Influenza

The Great Influenza: The Epic Story of the Deadliest Plague in History, by John M. Barry. Viking. 546 pages. $29.95. Perhaps if the worldwide flu epidemic hadn't coincided with the last months of World War I -- itself a horrific and up-until-that-moment unparalleled event in human history -- the impact of a deadly outbreak of infectious disease that carried away more than 40 million souls in a single year would have been more enduring. As it is, the influenza pandemic gets lumped into the general ghastliness of the era -- and the long-term implications of what scientists and doctors learned from it too easily brushed aside.

A Baltimore area child who died in December has tested positive for influenza, state health officials announced Friday, declaring it the first pediatric flu death in Maryland this winter. The Department of Health and Mental Hygiene declined to release any other details about the case, beyond saying that influenza was confirmed through laboratory tests, and that the child had an underlying health condition. This is the first influenza-associated death of a Maryland child since the 2009-2010 flu season, according to the department, when two youths died.

Expecting delays in shipments of this year's influenza vaccine, the state health department is asking people at low risk for the disease to wait until late November or early December to get their shots. Included are students and healthy adults younger than 65. "There will be enough vaccine for those who want to receive it, but because of the delay in receiving vaccine shipments, we are asking low-risk people to wait," said Health Secretary Dr. Georges C. Benjamin. Benjamin said yesterday that initial supplies should go to the elderly, people with chronic diseases and women in the second or third trimester of pregnancy.

Maryland has confirmed its first cases of seasonal influenza, state health officials announced Friday, several months earlier than last season. Four children in the Baltimore region have laboratory-confirmed cases. One was hospitalized, but all are doing well, the Department of Health and Mental Hygiene said. Three were type A (H3N2) influenza, while one had type B influenza. The first seasonal case of last season was confirmed in December 2011. "Flu is here earlier this year than last year, and we are seeing two different flu strains," said Frances Phillips, DHMH deputy secretary of Public Health Services.

They're calling it the flu, but the illness that struck President George Bush today was more likely a stomach virus transmitted by a food handler who failed to use proper bathroom hygiene, a Maryland public health official said today."

Six bodies unearthed last year in the Norwegian Arctic have unexpectedly yielded a scientific prize: They hold part of the virus that caused the Spanish influenza of 1918, which killed at least 40 million people in one of the worst disease outbreaks in history.Researchers at a scientific meeting in London said this week that they have identified fragments of the long-sought virus in the brains and organs of six young men who died in October 1918 on Svalbard, an island less than 800 miles from the North Pole.

One minute you feel fine; the next, your head throbs and your muscles and joints ache. You feel hot, then cold. Weak and dazed, you can only burrow in bed and cough and sneeze and sniffle for the 10 days it takes for the virus to run its course.Influenza strikes fast and hits hard.After it does, there's little any doctor can do to help. That is, until now.Last month marked the debut of a new prescription drug called Relenza. Relenza has been shown to shorten the duration of the flu by an average of 1 1/2 days.

Q: The papers keep reminding people to get their flu shots. Can I get them for my children? Every winter they miss school several times with the flu.A: The flu shot you have been reading about is given in the fall to vaccinate against the influenza virus that usually begins to circulate in the United States in December or January. Influenza virus infection often makes people quite ill. They have fever, headache, runny nose, cough and muscle aches. They often feel so ill they decide to stay in bed. Influenza is a much bigger illness than the usual cold.

A Baltimore area child who died in December has tested positive for influenza, state health officials announced Friday, declaring it the first pediatric flu death in Maryland this winter. The Department of Health and Mental Hygiene declined to release any other details about the case, beyond saying that influenza was confirmed through laboratory tests, and that the child had an underlying health condition. This is the first influenza-associated death of a Maryland child since the 2009-2010 flu season, according to the department, when two youths died.

My pediatrician gives our son a flu shot every fall, . but this year he has been sick already. I know the flu vaccine is made new each year. Is it just not good this year?"

Once the H1N1 influenza outbreaks begin - and Maryland health officials have no doubt that they will - this series of nondescript scientific laboratories, located past security guards instructed not to let anyone in without an official escort, will certainly be humming. Here, inside the state office complex on Preston Street in Baltimore, dozens if not hundreds of polyester swabs will arrive each week, containing what doctors believe is evidence of swine flu's resurgence. Lab workers will then determine whether it is the flu - H1N1 or seasonal, or something else entirely - and whether the virus seems to be gaining strength.

The flu is usually gone by now. Dr. Ann Morrill isn't generally prescribing Tamiflu and bed rest in July to her Perry Hall patients. The emergency department at St. Joseph Medical Center in Towson doesn't typically do a dozen flu tests a day this deep into summer. But the H1N1 influenza virus - commonly called swine flu - continues to spread in Maryland and many other states, even though some experts thought it would have faded away by now across the country. During the last week of June, the state confirmed 166 new cases - the highest weekly total since the first cases were confirmed here May 4. And officials believe that for every confirmed case, there are many more that go unconfirmed as the sick either don't seek medical treatment or are refused testing.

The H1N1 flu epidemic is not over. It is just the end of its beginning. This virus continues to sicken (and even kill) people in the U.S. and elsewhere in the world. We will begin to see its broader impact here and elsewhere - particularly in the Southern Hemisphere - this summer. And the most important part of this story, at least the U.S. version of it, will come with the return of the fall flu season, when we return to conditions conducive to the spread of influenza. While H1N1 is no longer as prominent a story in the press, the numbers of those ill and hospitalized continues to rise.

Swine flu, otherwise known as "H1N1 influenza A," may have arrived in Maryland, with six likely cases identified in Baltimore and Anne Arundel counties, and other possible cases being tested. But just how dangerous the influenza virus will prove to be here and elsewhere remains to be seen. As of late Thursday there had been one U.S. death attributed to the flu, and experts at the Centers for Disease Control and Prevention tell us to expect more. But they also note that some form of flu hospitalizes hundreds of thousands and kills 36,000 Americans every year.

The 2008-2009 influenza season is not quite over, but Maryland health officials say it appears to have peaked and the number of new cases is on the wane. "We expect lower levels of flu throughout the rest of the month of April, but it should finally be over by the beginning of May," said Rene Najera, an epidemiologist with the state Department of Health and Mental Hygiene. This flu season has been milder than last year's, Najera said, and he credits the design of this year's vaccine. "The vaccine strains were a better match" for the viruses actually circulating for most of this season, he said.

The flu strain most likely to make you sick this winter has developed a near-total resistance to one of the most popular drugs prescribed to blunt its symptoms. More than 98 percent of one of the influenza A viruses circulating this winter is now resistant to the antiviral drug Tamiflu, up from less than 1 percent just two years ago, according to a study in The Journal of the American Medical Association. Scientists say the increased resistance appears to be the result of a natural mutation, not over-prescription of the 10-year-old drug.

If you have a raspy voice and a runny nose today, relax. The flu season has not arrived ahead of schedule.What you probably are suffering from is para-influenza or a rhinovirus or an enterovirus, which somewhat mimic symptoms of the real flu, or influenza, but don't pack the same wallop.While the copycat ailments can be uncomfortable and something of a nuisance for a few days , unlike influenza, they simply don't develop into pneumonia, which in many cases leads to death, experts say.Still, North Americans could be in for a repeat of the 1989-90 influenza season when 50,000 people died of flu-related illnesses, warn specialists at the Baylor College of Medicine in Houston and the federal Centers for Disease Control in Atlanta.

The onset of fall is also the time to prevent the onset of influenza. Howard County's Health Department got in gear Sunday with a drive-through flu vaccine clinic offering both injection and inhaled flu vaccine. The event also was an exercise in community emergency planning.

Baltimore health officials declare influenza alert With the number of positive influenza tests rising sharply in the city, Baltimore health officials declared a flu alert yesterday. "We're really seeing sustained transmission of flu in Baltimore. Now is the time to protect yourself," said the city's health commissioner, Dr. Joshua M. Sharfstein. Sentinel hospitals reported that 12 percent of flu tests last week came back positive, more than twice the rate for the previous week. There have been no deaths, but the Johns Hopkins Children's Center is treating a teenager who is critically ill with flu. "This is not just the sniffles.

"Tired, beleaguered and battered" is how Dr. David del Rosario described himself yesterday as he hustled to care for the rising tide of patients streaming into his Patient First clinic in Glen Burnie with symptoms of the flu. "We started seeing the trickle in mid-January," he said, "and literally by the first week of February, that's when the tsunami hit." Since then, del Rosario's life has been a blur of 10-hour days in a succession of Patient First sites in suburban Maryland and a parade of patient misery.