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H1N1 diagnosis not made until days before Clark County man's death

A 33-year-old Clark County man who died Sunday of the H1N1 virus was not diagnosed until well into his 13-day hospitalization, the state's chief health officer revealed Monday.

Whether the slowness of the diagnosis played a role in the first death of a state resident from the H1N1 virus, also known as swine flu, is unknown, Dr. Mary Guinan stressed.


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  • "We have to be careful not to jump to conclusions," Guinan said. "We're trying to find out what happened."

    The man, who had no underlying health issues, was not diagnosed until a couple of days before his death, Guinan said.

    If a patient is diagnosed early, the anti-viral drugs Tamiflu or Relenza can be effective in interrupting the reproductive cycle of the virus, an action that lessens symptoms and helps the body fight off the virus.

    Guinan said it is best for doctors to run a sophisticated test called the Polymerase Chain Reaction on patients with flu-like symptoms to confirm an H1N1 diagnosis. It is possible, she said, that other less sophisticated "rapid" tests would come back negative.

    "We may have to educate doctors on testing," Guinan said. "This is a time for education for everybody."

    Guinan's observations late Monday came on the heels of the afternoon disclosure by Dr. Lawrence Sands, chief health officer of the Southern Nevada Health District, that three other Clark County residents are currently hospitalized with the virus.

    At a morning briefing where he talked about the death of the 33-year-old man, Sands did not mention the hospitalizations. When pressed later, he did.

    He said he could not go into any detail on those now hospitalized for "confidentiality reasons."

    At the briefing, Sands said he did not know what hospital the H1N1 patient died in, where he was employed or whether the man's fellow employees had contracted or been tested for the disease.

    Citing privacy regulations, Sands said he could not release the deceased's name.

    At the briefing, Sands said he did not believe the man's family had tested positive for the disease. He later said he wasn't sure.

    Sands said he did not know what symptoms caused the man to be hospitalized nor did he know how long the man was in the hospital before he was diagnosed with the virus. The man had been hospitalized on June 15, Sands said.

    He said it would not be helpful for people to know where the man died, where he worked or whether his family now has the disease.

    "Exposure is not unique to anywhere in the community," he said, adding that knowing that your workplace or hospital had a case of the H1N1 virus isn't going to help people take any better precautions.

    "H1N1 is now widespread in the community," he said.

    Sands said that his office always releases pertinent information related to public health.

    He noted that the district asked more than 50,000 people to get tested for hepatitis in 2008 after the district found a number of patients of clinics run by Dr. Dipak Desai had contracted the disease.

    The death of the Clark County man from H1N1 came a little more than two weeks after a 70-year-old woman from New York died of the virus in Nevada. The tourist was diagnosed with the illness after she arrived in Las Vegas.

    "It is not unexpected that we would see patients with severe illness and additional deaths related to this influenza strain," Sands said. He stressed that most cases of the virus have been mild, allowing people to recuperate on their own.

    Sands pointed out that any flu can be deadly, with 30,000 deaths out of the 200,000 cases of flu registered in the United States each year. A normal seasonal flu outbreak kills 250,000 to 500,000 people worldwide.

    The World Health Organization declared a pandemic in early June, when the number of confirmed cases in the world reached 30,000.

    Officials with the Centers for Disease Control and Prevention now estimate that more than 1 million Americans have been infected with the H1N1 strain.

    On Monday, international officials reported that, for the first time, a case of H1N1 had proven resistant to Tamiflu, the leading pharmaceutical weapon against the new virus. The resistance had been seen in a patient in Denmark, who recovered.

    In Southern Nevada, public health officials say the vast majority of H1N1 cases they've seen are mild.

    Four of those cases were reported from Marion Earl Elementary school earlier this month.

    Health officials did not recommend that the school be closed, but urged parents to keep sick children at home.

    The day after the H1N1 cases were reported in the media, the school had an absentee rate of nearly 60 percent as 365 students stayed home.

    Officials were uncertain how many students were actually sick because many children were kept home as a health precaution.

    The U.S. Centers for Disease Control and Prevention has reported that 70 countries had confirmed cases of the virus. Out of the 28,000 who have contracted the disease in the United States, 127 have died.

    As of Friday, state officials said there were 240 confirmed cases of the H1N1 virus in Nevada.

    There have been 80 confirmed cases in Clark County.

    "But that's just the tip of the iceberg," Sands said. "Most of the people who've gotten it have had a mild case and never been tested."

    Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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    Tragic wrote on June 30, 2009 10:54 PM: My heart goes out to the family and friends of the 33-year-old man who passed on sunday. It makes me upset that they didn't test sooner for the virus. As soon as the man went into the hospital, that is the first thing they should have test for. A man at 33 years of age shouldn't have paid the price becauese the hospital didn't do there job, or should I say "Dr." When I have gone to the E.R. for a broken foot, they run test that they don't even need to do, but someone goes into the hospital for the "flu" and don't find out tell the 13th day? What the hell are they thinking? When you watch the news that is all they been talking about, is the H1N1 outbreak. What doctor's don't watch the news or read the paper. "Sands said he did not know what symptoms caused the man to be hospitalized nor did he Know how long the man wa in the hospital before he was diagnosed with the virus." I think that they are covering up something. THE MAN WAS ONLY 33!! Also, they should get all the facts right before they go reporting it to the world. This is a very tragic loss. He will be missed.


    Vania wrote on June 30, 2009 07:18 PM: For all of you slamming the Canadian universal health care system, I am willing to bet you are not Canadian. I am, as is my 90 year old aunt, who lives in Montreal. She only speaks English, and in Quebec there is discrimination by government officials against English only speakers.

    Yet, when she lost most of her sight last year, the Canadian health care system doctors were quick to operate and saved her sight, even though at 90 you would think they might callously say "Oh well, she's old".

    This year, she became very weak while out shopping by herself. She was promptly taken by ambulance to a Montreal area hospital, where a doctor determined she needed open heart surgery. Again, it was done immediately, even though at age 90 a callous society might think the surgery was an economic waste.

    I pray for all Americans that the U.S.A. soon adopts a universal health care program, like Medicare, with cost controls so that patients are not ripped off by their dentists (the worst offenders), hospitals, test labs and the like. Here in the America, the only people I've found charging reasonable fees are the doctors themselves.

    The only people who benefit from America's system of health insurance, or no health insurance, are the insurance companies, testing labs and hospital chains that are smart enough to serve the upper middle class and the rich.

    Don't slam Canada's universal health care system unless you are a Canadian, have used the system, and have had a legitimate need for immediate care.


    Cyn wrote on June 30, 2009 03:39 PM: Tuesday, June 30, 2009 Fox News
    By Molly Line

    Private for-profit clinics are a booming business in Canada -- a country often touted as a successful example of a universal health system.

    Facing long waits and substandard care, private clinics are proving that Canadians are willing to pay for treatment.

    “Any wait time was an enormous frustration for me and also pain. I just couldn't live my life the way I wanted to,” says Canadian patient Christine Crossman, who was told she could wait up to a year for an MRI after injuring her hip during an exercise class. Warned she would have to wait for the scan, and then wait even longer for surgery, Crossman opted for a private clinic.

    As the Obama administration prepares to launch its legislative effort to create a national health care system, many experts on both sides of the debate site Canada as a successful model.
    But the Canadian system is not without its problems. Critics lament the shortage of doctors as patients flood the system, resulting in long waits for some treatment.


    Cyn wrote on June 30, 2009 03:36 PM: DBee -- Canada's total population is around 33 million while ours is more than 300 million. Seems like 35 deaths is a bit high for a country with such a wonderful health plan. BTW, Canadians are buying private health insurance in droves and coming into the U.S. for health care. Explain that.


    Tom, Las Vegas wrote on June 30, 2009 03:30 PM: You mean pigs like this actually get the swine flu?


    Tom, Burbank wrote on June 30, 2009 11:22 AM: "At the briefing, Sands said he did not know what hospital the H1N1 patient died in, where he was employed or whether the man's fellow employees had contracted or been tested for the disease."

    For someone who's the chief health officer of the Southern Nevada Health District, Dr. Lawrence Sands sure doesn't know much. Good luck, Las Vegas.


    Curious wrote on June 30, 2009 10:03 AM: So we have a guy who presents to a hospital with FLU LIKE SYMPTOMS and doesn't get checked for the recent pandemic outbreak?? What?????? That is a disgrace.


    VegasSucks wrote on June 30, 2009 09:51 AM: A perfectly healthy 33-year-old man is hospitalized with what must have been flu-like symptoms. Yet not one medical professional ever thought "swine flu" until it was too late to save this victim?? That's frighteningly incompetent.
    (But I'll bet you they didn't forget to bill his family for his lengthy hospital stay and the "care" he received.)
    Name the hospital, please.


    Natasha wrote on June 30, 2009 09:24 AM: What hospital?????


    DBee wrote on June 30, 2009 09:23 AM: Ann - maybe that's why Canada has had 25 deaths reported since the epidemic and the U.S. has had 87. Hmmm, health care for all or just those that can afford to save their own lives. You must be of the later.


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