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Manitoba Ventilator Request Raises H1N1 Pandemic Concerns
Recombinomics Commentary 23:51
June 8, 2009

Manitoba has experienced an increased concentration of severe respiratory illness admitted to the intensive-care units, which is higher in number than previous influenza outbreaks. The majority of the cases are in people of Aboriginal descent.

The Public Health Agency of Canada has provided three epidemiologists to Manitoba to assist in assessing Manitoba's cases of influenza-like illness.

The Winnipeg Regional Health Authority (WRHA) is taking steps to provide enough support in intensive-care units (ICUs) and prioritizing patients for personal-care home beds. There are also 15 additional ventilators that have arrived and will be put to use as needed. The WRHA may also defer non-urgent surgical procedures that would normally require ICU care.

The above comment from a Manitoba press release today describes an increasing problem of severe disease in First Nation residents.  The increase in number of cases began 1-2 weeks ago and is evident in multiple provinces (see updated map).  Last week the medevacing of patients to Winnipeg was detailed this afternoon's press release strongly suggests the problem is growing.

Although it is unclear if these more severe cases are linked to poor health conditions and overcrowding, of if there is a genetic component in the target population or circulating swine H1N1 that is exacerbating the problem, but it is a growing problem and many expand as swine H1N1 spreeads through less developed areas of Asia and Africa.

The circulation of a swine H1N1 in a heterogeneous human population is likely to cause problems, which can grow as the virus adapts to its new host or the virus spreads through populations at greater risk.

Although many local agencies in the United States and Canada have limited testing of mild cases and have begun focusing on the more severe hospitalized cases, the number of frequency of positives continues to grow, even though the flu seasonal has ended in the northern hemisphere.

The spread of the swine H1N1 during the off season may be linked to an avan PB2, which optimizes viral replication at 41C, which may contribute to the rapid spread of the virus.

Most cases have been mild, and the spread of the virus has been largely silent.  However, deaths are beginning to mount with five announced today (PA, OK, QB, OR, CA), in addition to three on Friday (TX, WA, NY), six on Thursday (AZ, PA, UT, IL, CA, WI) and seven on Wednesday (3 NY, MI, CT,VA).

These increase in fatalities among a population that is largely under 65, and the increasing admissions to hospitals and ICU's, continue to increase pandemic concerns.

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