Sickest swine flu cases in Canada and Mexico

Rapidly worsening breathing problems in the sickest swine flu patients in Mexico and Canada present a scary worst-case scenario and could foreshadow what U.S. doctors face as winter flu season sets in, new reports suggest.
In the global outbreak's first wave, many critically ill patients in both countries were obese, although their death rates weren't higher than others. Many in both countries also were younger than those typically hard hit by seasonal flu, as has been found in the United States.
Patients studied worsened quickly after being admitted to hospitals. Most survived after intensive, lengthy treatment, although the death rate in Mexican patients studied — 41 percent — was much higher.
The reports were published online Monday in the Journal of the American Medical Association.
They aren't a true snapshot on prevalence. But a JAMA editorial says they provide clues on what hospitals elsewhere may see in coming months.
A report on U.S. cases published last week in the New England Journal of Medicine provided similar guidance. It found that one-quarter of Americans sick enough to be hospitalized with swine flu last spring needed intensive care and 7 percent died.
In the Mexican report on six hospitals between March and June, critical illness developed quickly in 58 of almost 900 patients with confirmed or suspected swine flu patients — a rate of just under 7 percent. But 24 of these sickest patients died within two months, said the study led by Dr. Guillermo Dominguez-Cherit of the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City.