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Commentary

H1N1 Fatality Rate in Memphis Children Raises Concerns
Recombinomics Commentary 21:21
January 27, 2010

A 12-year-old has died of complications from the H1N1 flu, officials at Le Bonheur Children's Medical Center said Wednesday.

"Le Bonheur Children's confirms the death of a 12-year-old male resulting from complications of H1N1," a hospital spokesperson said in a written statement. "This is the fifth H1N1 death at Le Bonheur since we began tracking in September 2009."

It is the second time this week the hospital has announced a death from the virus. Le Bonheur confirmed the death of a 14-year-old patient from the virus Monday.

In a news conference Tuesday, Dr. Keith English, one of Le Bonheur's leading pediatricians, said there is no reason to be alarmed, but he does not want people to think the H1N1 threat is over.

The above comments describe the H1N1 deaths of two children in Memphis (see map).  The hospital had announced a spike in severe cases.  17 patients had been admitted this month, and 7 went to the ICU.  Two of those patients have died.  The ratio of hospitalized to ICU to deaths is markedly different this month than last fall, when thousands of children were seen and about 340 were admitted. 30-40 went to the ICU and 3 died.  Thus, the death of 2 of the 17 admitted or of the 7 in the ICU is at a much higher rate and raises concerns that the H1N1 circulating this year will be more virulent due to increases in D225G/N, which is being reported in multiple locations worldwide, including a Tamiflu resistant fatal cluster at Duke Medical Center.

The flu season in the US traditionally peaks in February or March, so the increases seen in Memphis may represent the start of a dramatic rise in severe and fatal cases.  Seasonal H1N1 and H3N2 have virtually disappeared in much of the northern hemisphere including the United States, so pandemic H1N1 variants will likely emerge in the next few weeks.

Sequence data on the H1N1 from these two fatal cases would be useful.

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