By Helen Branswell Medical Reporter (CP) – 19 hours ago 

TORONTO — Intensive care specialists who fought to save desperately sick swine flu patients this spring and summer have a warning for hospitals that haven’t yet dealt with an influx of these difficult-to-treat patients.

Prepare. Now. Experts predict ICUs are likely to be the main battlefield in the war against a pandemic virus which so far doesn’t appear to have much of a middle ground.

The vast majority of people suffer through a typical bout of flu. But of those who become sick enough to be hospitalized, a significant portion – maybe as high as 15 per cent, the World Health Organization says – end up in ICUs for weeks, hovering between life and death.

“I’ve never seen this,” says Dr. Paul Hebert, editor of the Canadian Medical Association Journal and an intensive care physician in Ottawa who has treated several of these patients.

“As an ICU doctor, it’s very, very, very rare I can’t deliver enough oxygen to someone to keep him alive. They die of other things, right? They die because their organs fail.”

“In this case, we can barely oxygenate them.”

The worst-hit hospitals talk of having been on the brink of not being able to cope. They describe nearly running out of specialized equipment and the skilled staff needed to monitor these highly unstable patients in their high-tech hospital beds.

Public health officials need to look for ways to keep novel H1N1 patients from getting this sick and help hospitals access enough key drugs, equipment and even staff to cope with an expected surge of cases in the fall and winter, says Dr. Anand Kumar, an intensive care physician who has treated dozens of these patients in Winnipeg.

Kumar was so concerned about what he saw in the city’s ICUs earlier this year that he has been agitating, in medical and political circles, for stepped up pandemic preparations for the country’s hospitals.

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Australia
•  Pandemic lessions learned from Australia (Link)

Bahrain
•  Bahrain reports first swine flu death (Link)

Bangladesh
•  Bangladesh reports first H1N1 flu death (Link)

Canada
•  Intensive care units could go over capacity in swine flu fight (Link)

China
•  Red alert at schools after A/H1N1 flu outbreaks (Link)
•  A/H1NI flu outbreak reported at middle school in northwest China (Link)

Colombia
•  Bogota: President Alvaro Uribe H1N1 positive (translated) (Link)
•  Colombian Defense Minister Silva Showing Symptoms of Swine Flu (Link)

Egypt
•  Avian Influenza, Human (110) 85 th case (Link)
•  WHO: Avian influenza – situation in Egypt – update 22 (Link)

France
•  H1N1: Spreading four times faster than other viruses (translated) (Link)

India
•  Seven more swine flu deaths, India toll now 100 (Link)
•  Three more positive for A(H1N1) influenza in Puducherry (Link)
•  Swine flu toll rises to 102 (Link)

Indonesia
•  Indonesia’s A/H1N1 flu death toll rises to 8  (Link)
•  22 cases positive for H1N1 (translated) (Link)
•  Poultry being infected by H1N1? (translated) (Link)
•  Doctors Terminate Fetus of H5N1 Suspect (translated) (Link)
•  Patients are Residents of one Village (H5N1 suspects)(translated) (Link)
•  Six Bird Flu Suspects From Sukamenanti (translated) (Link)

Ireland
•  Health Service clarifies rules on swine flu pupils (Link)

Lebanon
•  Lebanon to abandon swine flu running tally (Link)

Malaysia
•  99 New Cases Reported Today (Link)

New Zealand
•  New Zealand influenza A/H1N1 death cases rise to 17 (Link)

Papua New Guinea
•  47 Dead, 2000 Infected (Link)
•  Papua New Guinea hit by cholera (Link)
•  Australia reports on diseases hitting Papua New Guinea (Link)
•  102 Deaths Influenza/Dysentery (Link)

Singapore
•  Singapore reports two more A/H1N1 related death cases (Link)

Sweden
•  First swine flu death in Sweden: hospital  (Link)

Thailand
•  Thailand’s (A)H1N1 deaths rise to 130 (Link)

United States
•  TN: Child dies of swine flu at Chattanooga hospital (Link)
•  CA: Bar owner’s death shocks Castro area (Link)
•  AL: School closing due to H1N1 outbreak (Link)
•  SC: Two swine flu patients in ICU in Georgetown (Link)
•  NY: New flu hit estimated 10 percent of New Yorkers (Link)
•  North Kentucky University Records First H1N1 Case (Link)
•  South Carolina has first H1N1 death (Link)
•  MI: Lisbon Community Schools Confirm Student with H1N1 (Link)
•  CA: Teen Dies Of H1N1 Flu In Sonoma (Link)
•  Boy Dies In Jackson County: H1N1 Suspected Cause (Link)
•  AL: Boy Dies In Jackson County: H1N1 Suspected Cause (Link)
•  NM Woman Dies Of H1N1 Virus (Link)
•  TX:Lorena School District — fourth case of Swine Flu Monday (Link)
•  NY: School Bans Touching to Prevent Swine Flu Virus (Link)
•  LA: Loyola University Student Tests Positive For H1N1 (Link)

Vietnam
•  Vietnam’s A/H1N1 flu cases rise to 2,724 (Link)

General
•  WHO: Preparing for the second wave: lessons from current outbreaks (Link)
•  ProMED: 1st estimation of direct H1N1 2009 pandemic virus (Link)

Commentary
•  A(H1N1) not as dangerous or fatal as anticipated (Link)

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