Certain symptoms signal severe H1N1

FORT WAYNE, Ind. (WANE) - State health officials said last week they're seeing historic levels of people with flu-like symptoms. Some people are getting mild cases of H1N1 while many others have severe symptoms. Some recover quickly, but some lose their lives.

Last Tuesday Allen County had its first H1N1 death. A 47-year-old woman died from pneumonia and wide-spread infections, which she developed because she was sick with the flu. Health department spokesman John Silcox said Monday he doesn't believe the woman had any pre-existing conditions that could lead to a complicated course with the flu. He added that her symptoms progressed pretty quickly, but he couldn't say exactly how many days she was sick.

Her death was the twelfth in Indiana. Allen County Health Commissioner Dr. Deborah McMahan said while it's unfortunate, she's not surprised to have an H1N1 death in the county.

"Last year with seasonal flu we had four deaths in Allen County. Something with more widespread infection, it's likely we'll see something similar," McMahan said.

A new White House report expects about two million Americans to be sick with H1N1 and somewhere between 30,000 to 90,000 will die.

When someone with a chronic disease, like diabetes, asthma or COPD, has flu symptoms, he or she should call the doctor immediately. Those illnesses are all risk factors for H1N1 taking a dangerous turn.

But there are certain symptoms that can happen to anyone that are signs the flu is getting serious. Doctors said if someone with flu symptoms

* has a fever that can't be controlled or lowered with medicine

* has trouble breathing

* is confused or disoriented

* hasn't urinated for 8 to 12 hours

he or she should be seen by a doctor immediately. If someone isn't sure they should go to the hospital, a quick call to the doctor's office can help assess the situation.

Even if someone gets to the hospital quickly after experiencing any of the above symptoms, Dr. McMahan said sometimes it's still too late.

"There are times when someone gets infected with a virus or bacteria and there's just nothing you can do about it," she said. "IT can already be at a point that no matter what you do, it's not going to make a difference and that's really devastating to people."

Still many people will get the H1N1 flu and have a very mild course, feeling better after a few days.

"A mild case might be a headache, stomach ache, throwup once or twice," Parkview Hospital Emergency Department Medical Director Tom Gutwein said.

Parkview's ER has seen about five times more flu patients in the last few weeks than in a typical flu season.

"This came on quickly, really in just a few weeks. We've really ramped up staff and created areas for people with H1N1 so they won't contaminate other patients," Gutwein said.

Gutwein said he sees a whole range of severity come into the emergency room. Less than ten percent, he estimated, are not very sick. About seventy five percent are pretty sick, but don't need to be hospitilized and the rest need to be admitted to the hospital.

What's difficult with this H1N1 virus, and different from seasonal flu, is that about a thrid of severe cases are in seemingly healthy people.

"Usually if people are going to have adverse outcomes, it's usually someone who we can predict might have a problem, but not with this particular virus," McMahan said.

Because the symptoms can get worse quickly, it's important to pay close attention from the beginning.

"When a child is in the early phases and they have a low grade fever and just feel bad from head to toe, it's really hard to predict which of those will be better in 24 hours and which are going to get a lot worse," Gutwein said.

Gutwein added that good immune systems could actually be contributing to complicated courses in healthy people.

"If they get a large exposure to H1N1, they would have a big immune response in their system which would cause a lot of inflamation in the lungs. That makes it harder for them. It's really an over response to the illness," Gutwein said.

Many doctors say the death rates for H1N1 appear to be similar to seasonal flu, but more people are expected to get infected with H1N1 because there is no base community immunity.

Get weekly flu updates from the Centers for Disease Control and Prevention on its FluView page.