3 H1N1 deaths double the state's toll

Three more Minnesotans have died from complications of the pandemic H1N1 flu virus, bringing the total in the state to six since the new strain emerged in April.

State health officials said Friday that the latest deaths occurred in the past two weeks. They were a Watonwan County woman in her 40s, a Dakota County woman in her 50s and a Ramsey County man in his 50s. They declined to provide further details other than to say that all had underlying health problems that contributed to their deaths, officials said.

While the deaths appear to have occurred in a cluster, they do not indicate a significant change in the course of the disease, health officials said. Nor do they reflect anything substantially different than normal seasonal influenza, which is also dangerous to people with common health conditions such as asthma, diabetes and a suppressed immune system.

"We have expected that we might see additional deaths from H1N1 novel influenza when the illness became widespread," said Dr. Ruth Lynfield, state epidemiologist. "We know that H1N1 novel influenza, like seasonal influenza, can cause severe illness and even death in some people. However, we are not seeing any change in the overall severity or virulence of the disease."

One of the underlying health conditions that contributed to one or more of the recent deaths was obesity, Lynfield said. That's one of the hallmarks of the H1N1 virus. For reasons that are not well understood, obesity is a risk factor. That is not true of seasonal flu, she said.

The pandemic flu, also known as swine flu, is now widespread throughout most of the country. The Center for Disease Control and Prevention doesn't have an exact count of swine flu deaths and hospitalizations, but existing reports suggest the infection has caused more than 600 deaths and more than 9,000 hospitalizations.

On Thursday Dr. Anne Schuchat, the CDC's director of immunization and respiratory disease, said there was "significant flu activity in virtually all states," which, she added, was "quite unusual for this time of year." She said she was especially worried about pregnant women, who appear to be particularly susceptible to the virus. As of late August nationwide, 100 had been hospitalized in intensive care, and 28 had died since the beginning of the outbreak in April.

In addition to pregnant women, H1N1 appears to be particularly risky to older children and young adults. Seasonal influenza, in contrast, is much more of a risk for elderly people and very young children.

The CDC began shipping H1N1 vaccine Friday, and 28,000 doses of nasal spray vaccine are expected to arrive in Minnesota in the next week, state officials said.

But because pregnant women and young children cannot use the nasal spray -- it contains a live virus, which is risky for them -- the first doses will go to health care workers. Shipments of H1N1 injectable vaccine are expected to arrive in the following weeks.

"Until we have a good chunk of the population vaccinated, we are relying on people to stay home when they are sick to stop the spread of this," Lynfield said.

To date, Minnesota has reported 324 hospitalized cases of confirmed H1N1 flu, 39 of them in the past two weeks. Lynfield described it as a "big uptick."

Minnesota health officials said that at this point, doctors' clinics and urgent care centers are busy, but hospitals have not reported that they are nearing capacity.

Last week, 134 schools reported to the state that they had either 5 percent of their student body absent or three students in an elementary school classroom absent because of flulike illness. "This flu is very widespread, and we expect to see many more cases across the state," Lynfield said.

So far all of the reported cases have been H1N1, not the seasonal flu. But that could change starting next week. The official flu season begins Monday.

Josephine Marcottty • 612 673 7394