Patients who became the most critically ill with swine flu and those who died were relatively healthy young women — not the elderly and chronically ill as many still believe, according to an article released today by the Journal of the American Medical Association. The findings challenge public apathy evident in recent national and state polls over the need for healthy adults to get vaccinated against the swine flu, formally known as the H1N1 virus.
“This is not a year to be a skeptic about vaccination,’’ said the article’s author, Anand Kumar of the Health Sciences Centre and St. Boniface Hospital in Winnipeg. Kumar also is an associate professor for critical care and infectious disease at the University of Medicine and Dentistry of New Jersey-Camden.
The article examines the swift progression of the disease among 168 people hospitalized in Canada between April 16 and Aug. 12, at the height of the outbreak. The average patient was 32.3 years old, but 50 patients were children. All of them required treatment in the intensive care unit, with 136 of patients relying on a ventilator to help them breathe.
Ultimately, 29 people died, including 21 women and four children. Most died quickly — 24 died within 28 days from the onset of the serious respiratory symptoms that sent them to the hospital, according to the article.
Only 1 in 1,500 people has gotten seriously ill from the H1N1 virus, said Kumar, who compiled the research with the Canadian Critical Care Trials Group H1N1 Collaborative. “But healthy people can be hit. Once they are, he said, “these people are spectacularly ill — it’s hard to believe how ill these people are.’’
The challenge this season will be to convince the non-senior citizen population they ought to get vaccinated, said John W. Sensakovic, an infectious diseases specialist and director of medical education at Saint Michael’s Medical Center in Newark.
“Senior citizens are used to lining up to get that shot,’’ he said, adding that he would troubled by the “wait and see attitude’’ of other adults.
Sensakovic said although the study provides only a small “snapshot” of the those afflicted by the disease, he hopes the article “will get people’s attention to realize that although most cases are mild, some people do get severe illness and die. That can be prevented.’’
The vaccine in a nasal spray form began arriving at hospitals, local health departments and clinics in batches last week from manufacturers. The injectable form of the vaccine could begin arriving in staggered shipments later this week, state health officials say.
The swine flu has killed 17 New Jerseyans so far.
Information about only 12 of the 17 people who died was available from state health officials today. Seven of the victims were men and five were women; three were children; one was over 60; and the remainder were between the ages of 36 and 55, according to a Health Department spokeswoman, press releases and media accounts. The median age of those who died is 49.
“Our data suggest that severe disease and mortality in the current outbreak is concentrated in relatively healthy adolescents and adults between the ages of 10 and 60 years,’’ according to article, expected to appear in the Nov. 4 issue of the medical association’s journal. This trend hasn’t been seen since the 1918 Spanish flu pandemic, the article said.
Kumar said he could only speculate as to why women suffered more severely when they contracted swine flu than men.
“It’s one of the mysteries of the pandemic,’’ he said. One in three patients were obese, according to the article. Both severely overweight people and women — especially if they are pregnant — have less lung capacity, Kumar noted. “Men and women are hit equally’’ with swine flu but more women than men needed to be hospitalized. Star Ledger