New studies suggest that “[d]eveloping countries with limited access to advanced health-care facilities may be in for a rough ride with swine [H1N1] flu and even countries with high-tech ICUs may find themselves pushed to the limit as their hospitals struggle to save gravely ill H1N1 patients,” the Canadian Press reports. The studies, which compare outcomes among H1N1 patients admitted to intensive care units in Canada and Mexico,” show “the death rate in the latter was more than double that seen among Canadian patients. Just over 40 percent of critically ill Mexican patients succumbed to their illness by day 60, compared to 17.3 percent of Canadian patients by day 90.” The findings were reported online in the Journal of the American Medical Association (JAMA) on Monday (Branswell, 10/12).

One study examined six hospitals in Mexico between March and June, and the “Canadian study … involved 168 critically ill patients treated at 38 hospitals between April and August,” the Associated Press reports (Tanner, 10/12). The studies also revealed the toll H1N1 was taking on hospital intensive care units, ABC News reports. “In Winnipeg — site of the largest cohort of pandemic patients in Canada — all intensive-care beds were occupied with H1N1 flu patients when the outbreak peaked in June … And, in Mexico City, six major hospitals were so busy that admission to intensive care was delayed, and four patients died in the emergency department before they could get to the ICU,” the news service writes (Chitale/Smith, 10/12).

In an accompanying JAMA editorial, two U.S. doctors examine the strain H1N1 could place on U.S. hospitals, Agence France-Presse reports (10/12). “Hospitals must develop explicit policies to equitably determine who will and will not receive life support should absolute scarcity occur,” the authors write in the editorial. “Any deaths from 2009 influenza A(H1N1) will be regrettable, but those that result from insufficient planning and inadequate preparation will be especially tragic” (White/Angus, 10/12). TIME’s “Wellness” blog also includes a breakdown of the findings of the JAMA articles (Sharples, 10/12).

U.S. Begins H1N1 Vaccine Trial In Pregnant Women, Children Living With HIV

UPI examines the first H1N1 vaccine trials in pregnant women living with HIV in the U.S. A second trial of HIV-positive children is scheduled to begin next week (10/12).

WHO To Send 60M Doses Of H1N1 Vaccine; Kenya Named One of 100 Recipients

In related news, the WHO said Monday it plans to soon begin shipping out 60 million doses of the H1N1 vaccine to 100 low- and middle-income countries over the next four to five months, the AP reports (Jordans, 10/12). The Standard reports that the WHO named Kenya among the first 100 countries to receive the H1N1 vaccine (Orengo, 10/12).

The Health Minister of Egypt on Monday announced the country plans to manufacture its own H1N1 vaccine by 2011, Reuters reports. Until then, however, the country has ordered 5 million doses of the vaccine and requested 15 million additional doses from the WHO (Blair, 10/12).

Tanzania Reports First East African
H1N1-Related Death 

In an effort to stop the spread of H1N1 in Tanzania, health officials have quarantined 50 people following the region’s first H1N1-related death, IRIN reports (10/12).