Wednesday, March 17, 2010

Morbid Obesity And H1N1 Flu

 

 


# 4442

 

 

Very early on in the pandemic of 2009 it was suggested that obesity might be a risk factor for complications from the H1N1 virus.   This was based on anecdotal observations of ICU patients with flu related illness, many of whom were seriously overweight.

 

The earliest reference I can find in my blogging to an obesity connection was on May 25th (H1N1 Morbidity And Previously Existing Conditions), although the idea wasn’t fully fleshed out (sorry about that) until early July (see Obesity Seen As Major Risk Factor For Flu Complications).

 

Over the summer and fall we saw conflicting reports on the matter, with no firm conclusions.   

 

Until now. 


The CDC, following the publication of a study in PLoS One, has issued guidance on morbid obesity and influenza complications in the form of a Q&A page.   

 

First, the PLoS One research article,  then a few snippets from the CDC page.

 

 

 

Morbid Obesity as a Risk Factor for Hospitalization and Death Due to 2009 Pandemic Influenza A(H1N1) Disease

Morgan OW, Bramley A, Fowlkes A, Freedman DS, Taylor TH, et al. 2010 Morbid Obesity as a Risk Factor for Hospitalization and Death Due to 2009 Pandemic Influenza A(H1N1) Disease. PLoS ONE 5(3): e9694. doi:10.1371/journal.pone.0009694

Severe illness due to 2009 pandemic A(H1N1) infection has been reported among persons who are obese or morbidly obese. We assessed whether obesity is a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1), independent of chronic medical conditions considered by the Advisory Committee on Immunization Practices (ACIP) to increase the risk of influenza-related complications.

 

<BIG SNIP>

Our findings support observations that morbid obesity may be associated with hospitalization and possibly death due to 2009 pandemic H1N1 infection. These complications could be prevented by early antiviral therapy and vaccination.

(Continue . . . )

 

 

The CDC’s  Q&A  Page is lengthy, so just a few excerpts.   Follow the link to read it in its entirety.  

 

2009 H1N1 Flu In The News

March 16, 2010 10:30 AM ET

Morbid Obesity as a Risk Factor for Hospitalization and Death due to 2009 H1N1

This document provides updated information on obesity and morbid obesity as risk factors for serious 2009 H1N1-related complications based on findings from recent studies.

How are obesity and morbid obesity defined?

Body mass index (BMI) is a measure of body fat based on height and weight. Obesity is defined as a BMI of greater than or equal to 30 kilos per meter squared and morbid obesity is defined as a BMI greater than or equal to 40 kilos per meter squared. Among Americans 20 years and older, 28% are obese and 5% are morbidly obese.

Have obesity or morbid obesity been considered risk factors for serious flu-related complications in the past?

The Advisory Committee on Immunization Practices considers that certain chronic health conditions place persons at higher risk of serious flu related complications, including asthma, diabetes and heart disease, and emphasizes the importance of vaccination in people with these health conditions. In the past, neither obesity or morbid obesity have been considered independent risk factors that would place people at higher risk for serious flu-related complications.

What has been learned from the 2009 H1N1 pandemic about obesity and risk of serious influenza disease death?

During the 2009 H1N1 pandemic, early reports from the United States and abroad suggested that obesity was more frequent among persons hospitalized with 2009 H1N1 disease or who died following 2009 H1N1 infection.

Since that time, a number of studies have suggested that many 2009 H1N1patients tend to be morbidly obese. The study “Morbid Obesity as a Risk Factor for hospitalization and Death due to 2009 Pandemic Influenza A (H1N1) DiseaseExternal Web Site Icon,” published in PLoS ONE, sought to determine whether or not obesity or morbid obesity were in fact independent risk factors for serious 2009 H1N1-related complications, including death.  This study found that morbidly obesity persons have a higher risk of hospitalization for 2009 H1N1 infection compared to persons with normal weight. Data from this study also suggest that the risk of death following H1N1 infection may be higher for morbidly obese individuals.

 

 

Other than losing weight, and living a generally more active lifestyle, the CDC’s main recommendation is to take advantage of the flu vaccination.   This year, and every year.