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Commentary
Young
Adult Deaths At Garden Hill Raise trH3N2 Concerns
Recombinomics
Commentary 17:25
December 7, 2010
Manitoba Keewatinowi Okimakanak (MKO) Grand Chief David Harper says that two people from Garden Hill First Nation, in the Island Lake area, have died from a strain of seasonal flu in the last week. A third person has been airlifted to a Winnipeg hospital in critical condition, Harper said.
The victims were in their 30s and 40s and were healthy before becoming their deaths, he said, and both contracted a strain called H3N2.
The above comments indicate the first two fatalities at Garden Hill were previously healthy young adults. Although agency reports cite “underlying conditions”, there is little data supporting the role of the underlying conditions in the deaths. More recent media reports indicate that above patients died from complications associated with the influenza infections.
These reports have much in common with pH1N1 fatalities, including the two recent cases in Lehigh, Pennsylvania. The head of infectious diseases at the Lehigh Valley Hospital noted that it was unusual for previously healthy young adults to be admitted and then placed on a ventilator. Like the two cases at Garden Hill (35F and 35M) both patients at Lehigh Valley (45M and 28M) also died.
A recent report in Nature Medicine on deaths of previously healthy young adults infected with pH1N1 cites linkage of deaths with an aggressive immune system. These patients had H3N2 antibodies that reacted poorly with pH1N1, leading to a more aggressive immune response which killed lung tissues leading to death. Thus, the healthy immune system of the young adults was linked to the deaths, not underlying conditions.
The cited underlying conditions, including obesity, diabetes, asthma, and pregnancy are present in a high percentage of the adult population, and the vast majority of influenza infections in these young patients do not lead to severe or fatal cases.
Thus, the deaths of the patients at Garden Hill have much in common with deaths of pH1N1 patients, where 90% of fatalities were under 65.
This linkage increases concerns that the H3N2 in Manitoba is trH3N2 rather than seasonal Perth/16-like H3N2.
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