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H1N1 Deaths Among Youths Rise as Epidemic Spreads
19 Fatalities Reported in Past Week, Including 2 in Maryland, as Vaccine Distribution Gets Underway

By Rob Stein
Washington Post Staff Writer
Saturday, October 10, 2009

The number of children who have died from swine flu has jumped sharply as the virus continues to spread widely around the United States, striking youngsters, teenagers, young adults and pregnant women unusually often, federal officials said Friday.

The deaths of another 19 children and teenagers from the new H1N1 virus were reported in the past week around the country, including two in Maryland, pushing to 76 the number of fatalities this year among those under 18, officials said. It was the largest number of pediatric deaths reported in a single week since the pandemic began in the spring.

"These pediatric deaths seem to be increasing substantially," said Anne Schuchat, who heads the federal Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases.

While most of the children who have died have had other health problems that made them particularly vulnerable, such as asthma, muscular dystrophy and cerebral palsy, 20 to 30 percent were otherwise healthy, Schuchat said.

Between 46 and 88 children died from the seasonal flu in each of the past four years, so the fact that so many have already succumbed is disturbing, Schuchat said.

"It's only the beginning of October," she said, noting that the flu season usually starts much later and runs through May. "We saw a peak of deaths, you know, starting April, May, June. It started to level off this summer. Now it's starting to shoot up again."

In addition to the two deaths in Maryland, three were reported in Tennessee, seven in Texas and one each in Alaska, Arizona, Colorado, Florida, North Carolina, Oklahoma and Wisconsin.

Since the pandemic began, at least 3,873 Americans have died from complications associated with the flu, primarily the H1N1 virus, including at least 28 pregnant women.

The increase in pediatric deaths comes as the federal government's unprecedented vaccination campaign is just getting underway. Millions of doses of vaccine began arriving around the country this week.

It provided more reason why parents should get themselves and their children vaccinated against the virus, Schuchat said.

"Vaccine against flu is the best way to protect yourself . . . and those around you," she said.

The federal government has spent about $2 billion to buy at least 250 million doses of vaccine in the hopes of inoculating more than half the U.S. population, and it has pledged to buy enough to vaccinate everyone if there is sufficient demand.

So far, states and cities have ordered 3.7 million doses of the 6.8 million that have become available, and the first doses were administered this week. Some doctors and clinics are reporting being flooded with requests for the vaccine. But several national surveys have found that only about 40 percent of Americans are sure they will get it, with those who are reluctant citing doubts about the severity of the virus and concerns about side effects.

The vaccine campaign is also fueling anti-government sentiments and false rumors that the vaccine is mandatory. Although New York state and some individual hospitals and private health chains are requiring their employees to get vaccinated this year for the first time, the vaccine remains voluntary for most people.

"Lots of rumors out there, and we're trying to address them," Schuchat said.

Additional data from federal studies testing the vaccine have found no evidence of any unusual risks and have confirmed preliminary indications that the vaccine is effective for most adults with one standard dose.

At least 37 states are reporting widespread flu activity, up from 27 a week ago. While the number of cases appears to be decreasing in some places, it is increasing in others and could rise again in areas where cases are dropping, Schuchat said. New York and some other cities that experienced large outbreaks in the spring are reporting fewer cases than expected, but Schuchat warned that could change at any time.

"It's hard to know how many waves we're going to have into the fall, winter and spring," she said. "We still think the vast majority of people in a given community are vulnerable or susceptible to this virus."

Although the virus causes mild illness for most people, some people become seriously ill, requiring intensive care to try to save them.

"Unfortunately, we do expect more illness, including more hospitalizations and deaths, to be occurring in the weeks ahead," she said.

Schuchat also encouraged people to get the seasonal flu vaccine. Some areas are experiencing shortages of seasonal flu vaccine, in part because manufacturers are juggling production of both vaccines. New data from another federal study aimed at determining whether people can get both vaccines at the same time found that was no problem.

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