Caring Currents

H1N1 Swine Flu Alert: Adults Ages 50 and Older Getting Sicker, Dying In Higher Numbers

Last updated: Nov 03, 2009

Emergency Room / Health Care
Image by Rosser321 used under the creative commons attribution license.

Here's some important news for older adults. Researchers are reporting that contrary to the messages we've been hearing over the last six months, the H1N1 swine flu virus can be extremely dangerous for those ages 50 and older.

New research, to be published in the November 4th Journal of the American Medical Association (JAMA), reviewed the first 1088 cases of H1N1 reported in California after the disease first surfaced in April 2009. The findings, presented by Janice Louie of the California Department of Public Health, were both surprising and scary. A quick summary:

"¢ hospitalization and death can occur at all ages

"¢ 30 percent of all hospitalized cases were severe enough to require treatment in an intensive care unit

"¢ Although 32 percent were children under 18, 58 percent were adults

"¢ Those ages 50 or older had the highest rate of death once hospitalized

"¢ Overall fatality was 11 percent, but in those over 50 it was between 18 and 20 percent

"¢ Among fatal cases, the median time from onset of symptoms to death was just 12 days

"¢ The most common causes of death were viral pneumonia and acute respiratory distress syndrome

In other words, it's not just children, young people, and pregnant women who are getting seriously ill with the H1N1 swine flu virus. And when older adults get H1N1, they can get very very sick and have a higher death rate than other groups.

But there was a second revelation: In a startling 68 percent of all cases, the patients had an underlying condition that's known to be associated with severe influenza. These were:

  1. obesity
  2. hypertension (high blood pressure)
  3. hyperlidemia (high cholesterol and triglycerides)
  4. gastrointestinal disease

Louie made a specific point of mentioning obesity, saying she thought it should be considered a "newly identified risk factor" for serious H1N1 infection and deserves further study.

If you're obese or seriously overweight (or caring for someone who is), be aware that H1N1 flu could be more serious than you've heard to date.

There were two other revelations in this study that are particularly important. The first is that more than a third of all cases, flu victims were given a rapid antigen test for the H1N1 virus and had a false negative. This means the H1N1 test isn't completely reliable; what's more important is to pay attention to how severe someone's symptoms are.
  Based on the research, Louie urged doctors to be on the alert for adults 50 and older with H1N1 and take these cases seriously.

Lastly, the study showed that those who received antiviral treatment fared better, and indicated that anyone whose symptoms are severe enough to bring them to the hospital should be treated with antiviral medications.

Takeaway: If an older adult in your family gets the flu and has a severe cough or breathing difficulties, go to the doctor or hospital, particularly if she has any of the risk factors listed above. And if once at the hospital an H1N1 test is negative, don't treat it as gospel. Ask for antiviral medication based on your family member's symptoms and risk factors, rather than based on the test.