Resurgence of H1N1 virus worries area health officials

7 in area dead with months to go in flu season

1/19/2014
BY MARLENE HARRIS-TAYLOR
BLADE STAFF WRITER
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    Bridgett Rys holds her daughter, Isabella, 3, while she gets her shot from nurse Cindy McLeod at the Toledo-Lucas County Health Department. Anabella Rys offers support by holding her sister’s hand.

    THE BLADE/LORI KING
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  • EDITOR'S NOTE: This version corrects it was a 53-year-old man who died at Mercy St. Vincent Medical Center on Jan. 8.

    Bridgett Rys holds her daughter, Isabella, 3, while she gets her shot from nurse Cindy McLeod at the Toledo-Lucas County Health Department. Anabella Rys offers support by holding her sister’s hand.
    Bridgett Rys holds her daughter, Isabella, 3, while she gets her shot from nurse Cindy McLeod at the Toledo-Lucas County Health Department. Anabella Rys offers support by holding her sister’s hand.

    Lucas County is on track to surpass the number of flu deaths seen locally over the past five years after four county residents — along with three others in neighboring counties — have died from the flu in recent weeks.

    During the past two years, there were no confirmed deaths from the flu in Lucas County. There was one flu-related death in the 2010-2011 flu season, and in 2009-2010, the year of the H1N1 pandemic, there were four deaths.

    There are still months to go in this year’s flu season, raising concern among some health leaders.

    “We are not in the throes of an epidemic. I think we are probably seeing a little higher than normal, and we are having a more serious flu season, but it is not an epidemic,” said Dr. David Grossman, Toledo-Lucas County health commissioner.

    RELATED GALLERY: Click here to view photos from a local flu clinic.

    What’s more disturbing to health officials is the re-emergence of the H1N1 strain this year.

    Davis
    Davis

    The H1N1 flu virus caused a worldwide pandemic in 2009. Also called the swine flu, it affected millions of U.S. residents and spread quickly, causing confusion and panic around the world.

    Grossman
    Grossman

    “This year what is concerning is the unusual number of young, previously healthy adults getting sick, needing to be put on life support, and dying from H1N1,” said Dr. Matthew Davis, chief medical executive of the Michigan Department of Community Health.

    Lucas County residents who have died in area hospitals include 61-year-old Patricia Marshall, on Dec. 31; 62-year-old Connie Bucklew, on Jan. 7; 60-year-old Randy Bugg, on Jan. 13, and an unidentified 53-year-old resident who died on Jan. 8.

    Health officials confirmed that two southeast Michigan residents died from the H1N1 strain of the virus. James A. Crosby, 50, of Temperance died Dec. 28. The youngest victim in the area was Chris Wright, a 41-year-old father of five from Monroe who died Jan. 12.

    A seventh unidentified victim, a man in his mid-50s, died last week in Lenawee County. 


    Flu vaccine

    Dr. Davis said that after the pandemic in 2009, the H1N1 virus became one of the strains used in the flu vaccine, which helped contain the virus. But he said it never went away.

    He said the primary reason that H1N1 has resurfaced as a major issue is that health officials have not met the vaccination threshold needed to keep the virus from spreading through the overall population.

    “There are about 20 percent of people who are going to get the flu shot each year out of habit, and another 20 percent will not get it no matter what the circumstances. That leaves about 60 percent of the population who are on the fence each season that the medical community has to convince to get the shot,” Dr. Davis said.

    He said the target vaccination rate for children and adults is to be above 60 percent both in Michigan and nationally. But in recent years, the vaccination rate has been running closer to a much lower 30 to 40 percent.

    According to Dr. Davis and Dr. Grossman, about 30,000 flu-related deaths occur annually. Tracking how close the nation is to reaching that number is very difficult because many state health departments do not officially count or report the number of adult flu-related deaths. 

    Tracking deaths

    In Ohio and Michigan, the state health departments are required by law to keep track of children who die of the flu but there is no similar requirement for adult deaths. Instead, more informal channels of communication are used between health officials — information that is not always available to the public.

    In Michigan, for example, the state earlier this month issued a news release that said it was aware of six adult deaths and one pediatric death so far this year. After that, however, when asked about an update to that figure, health officials will only say that the state does not track adult flu-related deaths.

    Dr. Davis said the requirement to report flu-related deaths of people under the age of 18 is relatively new. “About 10 years ago there were hundreds of pediatric deaths in that flu season and the CDC then set that reporting expectation for states,” he said.

    As the leading public health official in Lucas County, Dr. Grossman has struggled in his efforts to provide information to the public and the news media about the deaths.

    Hospitals do not report the adult flu-related deaths directly to Dr. Grossman. Instead, he must wait days or weeks to receive the official death certificate from the physician of record before he can release information to the public. 

    Data lacking

    Officials at Mercy, ProMedica hospitals, and the University of Toledo Medical Center, formerly the Medical College of Ohio, have repeatedly refused to release any information about people who died in their hospitals from the flu virus or to give information about the number of people who are seriously ill with flu-related symptoms.

    Health officials say they are hindered from releasing information to the public by the Health Insurance Portability and Accountability Act, or HIPAA law as it’s known. The 1996 federal regulation requires that all health-care providers prevent the disclosure of a patient’s private medical information.

    “I’m not going to give any personal information about a patient; HIPAA law does not allow it and I think it would be unethical. Their name, their address, or anything that would unleash people sticking their nose into their business if they don’t want it,” Dr. Grossman said.

    Hospitals are required by law to supply information about the number of patients being treated for the flu to the Toledo-Lucas County Health Department. Hospitals must report those numbers within 48 hours of the first business day.

    According to the local health department in Toledo, 74 hospitalized flu cases have been confirmed so far this season, which is already far more hospitalizations confirmed for the entire flu season last year or in other recent past years. 

    Gauging the season

    The typical flu season begins in late September and ends in the spring.

    In Michigan, health department officials said that as of Jan. 16, there had been 123 influenza hospitalizations statewide: 39 children and 84 adults.

    Determining what is a good or bad flu season involves a complex formula.

    Health officials rely on a variety of indicators from the number of deaths and hospitalizations to the number of people visiting the doctor with flu-like symptoms, and even the number of thermometers being purchased.

    “My guess is in another month or two we will be able to know more clearly what kind of flu season we are having,” Dr. Grossman said.

    Contact Marlene Harris-Taylor Marlene Harris-Taylor at: mtaylor@theblade.com or 419-724-6091.