H1N1: Most Dangerous To Young People

(CBS)  If you're confused about the 2009 H1N1 "swine flu" virus, no wonder. There's a lot of conflicting information. The Centers for Disease Control tells us that the way this virus is spreading is unprecedented.

The CDC opened its doors to give 60 Minutes and correspondent Scott Pelley a look at the extraordinary federal response. It turns out, in many respects, that the 2009 H1N1 virus is no worse than the everyday flu.

Ninety-nine percent of the people who get it suffer just a few miserable days at home. But it is also true that for something less than one percent, H1N1 can be fatal. And many of them are the last people you'd expect to see rushing to an emergency room.

CDC: Learn More About H1N1
CDC: What To Do If You Get Sick
Flu.gov: Where To Get Your Flu Shots

On Oct. 7, 15-year-old Luke Duvall landed at Arkansas Children's Hospital in Little Rock. His life was slipping away. Luke was on a ventilator, not breathing on his own.

Dr. Michele Moss suspected H1N1. She had already lost one patient to the virus. "He's extremely fragile right now. His blood pressure is very tenuous and could go down at any second. So he's a very, very sick young man," she explained.

Luke had been perfectly healthy before. He had broken a state record in weightlifting. After a football game on Friday, Luke got sick.

His parents Belinda, a school teacher and Chad, a pastor, worried about H1N1 so they called their doctor.

"We were not able to get into the doctor until Monday, Monday afternoon about 2:30," Luke's father remembers.

Asked why, Chad Duvall told Pelley, "There's just so much of the flu around that by the time we were able to get a hold of the doctor Monday morning and get an appointment, it was that late in the day before they could actually even just get us in."

The family says the doctor sent Luke home to take medicine to control a fever of 103 and he started to improve.

His father remembers that they thought Luke was getting better. "And he actually said, 'I feel better. I think I'm going to get a shower now.' In the five minutes it took for him to go from the shower he came out and said, 'Something's wrong. I can't breathe.' His color had gone from normal pink to just grey in that five minutes, he was panting like a dog, just really fighting for his breath. At that point, it was no longer 'Do we go to the ER or wait 'til tomorrow?' Now it's 'We have to call 911 and get an ambulance to get him right now,'" Chad Duvall remembers.

At the local hospital, doctors decided Luke needed to fly to Arkansas Children's Hospital, with one of the nation's newest pediatric intensive care centers. Before the helicopter got there, Luke's football coach Charlie Sorrels rushed to see him.

"And he stuck his head in just before they put him to sleep and he said, 'Luke I just want to you know that I'm here for you and I'm gonna stay 'til your gone.' And he looked over and he said, 'Coach I can't play Friday night,'" Luke's father remembered. "And the coach said 'That's alright boy. I got you covered.' So that was the last words he said - it's Luke you know, 'Coach I can't play Friday night.' And so, you know, he's a fighter."

Luke was tested for H1N1. It would be hours before they would know.

But reports of his case and others like it were pouring into the emergency operations center of the federal Centers for Disease Control and Prevention in Atlanta.

Rear Admiral Anne Schuchat is the CDC's chief health officer in the war on H1N1. When 60 Minutes first met her two weeks ago, she showed us the virus was widespread in 27 states. When we saw her again last Thursday, things had changed.

"We think the virus is virtually everywhere in the country. Quite a lot of illness, hospitalizations, and deaths," she explained.

Asked what that tells her, Rear Adm. Schuchat told Pelley, "It's only October and we're seeing really uncharted territory. Typically, in the month of October, we would not have seen so much influenza. We would not see the whole country with widespread disease. That's something that we often will see in February."

The numbers are remarkable: last year, in the second week of October, there were seven cases reported. The same week this year there were nearly 5,000. By this time last year there were 7 deaths; today there are 885.

You can trace the jump to two things: because the virus is new, more people lack immunity and H1N1 never went away in the summer as flu usually does.

Asked who is most at risk, Schuchat told Pelley, "Children and young adults, pregnant women, people with chronic health conditions like asthma, diabetes, heart disease and neurologic problems, immune-suppression."

One of the most unusual things is the higher number of kids who are ill: usually, an average of 66 children die in a flu season; this year, it is 86, so far, with seven months to go.

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[GinaKorn]

Our daughter Molly, age 14 and a half, has a remarkably similar story to sweet Luke Duvall. She plays varsity volleyball and club soccer, is 5-10 and as strong as an ox. She is rarely sick. She came down with what seemed like a mild flu on Weds. October 7 .I knew she would get the flu as her teammates seemed to be getting it and she had roomed with two who came down with something at a tournament where they shared a motel room. She had a low grade fever, body aches, and a sore throat, but she was still able to cook for herself while I went to work and she stayed home. By Friday night, things started to change and her breathing felt worse and she felt her heart racing. Urgent care saw her and gave her Tamiflu , prednisone, said she most likely had the H1N1 and to go home and rest. By Sunday morning, she was coughing up bloody mucous, lying on the floor and gasping for air. We rushed her to the ER where a chest xray showed bilateral pneumonia. She was severely deheydrated, her heart rate was 160 and she was admitted. By midnight, she was rushed to the ICU with intentions to be intubated and put in a chest tube . She avoided that but was on bipap, and in the ICU for 6 days. She worsened and then had surgery to insert a chest tube and do Video Assisted Thoracic Surgery to remove almost 2 liters of infected fluid and gunk which had leaked from the lungs into the chest cavity. That relieved her every breath. She has lost 17 pounds and is still in the hospital on day 17.She just moved from the ICU to the pediatric floor. She is learning to walk again, to eat, to breathe on her own, and will be on IV antibiotics for weeks to come. She is going to make it, thanks be to God, but it is going to be a long recovery. She is a fighter, just like Luke and our prayers are with him and his family. My heart goes out to them as I sit with Molly in her hospital room here in California. I cannot wait to hear about both of these kids back on the field or court again someday! Oh, and most of her team did get some version of the flu, but did not have the bad luck of getting the secondary bacterial infection of MRSA Staph in the lungs as Molly did. Now their coach has them all carry antibacterial wipes or gel in their sports bags and use them immediately after practice. Thank you for sharing our children's stories and the reality of this flu and its devastating secondary infections to otherwise vibrant, athletic young people!

[josefatony]

Check out this link that includes 2 videos to two 60 Minutes episodes regarding Swine Flu. The first video is to the episode about Luke aired this month (my thoughts are with Luke and his family). The second video is to an episode aired in 1977.
http://www.livewellamerica.org/blog/?paged=2

[panseyv]

The 60 minutes segment on Swine Flu makes it sound like those before 1950 are pretty safe from getting the flu. I know 3 people that got it including my mother who is 70. My nephew in law has been in ICU a week now, he is about 58 years old. With pneumonia in his lungs...I wonder how accurate that comment is.

[mollydtt]

For those that think they should wait 10 years to get an H1N1 vaccination (in order to be sure that it is safe)--just remember that it is just a flu vaccine. People have been getting flu vaccines for a very long time.
The only reason this strain wasn't included in the seasonal flu vaccine is that it appeared after the deadline for deciding which 3 strains were to be included in this year's seasonal vaccine.
And, remember that it takes a long lead time from start to finish to actually produce the vaccine. That is why they include 3 strains. Months and months earlier, no one knows definitively which ones are going to be prevalent in the Fall. Too bad H1N1 wasn't around then.
So 10 years from now, that H1N1 flu vaccine won't be the least bit necessary. But then it will be considered "safe" by those that don't understand.

[sixtyminutes]

Perhaps you may like to ask for a disclosure as to what is in the vaccine. it is synthetically manufactured by the pharmaceutical companies to 'make money'. There is nothing 'safe' about them.

[brandonRNicu]

To sixtyminutes. You should understand that part of the reason why vaccines are usually limited in supply is that they are NOT money makers for pharmaceutical companies. Simply put, the patented, new drugs that pharmeceutical companies market(and don't offer a generic) are where they make their money.
Also, they are a much safer than risking getting a potentially lethal flu and risk spreading it to your family & friends.

[ebeeks]

I am not claiming to be an expert and my husband (who is active duty and will have to get it) and I have been debating on giving our children the H1N1 vaccine have decided to do it. My thoughts are this, there has not been any know side affects as of yet and my understanding is many people have gotten it since October 5 when it came out. If I have been given evidence that it has harmful side effects then I would re-think my decision. What I have been seeing is the amount of sickness and death from this flu and as a parent I AM NOT prepared to lose my child to the flu, especially if there is a vaccine that can prevent it from happening.
My children are 4 and 3. They are in daycare and not only do I want to protect them, I want to protect the children they come in contact with daily. Its my obligation as a parent to do so! We have also gotten our children the flu shot that comes out every year and they have not had the flu. My oldest one may have had the flu considering he got sympotoms of fever,cold like symptoms and complained his head hurt alot. I didn't have him tested, I just kept him home and took care of him. So maybe he did have it and he is now immuned. I also came down with very similar symptoms and I am positive I had the flu. Swine Flu, I am not sure since I didn't get tested either. But I haven't gotten a flu shot in years and I realized I need to take better care of myself!
I also want to point out that there are many different strains of the flu and many vaccines have been made according to each strain. Each year they "pick" which vaccine to mass produce according to which one they "think" will be the strain for that year. Sometimes they are right, sometimes they are wrong. It seems that they were able to identify what they were dealing with when the H1N1 first outbreaks took place then produced a vaccine for it according to the particular strain. It wasn't a guessing game as to what to produce.
The most important thing for me is to keep my family healthy. It doesn't mean my decision is the right one, I just feel its the right one for our family.

[weiskraut]

One thing to remember is that with this pandemic flu, people with a compromised immune system are another group that is especially at risk, no matter how old they are. And many nutritional supplements that may be helpful for the common flu will prolong, or make the pandemic flu worse.
This website: www.acu-cell.com lists many of these supplements.
One can also download the list at www.acu-cell.com/flu-remedies.rtf

[terry72118]

Dear mr Knoxville_voice_of_reason.Most of the time I would agree with you, but you are way off on this boy. I have been very close to Luke for the last 8 years . This is a real country boy. I have seen him helping his dad plant the garden and get honey from the bee hives. I have seen him in mud up to his waist digging his 4 wheeler out where he had gotten stuck when riding it in the mud. He is an avid hunter and fisher man. He traps beavers all by himself and I have seen him swimming in the creek many times. He has a 4. 0 grade point average and he is not a nerd. He is an all star in football and baseball. He is just an all around great young man any parent would love to have. There is a Facebook page with many pics of Luke being a NORMAL boy. This is why 60 minutes did this story so people can see that H1N1 can be very dangerous to some NORMAL kids. His grandmother has started a web site to keep people updated on Luke?s recovery. www.lukeduvall.org my e mail is [e-mail] if you would like to ask me any questions.

[terry72118]

Dear mr Knoxville_voice_of_reason.Most of the time I would agree with you, but you are way off on this boy. I have been very close to Luke for the last 8 years . This is a real country boy. I have seen him helping his dad plant the garden and get honey from the bee hives. I have seen him in mud up to his waist digging his 4 wheeler out where he had gotten stuck when riding it in the mud. He is an avid hunter and fisher man. He traps beavers all by himself and I have seen him swimming in the creek many times. He has a 4. 0 grade point average and he is not a nerd. He is an all star in football and baseball. He is just an all around great young man any parent would love to have. There is a Facebook page with many pics of Luke being a NORMAL boy. This is why 60 minutes did this story so people can see that H1N1 can be very dangerous to some NORMAL kids. His grandmother has started a web site to keep people updated on Luke?s recovery. www.lukeduvall.org my e mail is [e-mail] if you would like to ask me any questions.

[sixtyminutes]

Hello, Our family always enjoys 60 minutes. We have for many years. We were very disturbed to see the show last night about the H1N1 swine flu. Our heart goes out to the family of this young man. What made us very uncomfortable was the doctor who assured everyone that the swine flu vaccine is perfectly safe. A very broad statement to make. There was no information provided about the cases of people who have contracted swine flu and if they had had previous flu shots or had been immunized. We firmly believe that the pharmaceutical companies are out to make a lot of money on the fear that they are creating around the world. The medical system is completely backward in the way that they 'think' that all of these vaccines are the answer. Our family will not be having any swine flu vaccine or any other synthetically manufactured products injected into our bodies. Prevention is the best measure. Why do they never look at safer and more natural products. I guess there is no money in it.

[buckiii1]

FDA faces decision about use of peramivir for H1N1
Robert Roos News Editor


Oct 15, 2009 (CIDRAP News) ? In response to questions from citizens at a meeting yesterday, a Food and Drug Administration (FDA) official said the agency would make a decision "fairly soon" about permitting emergency use of the experimental antiviral drug peramivir to help patients severely ill with pandemic H1N1 influenza.

The FDA has been reviewing a possible emergency use authorization (EUA) for peramivir, which, like the licensed drugs oseltamivir (Tamiflu) and zanamivir (Relenza), is a neuraminidase inhibitor. Peramivir can be given intravenously (IV) or intramuscularly (IM), whereas oseltamivir is taken orally and zanamivir is inhaled as a powder.

During a public teleconference of the National Biodefense Science Board (NBSB) yesterday, Aubrey Miller of the FDA Office of Counterterrorism was asked to comment on the status of the FDA's review of an EUA for peramivir for H1N1 patients. The NBSB is an advisory board to the Department of Health and Human Services (HHS).

"There should be information or decisions being made fairly soon. That amongst other medical countermeasures are currently being evaluated by the agency," Miller said. "I don't have a specific time frame at this time, because things are under review."

Board members asked Miller for a status report after several people asked about peramivir during a public comment portion of the 2-hour meeting.

A man who identified himself as Paul Gordon of San Francisco asserted that there is "an incredible need" for an IV antiviral for patients in intensive care because of H1N1 flu. He noted that the drug can be used currently in individual patients under an emergency use investigational new drug (IND) procedure, but said the Centers for Disease Control and Prevention (CDC) Web site provides no information about this option. Gordon asserted that the drug has already "saved multiple individuals' lives."

Catherine Collier Kyroulis, a spokeswoman for BioCryst Pharmaceuticals, maker of peramivir, said today the company has had 20 requests from physicians to use the drug in H1N1 patients under the emergency-use IND rules. She said information on the outcomes of those cases was unavailable.

Physicians who want to use peramivir under the emergency IND rules must contact BioCryst for an evaluation of the case and then fill out an application, according to the company. The request also must go through the appropriate institutional review board (IRB), said Karen Riley, an FDA spokeswoman. The arrangements must be authorized by the FDA.

In September HHS asked BioCryst to submit a proposal to supply between 1,000 and 40,000 doses of peramivir under an EUA, the company reported on Sep 21. The HHS request for proposal did not guarantee that HHS would actually order the doses or issue an emergency authorization, the company said.

The NBSB heard comments and questions from two other people about peramivir during yesterday's teleconference.

A man who described himself as a concerned parent in Texas expressed impatience with the FDA. With the H1N1 vaccine not yet widely available and with severe cases occurring in children, he said, "To me it's unacceptable that FDA can't comment on this. BioCryst has been working with FDA since April on this. I don't understand what the holdup is."

Also, a man identifying himself as a teacher from Los Angeles wanted to know about a rumor that peramivir has been effective in hospitalized H1N1 patients.

NBSB members did not reply to the citizen questions other than by asking Miller for a status report on the FDA review.

The peramivir issue has come up at previous NBSB meetings. At a session on Aug 14, board members and citizens expressed concern about the lack of an IV or IM antiviral for flu patients and urged HHS officials to strongly consider issuing an EUA.

BioCryst is currently preparing to launch two phase 3 clinical trials of IV peramivir. In September the company received a $77.2 million HHS contract modification to complete phase 3 development. The company's original contract was a $102 million award in 2007.

"Based on the recent stats on number of H1N1 cases we would assume that patients with H1N1 will be included in the [phase 3] trials," said Kyroulis.