2 more Boston residents die from swine flu

By Kay Lazar
Globe Staff

The deaths of two more Boston residents have been linked to swine flu, Boston health authorities reported tonight, bringing to four the number of Massachusetts adults killed by the novel virus.

The victims, both men, were 52 and 30 years old.

The 52-year-old had underlying medical conditions that might have made him more susceptible to complications from the germ, known scientifically as H1N1, but the younger victim did not, said Boston Public Health Commission spokeswoman Susan Harrington. She declined to elaborate, citing patient confidentiality laws.

Test results confirmed today that the 52-year-old, who died last Friday in his home, was infected with the virus.

The 30-year-old was hospitalized two weeks ago and died Monday; preliminary tests strongly suggest he harbored H1N1. Tests designed to confirm his infection are pending in Atlanta at the US Centers for Disease Control and Prevention.

Since the arrival of the virus in Massachusetts in April, Boston appears to have borne a disproportionate share of the illness, said Barbara Ferrer, executive director of the Boston Public Health Commission. In addition to all four of the state's swine flu-related deaths, the city has recorded 475 of the 1,287 cases of swine flu confirmed in the state.

"Boston has about 11 percent of the state population but roughly 30 percent of the H1N1 confirmed cases," Ferrer said.

That ferocity has perplexed disease specialists.

"We are going to need to work closely with the state and CDC to understand the pattern of H1N1," Ferrer said. "As with any urban city, people live in much closer proximity with each other and given this is transmitted through respiratory droplets, that proximity is worth noting. The density in Boston is much greater than the density in a Webster or Wayland."

Earlier this week, health authorities reported that the virus had killed an 84-year-old Boston resident. The state's first swine flu victim was a 30-year-old mother from Boston who died June 14. Like the 30-year-old man who died on Monday, the woman suffered from none of the underlying medical conditions -- such as heart disease, asthma, diabetes, or cancer -- that can turn a relatively mild viral infection into a life-threatening illness, city disease trackers said.

Despite the four deaths, surveillance data show that for the first time since the virus hit the state, there is decreasing illness linked to influenza in Boston and across Massachusetts. Still, the level of flu activity is much higher now than normal for summertime.

Nationwide, the germ has proved most troublesome to younger adults and children, unlike the seasonal flu, which disproportionately harms the aged. More than two-thirds of the confirmed illnesses in Massachusetts have been in people under 25.

Some disease specialists theorize that older people may have added protection because they were exposed to H1N1 viruses circulating widely from 1918 to 1957, before those strains vanished for two decades. Other H1N1 strains have been circulating in recent years, however.

In this swine flu outbreak -- there have been more than 21,000 confirmed cases nationwide -- the vast majority of illnesses have been mild. But officials are concerned that the strain might re-emerge in the fall, possibly in a more virulent form.

Citing that possibility, Senator Richard T. Moore, an Uxbridge Democrat who chairs the legislature's Health Care Financing Committee, yesterday sent a letter to state public health Commissioner John Auerbach asking how various Massachusetts health and educational agencies are coordinating strategies to help protect the state's one million school-aged children.

State public health spokeswoman Jennifer Manley said preparing for the fall is a "high priority" for the department. She said Auerbach was unavailable to comment because he was flying back last night from the CDC in Atlanta, where he discussed this issue and other swine-flu related concerns with federal officials and health directors from around the country.

"It will be a busy summer of planning as we work with our partners in health care, in government, and with the public to prepare for the upcoming flu season," she said.