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Commentary


Critical Escalation of Severe and Fatal H1N1 In England
Recombinomics Commentary 02:50
December 16, 2010

Ten of the worst affected patients whose lungs have given out, including three pregnant women, are being treated on Extra-Corporeal Membrane Oxygenation (ECMO) machines. A further six critically ill patients are waiting for spaces on the machines to become available. Extra beds have been opened in four hospitals at Papworth in Huntingdonshire, the Royal Brompton in London, Newcastle Upon Tyne NHS trust and University Hospitals of South Manchester, in addition to the existing unit at Glenfield Hospital in Leicester.

Last year only Papworth and the Royal Brompton were opened.

The numbers of severely ill patients have taken specialists by surprise because monitoring suggests low levels of swine flu in the community.

"Something different is happening this year. The last 10 days have seen a sudden surge of activity. The numbers in intensive care are increasing across the UK. In the north west they are more than at the peak of the pandemic.

"We have told the Department of Health that this is emerging as a serious issue. We suggested the groups convened last year for swine flu critical care planning should be reconvened. The disease seems disproportionately severe."

"We have already had to escalate [provision of ECMO beds] two steps beyond what we had last year. Things are at least as bad as they were last year in intensive care generally, as well as ECMO. What we don't know is whether this is the peak or there is worse to come. Our feeling is it is probably going to get worse. If it gets a lot worse we could be in a lot of difficulty."

The above comments describe a significant escalation of the crisis caused by increasing numbers of severe and fatal H1N1 cases in England.  These numbers are growing in spite of a relatively low frequency of pH1N1 infections in the community.

This increase in severe cases may be linked to an increase in D225G levels, which was predicted last season due to low reactor results reported by Mill Hill.

Release of sequences from these severe and fatal cases is critical.

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