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The Honolulu Advertiser
Posted on: Saturday, July 18, 2009

3rd swine flu death in Islands


By Mary Vorsino
Advertiser Staff Writer

The state Health Department confirmed a third swine flu-related death yesterday.

The Big Island woman, who was in her early 50s, died July 7 at Kona Community Hospital.

"Although flu was the primary cause of death for this individual, she had serious underlying medical conditions that exacerbated her condition and contributed to her decline and death," said Dr. Sarah Park, chief of the Disease Outbreak Control Division and state epidemiologist, in a news release. "We all need to take care of ourselves ... to fight off infection."

There have more than 1,000 reported cases of swine flu in the Islands since May.

Nationwide, there have been more than 40,000.

The first swine flu death in the Islands — a woman in her 60s — was on June 19. The O'ahu woman died at Tripler Army Medical Center and officials said she had other serious health problems. The second swine flu death was July 10 at The Queen's Medical Center. The O'ahu resident was in his late 40s and also had underlying medical conditions.

The news of a third swine flu death comes as the Health Department is making a major shift in how it reports swine flu activity in the Islands.

DOH officials said yesterday they would no longer be tallying up the total number of swine flu cases or investigating each case, but instead would concentrate their efforts on investigating clusters of cases, severe cases and swine flu cases in health care workers or among those who have traveled recently.

Other states are also deciding to stop their counts, which officials say represent just a small fraction of the total number of people who have gotten swine flu, or the H1N1 virus.

MOST CASES MILD

The state started releasing swine flu counts in May and at one point released daily updates. As the number of confirmed cases rose statewide, tourism officials say they saw visitor arrival numbers from Japan drop while doctors' offices were inundated with people who feared they had the virus. At last count, last week, the state had recorded more than 1,000 confirmed cases of the flu.

Nationwide, there have been 40,617 confirmed cases and 263 swine flu-related deaths.

Janice Okubo, state Health Department spokeswoman, said most cases of swine flu have been mild, so confirming and investigating each case doesn't make sense.

She said the Health Department stopped tallying cases last week, and is telling doctors that they don't need to test everyone with flu-like symptoms for swine flu. With laboratories backed up and the cost of testing high, physicians are being told to test only severe cases or those in special populations.

HIGHER TALLY LIKELY

Confirmed cases of swine flu are still being reported to the Health Department, Okubo added, but those numbers are no longer being actively tracked.

"That information doesn't yield anything for us," she said.

Other states, along with the World Health Organization, have also stopped tallying swine flu cases.

Joe Quimby, spokesman for the national Centers for Disease Control and Prevention, said the CDC also plans to stop tallying counts from around the country sometime in the next few weeks and will instead try to get information on the flu out in other ways, including with maps that show outbreaks.

He said the swine flu numbers only show those that have been confirmed, so the actual count is believed far higher.

"Why spend money, time and effort on things that don't bring you value?" Quimby said.

SOME TESTS NEEDED

State House Health Committee Chairman Ryan Yamane, D-37th (Waipahu, Mililani), said he understands the reasons for moving away from the tally. But he said the positive thing about the count is that it raised awareness and gave people some inkling into how widespread the flu was.

"We don't want to inadvertently cause distress or panic in the community," Yamane said. "At the same token, we want to make sure people are aware so they can (be) properly prepared."

Dr. Alan Tice, an infectious disease expert, agreed with the Health Department's decision to end its tallying.

"The virus in its present form is no worse than the seasonal strains of influenza," he said, adding that testing for swine flu is expensive — and a confirmation is virtually useless, since it doesn't change how a patient is treated.

Testing in severe cases of swine flu, though, is a different matter, he said. He said in those cases, health officials need to be aware of more virulent strains.