http://www.washingtonpost.com/wp-dyn/content/article/2009/05/19/AR200905190
2609.htm

Survey Finds Link Between Obesity and Flu Severity

By David Brown and Robin Shulman
Washington Post Staff Writers
Wednesday, May 20, 2009

A survey of people hospitalized because of swine flu in California has
raised the possibility that obesity is as much of a risk factor for serious
complications from the flu as diabetes, heart disease and pregnancy, all
known to raise a person's risk.

In all, about two-thirds of the California patients had some underlying
medical condition, according to a report yesterday in the weekly bulletin
of the Centers for Disease Control and Prevention.

Nationwide, 47 states and the District have reported 5,469 cases and six
deaths since the start of the outbreak in late April, according to the
CDC's count. Yesterday, officials in Missouri reported a seventh U.S. death
-- that of a 44-year-old man who had no underlying medical problems, wire
services reported.

"We were surprised by the frequency of obesity among the severe cases that
we've been tracking," said Anne Schuchat, one of the CDC epidemiologists
managing the outbreak. She said scientists are "looking into" the
possibility that obese people should be at the head of the line along with
other high-risk groups if a swine flu vaccine becomes available.

Other studies have shown that pregnant women are also at higher risk for
serious influenza infection, especially in the third trimester, when the
fetus and womb compress the lower parts of the lungs. This makes it harder
to breathe deeply and cough forcefully; it may also alter blood flow in the
chest. A similar thing may be occurring in severely overweight people, some
experts speculated.

The average age of the 30 Californians hospitalized for swine flu was 27.5
years. Nearly three-quarters were women, and 65 percent were Hispanic. Half
lived in two counties bordering Mexico.

Of the 30 people, 11 had a lung ailment such as asthma or emphysema, six
had an immune disorder, five had heart disease, five were pregnant, four
had diabetes and four were obese.

In New York, Mayor Michael R. Bloomberg (I) said officials were
investigating whether 16-month-old Jonathan Castillo, who died with a high
fever Monday night at a Queens hospital, had contracted the H1N1 virus. The
toddler's 3-year-old sibling was treated for flulike symptoms and released.

The mayor said lack of health insurance or immigration status should not
deter people who feel sick from seeking attention.

"Whether you have health insurance coverage or your immigration status is
in question, it doesn't matter," Bloomberg said. "We will not ask about
that."

The mayor also said four inmates at a Rikers Island jail had been confirmed
to have the H1N1 virus and four more are likely to have it.

The union representing the city's correctional officers criticized the
response to the swine flu outbreak among inmates and filed a letter of
protest with the state Labor Department.

"If I had to design a place where you could put people who were sick and
get as many people sick as possible, it's the New York City jail," said
Richard J. Koehler, a lawyer for the Correction Officers' Benevolent
Association.