Obesity May Raise Risk For Flu Complications, Survey Shows

By David Brown and Robin Shulman
Washington Post Staff Writers
Wednesday, May 20, 2009

A survey of people hospitalized because of swine flu in California has raised the possibility that obesity is as much of a risk factor for serious complications from the flu as diabetes, heart disease and pregnancy, all known to raise a person's risk.

In all, about two-thirds of the California patients had some underlying medical condition, according to a report yesterday in the weekly bulletin of the Centers for Disease Control and Prevention.

Nationwide, 47 states and the District have reported 5,469 cases and six deaths since the start of the outbreak in late April, according to the CDC's count. Yesterday, officials in Missouri reported a seventh U.S. death -- that of a 44-year-old man who had no underlying medical problems, wire services reported.

"We were surprised by the frequency of obesity among the severe cases that we've been tracking," said Anne Schuchat, one of the CDC epidemiologists managing the outbreak. She said scientists are "looking into" the possibility that obese people should be at the head of the line along with other high-risk groups if a swine flu vaccine becomes available.

Other studies have shown that pregnant women are also at higher risk for serious influenza infection, especially in the third trimester, when the fetus and womb compress the lower parts of the lungs. This makes it harder to breathe deeply and cough forcefully; it may also alter blood flow in the chest. A similar thing may be occurring in severely overweight people, some experts speculated.

The average age of the 30 Californians hospitalized for swine flu was 27.5 years. Nearly three-quarters were women, and 65 percent were Hispanic. Half lived in two counties bordering Mexico.

Of the 30 people, 11 had a lung ailment such as asthma or emphysema, six had an immune disorder, five had heart disease, five were pregnant, four had diabetes and four were obese.

In New York, Mayor Michael R. Bloomberg (I) said officials were investigating whether 16-month-old Jonathan Castillo, who died with a high fever Monday night at a Queens hospital, had contracted the H1N1 virus. The toddler's 3-year-old sibling was treated for flulike symptoms and released.

The mayor said lack of health insurance or immigration status should not deter people who feel sick from seeking attention.

"Whether you have health insurance coverage or your immigration status is in question, it doesn't matter," Bloomberg said. "We will not ask about that."

The mayor also said four inmates at a Rikers Island jail had been confirmed to have the H1N1 virus and four more are likely to have it.

The union representing the city's correctional officers criticized the response to the swine flu outbreak among inmates and filed a letter of protest with the state Labor Department.

"If I had to design a place where you could put people who were sick and get as many people sick as possible, it's the New York City jail," said Richard J. Koehler, a lawyer for the Correction Officers' Benevolent Association.

Shulman reported from New York.

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