The Associated Press

REDWOOD CITY, Calif.—San Mateo County health officials are reporting California’s ninth death from swine flu.

The county health department said Monday that a middle-aged woman with underlying health problems had died after contracting the H1N1 flu. Health officer Scott Morrow reminded residents of the county, which has 31 of the 1,076 cases reported statewide, to avoid large gatherings of people.

California health officials had tallied 99 hospitalizations and eight deaths from swine flu as of June 18. Half of the deaths have been in the San Francisco Bay area, half in Southern California.

By IAN McCANN, The Dallas Morning News

Scrapes and bruises aren’t all that kids are getting at summer camp this year.

Swine flu is spreading through dozens of camps across the country, forcing some to shut down, delay openings or treat campers with antiviral drugs. It’s something they haven’t had to deal with previously, as seasonal flu has usually subsided by this time of year.

“It’s kind of a wake-up call to be aware of this,” said Ann Sheets, past president of the American Camp Association. “The thing that is saddest to us is, there are kids who look forward to camp for the whole year, and then they don’t get to go.”

Swine flu, now officially known as novel H1N1 influenza, appears to be here for the summer and should last until the seasonal flu season begins in the fall, said Dr. Daniel Jernigan, deputy director of the influenza division of the Centers for Disease Control and Prevention.

Flu cases are popping up at scouting, religious and other camps across the country, including in Texas, North Carolina, New York and Georgia.

Campers and staff at Greene Family Camp near Waco, including many from the Dallas area, are taking Tamiflu to prevent the spread of the disease after one confirmed and four suspected swine flu cases. And the Muscular Dystrophy Association has canceled its remaining 47 camps across the country, including one for North Texas children. Flu cases have occurred among participants in previous MDA camps this year.

“We were completely shocked,” said Kathy Spann, whose son Brian was to spend his sixth year with the MDA at Camp John Marc in Bosque County. “When I read the national stuff, I certainly understand it.”

Brian, 14, said he is most disappointed for his 17-year-old friends, who would have been attending their final camp.

“One friend said she was disappointed because she would have tried harder to remember things last year,” he said.

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By Rob Carson, The News Tribune, Tacoma

TACOMA — When the Muscular Dystrophy Association announced Friday that it was canceling its national summer camp program because of concerns about swine flu, it meant an abrupt change of plans for hundreds of Washington volunteers.

The weeklong MDA session at the YMCA’s Camp Seymour on the Key Peninsula was to have started Saturday, the day after the announcement.

The cancellation affected scores of firefighters, Harley-Davidson motorcycle club members, National Guard members and others who assist the annual gathering of “Jerry’s kids,” so called because of the long support of comedian Jerry Lewis.

“The number of people affected is countless,” said Geoff Ball, senior executive director of Camp Seymour. “It’s been a very emotional time. No one took this lightly.”

Ball stressed that no evidence of the H1N1 virus has been reported at Camp Seymour.

“The MDA kids are more susceptible to swine flu, so they’re taking extra precautions,” he said. Fifty-one children were enrolled to take part this year, he said.

All of the other summer sessions at Camp Seymour will continue as regularly scheduled, Ball said.

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The Associated Press

EMPIRE, Colo. – A western Colorado summer camp scheduled this weekend for children with muscular dystrophy has been canceled over swine flu fears.

The national Muscular Dystrophy Association says 53 children were expected at the camp Sunday in Empire, about 40 miles west of Denver. Association officials say they canceled the camp along with others across the country because children with muscular dystrophy have weakened respiratory muscles that make them more vulnerable to swine flu.

Officials announced the cancellation Monday. MDA officials say 47 camps across the country that were expecting about 2,500 children were also called off after suspected swine flu cases in Utah and Pennsylvania.

This week, seven children and three adults at a Minnesota camp contracted swine flu.

Reuters

Germany’s federal agency for infectious diseases said on Tuesday there were signs the H1N1 swine flu virus had started to mutate and warned it could spread in the coming months in a more aggressive form.

Experts were concerned about how the flu was developing in Australia and South America, said Joerg Hacker, head of the Robert Koch Institute for infectious diseases.

“It’s possible the virus has mutated. In autumn the mutated form could spread to the northern hemisphere and back to Germany,” Hacker told a news conference in Berlin.

The World Health Organization raised swine flu to pandemic status earlier this month. According to its latest figures, more than 230 people have been killed by the flu worldwide from 52,000 confirmed cases, mostly in the United States and Mexico.

Symptoms of swine flu are typically fairly mild, but doctors have said the virus could evolve into something more aggressive.

According to WHO figures, Germany has the third highest rate of swine flu infection in Europe with 275 confirmed cases.

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By ARTHUR H. ROTSTEIN, Associated Press

TUCSON, Ariz.—Thousands of Jerry’s Kids won’t be going to summer camp this year because of the swine flu.
The Tucson-based Muscular Dystrophy Association says it is canceling the remainder of its summer camps immediately because swine flu has been reported in camps.

The MDA says children with muscular dystrophy are particularly at risk from the flu, although none of the children sickened after camps in recent weeks have died. About 1,800 children have gone to camp this year, but another 2,500 set to go in 35 states will be affected by the cancelations.

MDA spokesman Bob Mackle said Tuesday that nine children and three adults were confirmed to have swine flu after attending three MDA camps in May or early June.

By Stephanie Desmon, The Baltimore Sun

Elderly woman suffered serious underlying condition, officials say

An elderly woman from the Baltimore area is the first person in Maryland to die from the swine flu, health officials said Tuesday.

Officials did not name the woman, who died on Monday, or give her age or hometown. They did say she suffered from a serious underlying medical condition in addition to the H1N1 influenza virus.

The Centers for Disease Control and Prevention has reported 87 deaths nationwide of people who have contracted this strain of the flu, which started making people sick in Mexico this spring. More than 21,000 people across the United States have become ill with the flu, but most have had relatively mild cases.

“While hundreds of Marylanders have recovered from this relatively mild form of novel flu, this death illustrates how serious influenza can be, especially for persons with serious underlying health conditions,” said John M. Colmers, the state’s health secretary, in a statement.

To date, 370 cases of the swine flu have been confirmed in Maryland. That figure is likely a fraction of the total swine flu cases statewide. Many people who become ill with flu-like symptoms are not tested and recover within a week’s time, much like seasonal flu.

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CDC has another snapshot of what the flu surveillance system is seeing up through week 23 (ending June 13). It shows flu still circulating in many communities at a time when most seasonal flu is normally at a very low level. Indeed of the 2765 specimens tested in CDC’s network of 150 laboratories, virtually all of the roughly 40% were influenza A (seasonal influenza B has all but disappeared; the others were not influenza). Not all the flu A viruses were or could be subtyped, but of those that were or could be, 98% were novel H1N1. IN other words, there’s lots of flu around, but essentially none are the seasonal strains of last winter. They are almost all pandemic H1N1. Here is a bar chart of positive specimens by week:

Strictly speaking this is not what we would call an epidemic curve (the time course of an epidemic), because neither of the two things depicted (the bars or the heavy black line) are the numbers of new cases of flu in a time interval. Let’s take the bars, first. The bars are positive specimens submitted to laboratories. The chance a true case in the community is counted here depends on several factors. One is whether the specimen will be submitted at all, i.e., whether a practitioner decides it is worth while to swab a patient and submit it to the laboratory. Once submitted, a lab may make its own decisions depending on workload, priorities and other factors. When the flu index of suspicion is high, as it is when there is public attention, practitioners are more likely to submit specimens. Whether a case of illness will be counted in a bar also depends on the chance that someone with symptoms or signs that are otherwise fairly non-specific will actually have influenza. The chance of all of these factors being true increases as flu circulates in the community, but may do so in complicated ways that make it difficult to compare one week with another. There may also be geographic variations that offset or add to each other for the final national tally.

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– 5 confirmed cases in Wales including two new cases: – A 28 year old male from Powys. He has been offered antivirals and is recovering. The NPHS has identified six close contacts who are all are well and have been offered antiviral medicine. The NPHS is investigating the source of the infection. – A three year old boy from Ceredigion. He has been offered antivirals and is recovering. The NPHS has traced 14 close contacts, including children who attended Cylch Meithrin, Cei Newydd. All are well and have been offered antiviral medicine. The infection is linked to a confirmed case of swine flu from Birmingham.

– 0 probable cases in Wales.

– 148 people have been under investigation in Wales. Of these, swine flu has been confirmed in five cases (see above) and ruled out in 133 cases, leaving 10 still under investigation. All of these are displaying, or have displayed, mild symptoms.

– Of the 10 people under investigation, seven were well when first identified, but reported recent flu-like symptoms following travel to affected areas. Blood tests are being undertaken on these individuals to see if they had the flu and to help the NPHS understand the pattern of the disease from the past. Their symptoms may or may not have been due to swine flu. Testing will be conducted in a number of weeks to check whether these people did have swine flu – scientifically it won’t work before that. Investigations have shown that people they had close contact with did not catch flu from them when they were ill.

– No further details will be confirmed or denied about cases in order to protect their right to confidentiality.

– There are now 2,508 laboratory confirmed cases in the UK – five cases in Wales, 566 cases in Scotland, 1,923 cases in England and 14 in Northern Ireland.

– One person with swine flu in the UK – a case in Scotland – has died. The patient had underlying health conditions.

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A call for research on the emerging influenza pandemic is being launched by the NIHR as the World Health Organization (WHO) announces the move to pandemic phase 6. The research will provide evidence to influence ongoing health policy and practice.

As part of the collaborative effort into research concerning pandemic flu with MRC and Wellcome, the Director General for Research and Development at the Department of Health has asked the National Institute for Health Research to undertake a themed call for research that will inform policy and patient care in the current influenza pandemic. This call is being managed by the NIHR Evaluation, Trials, and Studies Coordinating Centre. It is limited to research that will have rapid practical benefit to the NHS and to NHS patients.

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