27-year-old Chesapeake mother dies of swine flu

Angela Mefford's cough early last week seemed run-of-the-mill.

Her husband said he figured it was caused by a change in the weather, or a simple cold. Then the 27-year-old mother of two developed a fever, and last Wednesday she went to the emergency room at Chesapeake Regional Medical Center.

Even after a doctor said Angela probably had contracted the H1N1 flu, or swine flu, Hank Mefford and his wife still didn't worry too much.

After all, the Chesapeake woman wasn't in any of the "priority" high-risk groups. She didn't have asthma or heart disease or diabetes or other health problems. She wasn't pregnant. She was not in the population of children and young adults through age 24 that the virus has been hitting the most.

But by Friday, the fever had not broken, her breathing was labored and she went back to the emergency room. This time, she was diagnosed with pneumonia and admitted to the hospital.

On Saturday, she died.

"It just tears you up," said Angela's mother-in-law, Janice Mefford. "One day she was here, and the next she's gone."

Angela's is the third swine-flu-related death reported in this region. The first was a Chesapeake woman who died in June at the age of 34; the second was a teenage girl in the Western Tidewater Health District who died in September. Both had underlying health conditions.

Virginia has officially reported 17 H1N1-related deaths, but that figure doesn't include Angela's.

Chesapeake Health Director Nancy Welch said she received confirmation Tuesday evening that the woman had the H1N1 flu. In reviewing the records, she said the virus took a rapid course but that Angela Mefford did everything health officials would advise.

Welch said Mefford did not fall into any of the priority groups that were advised to get the H1N1 vaccine but that she did fall into a health category in which more than the usual percentage of people die. Because of privacy issues, Welch could not say what that was.

Hank Mefford said his wife didn't have any other health conditions, other than suffering a case of bronchitis about once a year and being a little overweight.

Welch said Angela's death fit a pattern of what is being seen across the country, as reflected in a report released Wednesday by the Journal of the American Medical Association. The study showed that while young people may be more likely to contract the virus, adults are more likely to have severe complications and death.

The study surveyed the records of 1,088 people in California who needed inpatient care or died of the pandemic flu strain between April 23 and Aug. 4. The median age was 27. The rate of hospitalization was highest in infants under 2 months of age, but the rate of death was highest in people older than 50.

The study also showed higher rates of hospitalization and death among people with high blood pressure, high cholesterol and gastrointestinal disease. The study showed 58 percent of those who were hospitalized were obese, a higher rate than the general population. That condition can reduce lung function, which can make it difficult to overcome respiratory infection.

The study said the risk of complications in overweight people seems to be higher in H1N1 cases than in regular winter flu.

Hank Mefford said his wife went to the emergency room at Chesapeake Regional Medical Center last Wednesday because she didn't have health insurance to see a regular doctor. He said she received some pain medication, but no anti-viral medication, and was sent home.

By Thursday, the couple's 7-month-old son, Hank Mefford Jr., also had contracted the flu. Janice Mefford took the boy to the emergency room that day and a doctor said he, too, probably had the H1N1 flu.

The boy was given Tamiflu, an anti-viral medication that eases the symptoms. The medication is generally given to people in high-risk categories or people who are hospitalized with severe symptoms. Welch said that's in keeping with a recommendation from the Centers for Disease Control and Prevention to help keep the H1N1 virus from becoming resistant to the medication.

By Friday, Angela's symptoms continued to worsen and she had a hard time breathing. She went back to the emergency department at Chesapeake Regional on Friday evening, where she was diagnosed with pneumonia, one of the most common severe complications of H1N1. She was put on a respirator to help her breathe.

When Hank arrived the next morning, a doctor told him her chances of living were 50-50.

"They said it didn't look good," Hank said.

She died about 1 p.m., he said.

"They did everything they could for her," he said.

Hank said the family was in shock at how fast the disease progressed.

The couple's son has improved but still has a cough, so Hank took him to the doctor again Wednesday. Angela also had an 8-year-old daughter from a previous relationship.

Hank said the family doesn't have life insurance but that Altmeyer Funeral Home is handling the funeral arrangements.

Donations can be sent to Altmeyer Funeral Home Southside Chapel, 5792 Greenwich Road, Virginia Beach, VA 23462.

Welch said that in a small number of flu cases, both H1N1 and other strains, people suffer complications and die. About 36,000 people a year in the United States die from the regular winter flu. In Virginia, it's estimated about 1,000 people die a year of seasonal flu or pneumonia.

So far, about 1,000 people in the United States have died from complications due to the H1N1 flu.

Welch said she hoped the death would not unnecessarily alarm people to the point that they go to the emergency room or doctor for mild or moderate symptoms. Most flu cases can be treated at home, she said, and only people who are showing severe signs, such as dehydration, confusion and shortness of breath, need to call a doctor to ask for advice.

Joan Stanus, public spokeswoman for Chesapeake Regional Medical Center, said the hospital has been seeing an increase in people with flu-like symptoms since mid-October. She said the hospital had eight inpatient admissions related to the flu last week, which was a peak for the season.

As in hospitals across the region and country, doctors there are advising only people with flu-like symptoms that have led to complications or those in high-risk groups to seek medical treatment or advice.

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com