State officials outline plans for next wave of H1N1

Minnesota children and young adults have been hit the hardest by the new H1N1 pandemic influenza, according to statistics released Monday by the Minnesota Department of Health. Agency officials discussed the state's 253 cases that resulted in hospitalization during a legislative hearing.

State epidemiologist Ruth Lynfield began her presentation to lawmakers by talking about seasonal flu. She reminded lawmakers that each year, seasonal influenza kills 36,000 Americans -- most of them elderly. Then she pulled out her statistics for the new influenza strain that has been spreading rapidly throughout Minnesota.

"The majority of our hospitalizations, 70 percent, have been in people under 25," she said. "And that's remarkable because as I showed you before for seasonal influenza, very different picture."

Besides age, a major risk factor for flu complications was pregnancy. Eighteen Minnesota patients were pregnant. Other risk factors included diabetes, cardiovascular disease, obesity and respiratory problems. Thirty percent of the hospitalized patients had asthma.

Three patients with H1N1 have died so far. One was a child with an underlying health condition. Another child who was previously healthy died after contracting the virus. The third death was in a very elderly person.

Among the hospitalized patients who recovered, Lynfield says 12 percent were so sick they spent time in the intensive care unit.

No one knows what will happen with H1N1 this fall. The virus could mutate and become more severe. It could fizzle out. Or it could follow the path it has charted so far. Lynfield is bracing for a surge in cases and she told lawmakers it will likely continue to affect children and young adults disproportionately.

"We do think that in any event there will be a very large burden of disease in younger age groups and this is going to impact our society in many, many ways," she said.

The Health Department estimates that 30 percent of Minnesotans -- about 1.5 million people -- may become infected by H1N1 as multiple waves of the pandemic move through the state over the next year or two. Of those, the agency says anywhere from 3,600 to nearly 33,000 could die.

But Lynfield is hopeful about a new flu vaccine currently in production. The first shipments are due to arrive in Minnesota in October. Initially there won't be enough of the vaccine for everyone, so priority will go to health care workers, pregnant women, young children and people who care for infants under 6 months of age. "If there is adequate vaccine, we would like in this initial batch of vaccine to vaccinate folks up until the age of 24," she said. "If there's not adequate vaccine, we will at least vaccinate young children and then children up through 18 who have a high risk condition."

Older adults who are under age 65 and have a high-risk health condition would be next. Eventually though there should be enough vaccine for the entire population, if they want it. The Health Department says it will not require people to get the H1N1 vaccine.

But that didn't alleviate Diane Miller's concerns. Miller, an attorney with the National Health Freedom Coalition and the Minnesota Legal Reform Project, advocates on behalf of a natural approach to fighting the flu. Miller told lawmakers that some Minnesotans are worried that their kids will get inoculated without their parents' consent.

"We wanted to make sure that parents don't ever have the experience where they have a child come home from school and say 'by the way, mom, I got my flu shot today,'" she said. "We want the same notices to come to parents. We want parents to think about it, to find out what the ingredients are, to make an informed decision about the flu pandemic and what they want to do in their family situation."

Miller says the new H1N1 vaccine isn't being tested as thoroughly as some people would like. She says that's especially worrisome considering the problems that cropped up with a previous swine flu vaccine in the 1970s that caused a neurological disease in some people.

Lynfield says the Health Department will be watching very closely for that condition and any other potentially adverse affects from the vaccine. But she said the agency also plans to work very hard to make sure that parents know the risks of not vaccinating their children for pandemic flu.

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