children younger than 2.
Pregnant women.
Adults over 50, particularly over 65.
Adults and children with certain chronic medical conditions including chronic lung problems such as asthma, heart, liver, blood, nervous system, muscular, or metabolic disorders such as diabetes.
Adults and children who have immunodeficiency or immuno-suppression, including that caused by medications such as corticosteroids and chemotherapy, or diseases such as HIV/AIDS.
Children ages 6 months to 18 years who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection.
People who live in settings such as nursing homes, residential schools, and jails.
Source » Salt Lake Valley Health Department
Six Utahns, all from Salt Lake County, have died after testing positive for H1N1 flu, with the last four dying in the past week. All had underlying health factors that put them at higher risk, health officials say.
21-year-old Marcos Antonio Sanchez died in May. He was overweight and had sleep apnea.
A child between the ages of 5 and 8 who had a "pretty severe underlying chronic condition" and respiratory problems, according to a health official.
Doug Dunford, a 42-year-old from Cottonwood Heights with a liver condition.
Francine Rushton, 47
A man between the ages of 25 and 50
A woman between the ages of 25 and 60
