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October 12, 2009
Swine flu vaccination
CHICAGO (AP) -- 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. (17 images)

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Three-year-old Clayton Mathiason of Omaha, Neb. reacts after he received a dose of Swine Flu vaccine via nasal spray, at Physician's Clinic, affiliated with Omaha's Methodist Health System, in Omaha, Neb. on Tuesday, Oct. 6. AP / Nati Harnik


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Athletic trainers Roni Emert, center, and Brian Parker, left, take students' temperature, Tuesday, Sept. 29, in Huntsville, Texas, before the start of football practice. All schools in the Huntsville Independent School District are closed until Thursday due to students and staff being sick. Concerns about swine flu and other illnesses have led to numerous absences at schools statewide. Houston Chronicle / Michael Paulsen



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Melissa Bennett, 23, of South Bend, sits in the waiting room with her daughter Destinee, 5, who is experiencing flu symptoms, at Granger Family Medicine in Granger, Ind., Wednesday, Oct. 7. H1N1 arrived in the South Bend, Ind., area about one month ago. The South Bend Tribune reported that Mercedes Lewis, 11, of South Bend, died Tuesday after being admitted to the hospital with symptoms including a sore throat. Lewis was reportedly healthy until Monday. South Bend Tribune / Jim Rider



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Duncan Barnes, 1, being held by his mother Jennifer Barnes, reacts after receiving vaccine for swine flu from Dr. Allison Ross, left, and at the same time a vaccine for seasonal flu from a nurse at right, during a swine flu vaccination clinical trial for children at Emory Children's Center Sept., 2, in Atlanta. AP / John Amis



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Drennan Barnes, 3, watches as a nurse takes a measurement of the mark left on her arm after receiving a swine flu vaccination during a clinical trial for children at Emory Children's Center Sept., 2, in Atlanta. AP / John Amis



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Registered nurses Michelle Lambert, second from left, of the Cleveland County Health Department, and Angie Strawderman, right, of the McClain County Health Department, administer doses of swine flue nasal spray vaccine to children at Newcastle Elementary School in Newcastle, Okla., Wednesday, Oct. 7. AP / Sue Ogrocki



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Dr. Kevin Rodriguez, left, a frontline care provider, is given the swine flu live virus vaccine nasal mist by nurse practitioner Judy Gallob at the Maricopa Medical Center Thursday, Oct. 8, in Phoenix. Only healthcare providers will be issued this first-run of the swine flu vaccine, while the general public will be getting the injection version of the vaccine starting next week. AP / Ross D. Franklin



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A child is restrained as he receives a nasal spray during a vaccination clinic held by Montgomery County Health and Human Services for the H1N1 virus on October 9, at the Dennis Avenue County Health Center in Silver Spring, Maryland. AFP / Getty Images / Tim Sloan



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A box holding nasal spray doses of the H1N1/ swine flu vaccine is seen at the Montefiore Medical Center Oct. 6, in the Bronx borough of New York City. About 68,000 doses of the vaccine have arrived in the city so far and around 560 were administered yesterday. Some of the first doses are being administered to health care workers and children in a massive citywide vaccination program. Getty Images / Mario Tama



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A nasal spray dose of the H1N1/ swine flu vaccine is prepared for Brandon Marti, 13, at Montefiore Medical Center October 6, in the Bronx borough of New York City. About 68,000 doses of the vaccine have arrived in the city thus far and around 560 were administered yesterday. Some of the first doses are being administered to health care workers and children in a massive citywide vaccination program. ) Getty Images / Mario Tama



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Doses of H1N1 influenza vaccine sit in a basket at Rush University Medical Center Oct. 6, in Chicago, Illinois. Rush is one of many hospitals and clinics that have started to distribute the vaccinations against the H1N1 swine flu virus in the United States this week. Getty Images / Scott Olson



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Mike Castling, left, is injected as part of a clinical study of the H1N1 vaccine as Health and Human Services Secretary Kathleen Sebelius, center, and U.S. Rep. Wm. Lacy Clay, D-Mo., stand nearby during a tour of Saint Louis University's Center for Vaccine Development where work on the H1N1 flu vaccine is being conducted Tuesday, Oct. 6, in St. Louis. AP / Jeff Roberson



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A woman receives a flu vaccination in the western German city of Mainz on October 7. A vaccine for run-of-the-mill flu also provides some protection against swine flu, especially the severest forms of the disease, Mexican scientists report on October 7. AFP / Getty Images / Torsten Silz



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Dr. Toral Shah examines Sammi Jiminez, 4, in a tent clinic where patients with flu symptoms are treated outside the emergency room at Dell Children's Hospital Monday, Sept. 28, in Austin, Texas. AP / Harry Cabluck



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Patients receive nasal spray vaccine for the H1N1 virus during a clinic held by Montgomery County Health and Human Services on Oct. 9, at the Dennis Avenue County Health Center in Silver Spring, Maryland. AFP / Getty Images / Tim Sloan



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A volunteer directs foot traffic during a H1N1 vaccination clinic held by Montgomery County Health and Human Services on Oct. 9, at the Dennis Avenue County Health Center in Silver Spring, Maryland. AFP / Getty Images / Tim Sloan



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Danielle Lecky M.D., right, receives the live, attenuated nasal spray vaccine for H1NI influenza at the Children's Hospital of the King's Daughters in Norfolk, Va. on Friday, Oct. 9. The vaccine was mandatory for the hospital staff, and coincided with a news conference about Virginia's preparedness for H1N1 vaccinations by State Health Commissioner Karen Remley M.D. The Virginian Pilot / Amanda Lucier



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