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 Conroe patient with 'mystery illness' diagnosed with H1N1 
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Post Conroe patient with 'mystery illness' diagnosed with H1N1
by Jeremy Desel / KHOU 11 News & Shern-min Chow / KHOU 11 News

Posted on December 18, 2013 at 5:08 PM

Updated yesterday at 11:52 PM


HOUSTON – At least one of the eight patients being treated for a mysterious illness at Conroe Regional Medical Center has tested positive for H1N1, according to Montgomery County health officials.

It's the same strain of H1N1 that caused a pandemic in 2009. Doctors have been seeing hundreds of new cases recently in Texas and nationwide. In fact, H1N1 is one of the viruses included in this year's flu shot.

The patient diagnosed with H1N1 is still alive. Two other surviving Conroe patients tested negative for H1N1. The results are still pending for one patient.

"So what we're doing now is we're retesting those patients who tested negative from the private lab," Montgomery County Medical Director Dr. Mark Escott said. "And those samples will be sent to the state and the CDC for confirmation testing."

The other four patients treated for the mystery illness in Conroe have died.

The illnesses started with flu-like symptoms, then progressed to pneumonia and, in some cases, organ failure. They all initially tested negative for the flu.

It’s been busy at the Conroe Urgent Care Clinic. Some 18 patients came in with flu-like symptoms. Physician Assistant Derrick Goodwill says on a daily basis, “We’re testing at least 5–7 people positive for H1N1 as opposed to October when we hardly had any.”

The commonly used RAPID flu test is not very reliable.

“The recommendation right now is to give Tamiflu to patients even if they don’t test positive,” Goodwill said.

That is also why Montgomery County health officials now plan to use a more reliable but costly and time consuming test on those patients sick from the ‘mystery’ bug and those who died from it.

snip

Read more here: http://www.khou.com/community/Health-officials-Conroe-patient-with-mystery-illness-diagnosed-with-H1N1--236459811.html

Been watching this with increasing interest over the last two days.

BTW Conroe, TX is a suburb just north of Houston.

Quote:
snip

The Texas Department of State Health Services (TDSHS) yesterday issued a statement that said the level of flu-like illness is "high" and that health providers are seeing illness increases in several parts of the state. With disease activity ramping up, it urged state residents who haven't been vaccinated to get flu shots for themselves and their families.

Texas and a handful of other southern states have been the nation's flu hot spots so far, according to the latest surveillance reports from the US Centers for Disease Control and Prevention (CDC). Nationally, flu activity registered a modest jump, and the 2009 H1N1 has been the most common among subtyped strains, according to the CDC's most recent report.

Mark Escott, MD, the MCHD's medical director, said in an audio recording posted on the Montgomery County Police Reporter Web site that health officials are seeing an unusual pattern of serious illnesses, with patients having symptoms similar to flu, such as fever, sore throat, body aches, and fatigue. The eight patients have had complications such as pneumonia, which is expected in severe flu cases, he said.

The patients with serious illnesses range in age from 41 to 65, which Escott said is a bit unusual, because flu complications are most common in the very young and in adults older than age 65. "Because of the significant number of cases—half died—we are concerned about it, and we are investigating the cases," he said.

He said the numbers of flu-like illnesses have piled up over the past few months, and about 250 of the roughly 1,900 patients tested positive for influenza A or B.

The MCHD is in contact with health officials in the TDSHS and the city of Houston to coordinate efforts to identify what's causing the illnesses, Escott said. On its Facebook page the MCHD said the CDC is not in Texas assisting with the investigation and that the events so far don't meet the criteria that would trigger the CDC's involvement. However, in its update today the MCHD said the CDC is part of the discussions.

Escott urged area residents to take the usual infection control steps, such as using hand sanitizer, covering coughs and sneezes, and staying home when sick.

The MCHD today established a phone hotline to field questions about the flu-like illness cases and responded to questions from the public on its Facebook page.

The outbreak in Texas resembles a cluster of severe respiratory infections that occurred in Dothan, Ala., in May, an event that also raised public concern initially. However, tests revealed that the hospitalized patients had a variety of common respiratory viruses and bacteria, with no unusual pathogens. Ten patients in the same southeastern corner of the state were hospitalized with similar symptoms, and at least two deaths were reported.


Read more here: http://www.cidrap.umn.edu/news-perspective/2013/12/texas-health-officials-probe-severe-flu-illness-cluster

So the question remains "Who was patient zero?" Where did this originate? Also note the weird age group.

Basically KHOU TV is the only one really following this at this point. The rest of the media are like "just get a flu shot."

:hmm

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Thu Dec 19, 2013 5:34 pm
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Post Re: Conroe patient with 'mystery illness' diagnosed with H1N
From Niman:

Commentary

Quote:
H1N1pdm09 Confirmed Again In Montgomery Co Texas
Recombinomics Commentary 23:45
December 19, 2345

As of Thursday afternoon, one additional case of H1N1 has been confirmed in Montgomery County. This patient is currently in an area hospital receiving treatment. Labs are being repeated on all remaining cases by the CDC. There are currently two confirmed H1N1 cases in Montgomery County.

The above comments are from the latest of three press releases from the Montgomery County Public Health District in Conroe, Texas. Yesterday’s released announced the first lab confirmation of cases in a cluster described in the first press release. That cluster included 8 individuals (between ages of 41-65) who had been hospitalized at the Conroe Regional Medical Center. Four had died and all had textbook H1N1pdm09 symptoms, but had tested negative on a rapid test (which has a notoriously low sensitivity, especially for H1N1pdm09 cases).

The samples from the clusters were subsequently sent to the CDC, where H1N1pdm09 confirmation and sequencing is expected. The lab confirmation yesterday was followed by media reports noting that the working definition was H1N1pdm09 infections for all eight cases in the original cluster, as well as additional cases in other area hospitals.
.
The latest press release confirms that an additional case in H1N1pdm09 infected, and media reports note that there are now six recent deaths that are assumed to be H1N1pdm09 cases as well as 14 critical cases.

These recent events highlight the limitations of the rapid tests and area doctors have been instructed to treat symptomatic patients as H1N1pdm09 cases, even if the rapid test is negative. Texas leads the nation in ILI cases with an intensity level of 10 on a scale of 10.
These deaths raise concerns that the 2013/2014 flu season in the United States will have striking similarities to the 2009 pandemic. Although the sequence of events in 2013 is slightly later than the fall of 2009, the spiking of cases in the south in December is similar to the August southern spike in 2009.

H1N1pdm09 confirmation of the fatal cases, and associate sequence data will be useful. To date only one Texas H1N1pdm09 sequence has been released from the 2013/14 season and H7N9 has been detected in four cases in Louisiana, raising Tamuflu resistance concerns. The death toll also raises concerns for D225G, which was disproportionately present in severe/fatal H1N1pdm09 cases in 2009.


http://www.recombinomics.com/News/12191302/H1N1_Mystery_TX_Conf_2.html

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Thu Dec 19, 2013 5:39 pm
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Post Re: Conroe patient with 'mystery illness' diagnosed with H1N
One interesting item of note, there are lots of folks who live in the Conroe area who travel to and from the Middle East.

Could some of this be MERS? :scared

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Thu Dec 19, 2013 5:52 pm
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Post Re: Conroe patient with 'mystery illness' diagnosed with H1N
But how would we have another pandemic if this year's flu vaccine contains this very strain of H1N1? Have you noticed any articles that give statistics on how many, if any, of the patients involved had already had the flu vaccine? That would be interesting to see. Thanks for the info, BB. There have been ongoing articles in ProMed Mail on the MERS virus, especially speculation on the mammal reservoir. They are still considering camels. I'll see if I can find an abstract and post it in that thread.

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Wed Jan 01, 2014 10:14 am
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Post Re: Conroe patient with 'mystery illness' diagnosed with H1N
One interesting item the local reporters are saying is that the flu vaccination is only good for 3 months.

I have never heard that before.

I have two grandchildren who came down with flu (type A not swine) after having nasal vaccinations in the early Fall. Coincidence? Hmmm

East Texas and I got our shots in early October. :scared

We are seeing widespread Flu A and Swine in my State. They are no longer testing folks for flu in doctor's offices and clinics. If you present with cough, high fever and aches - they give you Tamiflu and move on.

East Texas and I have both had the other disease currently widespread in my area. It starts out viral and quickly goes bacterial. Basically it is upper respiratory infection. I've had it over a week as has DH. My brother and his wife both have it. My niece and her whole family have it as well. We think we all caught it Christmas Eve from one of the twins.

Little Typhoid Mary... :crylaugh

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Sat Jan 04, 2014 10:20 pm
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Post Re: Conroe patient with 'mystery illness' diagnosed with H1N
I Never ever EVER get vaccinated because I always end up with what I got vaccinated for I've had the H1N1 strand an fought it off took AGES I'm still fighting the intestinal stuff feels like nasty pinching feeling in my lower abdomen before it felt like Appendicitis with a burning sensation Wafting up to my Liver and felt like it it was ripping chunks out of my liver.horrible!

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Sun Jan 05, 2014 12:02 am
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