Health experts working to better understand the H1N1 virus

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SALT LAKE CITY -- Though Utah's swine flu virus remains very active, there is a hint the actual sickness level may be declining a bit, at least that's the signal at Primary Children's Medical Center over the past three days. But watching what this virus is doing and where it's going is far from over.

While the H1N1 virus continues to be moderate in its potency level, it spreads rapidly. And for the first time, it's hitting one group particularly hard.

"This is the first time that obesity has emerged as a possible risk factor for severe disease in an influenza epidemic. Now we know a lot more Americans are obese than were in '68 or '57, so one of the key questions: Is it really causing an increased risk or are we just seeing a lot more heavy people? I suspect there is a risk associated with obesity," said Dr. Andrew Pavia, an infectious disease physician at Primary Children's Medical Center.

In addition to his work at Primary Children's, Pavia is a consultant for the CDC and chairs the Infectious Disease Working Group for the National Biodefense Science Board. H1N1 is currently the focus of these groups right now. In fact, they're currently watching what the virus is doing in the Southern Hemisphere. Australia, for example, which is going into its fall and winter season, is getting hit hard.

"We expect it will be a more dramatic and more rapid outbreak in a cold climate than it will be here in the spring. In fact, that's what it's beginning to look like. Australia, Chile, Argentina are seeing a very rapid increase in cases," Pavia said.

He says from all he and his colleagues can observe, so far, H1N1 will be back this winter with a lot more people probably getting sick here in Utah and elsewhere.

"If you put a virus into a tightly-packed community where the air is dry, you get much more efficient and explosive spread," Pavia said. "This is likely to come back in the fall as a fairly robust epidemic, if you will. Not catastrophic, we're not talking about 1918, but something that is going to be noticeable and disruptive."

Flu vaccine for the new H1N1 virus will be ready for the fall and winter season, but some people may have to get two to three shots.

"I think it's pretty likely that children who have not seen a lot of H1N1 viruses before may need two doses, at least a conventional vaccine. Also, I think it's pretty likely older people ... who already have some immunological memory may respond well to one dose. But what age is going to be the cutoff? How well will one dose protect? We don't know," Pavia said.

There are those who have volunteered to test the new vaccine. Health departments and the CDC will measure antibody responses and monitor potential side effects in those folks before its release to the public.


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Ed Yeates


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