A review of 1,400 hospitalizations from ten states and large cities participating in a CDC influenza surveillance system suggests some risk factors for serious complications from H1N1 swine flu.

According to Dr. Anne Schuchat of the CDC, of 1,400 adult hospitalizations, 26 percent of patients had asthma, 10 percent had diabetes and 6 percent were pregnant.

Schuchat said more than 9.8 million doses of vaccine have been made available to states, and more is rolling out all the time.

To find public sites where vaccine may become available, go to http://www.flu.gov or http://www.vdh.virginia.gov.

Virginia health care workers have already started getting vaccinated. The Richmond Ambulance Authority last week started vaccinating workers with the nasal spray version of the vaccine.

Today’s Wall Street Journal has a story on the situation.

The Canadian action has also been covered by The Globe and Mail , Web MD, The Canadian Press.

More information is available from archives of news briefings of the Public Health Agency of Canada.

CDC director Dr. Thomas Frieden, when asked recently about the research at an Oct. 1 briefing, said:

“In terms of the media reports coming out of Canada, there are reports that the—in some analyses, people who received the seasonal flu vaccine were more likely to get h1n1 infection. We have looked at our data at the CDC nationally. I have looked carefully at the data from New York City where we had a very large outbreak and lots of information about what vaccine was received. The Australians have looked at it and published their information. And in none of those data is there any suggestion that the seasonal flu vaccine has any impact on your likelihood of getting h1n1. It doesn’t protect you at all and there’s no suggestion from any of the other data sets that it increases your risks. If data is published in the scientific literature, but all means, we would love to see it. If there’s preliminary data, we would love to see it. But nothing that wove seen suggests that that is likely to be a problem.”

“We heard from our readers,” said Judy Norsigian, a founder of the Boston Women’s Health Book Collective, which authored the book series.

They asked, “Why did you take this out. Don’t you know how many women are affected.”

Subsequently there were studies,” said Norsigian. “It is a greater problem than we assumed,” she said, and the section was returned.

Registration is full for a Friday forum featuring Norsigian and organized by the VCU Institute for Women’s Health, but people are still welcome at a Thursday event 7-9 p.m. at the Gay Community Center of Richmond’s Art Gallery Space, 1407 Sherwood Ave. There are about 20 slots left.

In advance of her trip to Richmond, I talked to Norsigian about women’s health issues. Here are excerpts from that interview.

Q. Women today can find a lot of health information on the Web. Is there still a need for books like Our Bodies, Ourselves.
A. Norsigian: “When we got going there was nothing out there is lay language for women. It was an abyss. Even educated women were remarkably ignorant about their bodies, about childbirth contraception, basic things. What’s happened is over the years is much more women’s health information is available everywhere. But there are a few problems that haven’t changed. One is partly because of the profit motive and the role of the pharmaceutical industry and other profit interests, we often see women’s normal health stages of their lives medicalized in unnecessary ways. If we were just wasting out money it would be one thing. There are harmful effects of this medicalization. Over the years what our challenge has been was to point to evidence-based practices. Where and when do we intervene, when do we get the best outcomes.

“The Internet is loaded with a tremendous amount of misinformation. There is tremendous need for good quality information that guides women so they can make good decisions. Especially with the advertising and the advertorials and the inability to know the source of your information when you are on the Web. It’s critical to look twice to find out who is behind the Web site or source of information that they are looking at.”

Q. Who are your sources for Our Bodies, Ourselves?
A. Norsigian: “We have built up a pool of a few thousand incredible people, several hundred are probably our most common advisers. They are experienced in decades of research and clinical (practice) or have been advocates for many years. The knowledge base is huge. What we do, whenever we produce something, a Web-based article or chapter for our book, for instance, we run it by numerous reviewers.“

Q. What’s new in the most recent edition?
A. Norsigian: “The 2005 edition updated every single chapter. So whether you are looking at nutrition, the environment, workplace safety or cancer, or childbearing or violence in women’s lives, we introduced lots of new material.”

“We have two single-topic books. We produced Our Bodies, Ourselves Menopause in 2006 and Our Bodies, Ourselves Pregnancy and Birth in 2008. The latter of the two has received a huge amount of attention.”

Q. What are some controversial topics in women health?
A. Norsigian: “One of the things we discovered in the course of working in the pregnancy and birth book is this is one of the areas where we have medicalized an aspect of women’s lives so far and so extremely that we are now seeing the downside. We are actually in good studies measuring poorer outcomes from the higher rates or intervention. Cesarean section is probably the most famous example. But a lesser well-known example which the American College of Obstetricians and Gynecologists is dealing with right now is the use of medically unindicated induction, that’s starting your labor before 39 weeks of pregnancy. What it’s done it’s produced a whole rash of premature births that have led to low-birth-weight babies and premature babies. This is causing the NICUs to fill up. Some hospitals have reviewed what has happened when they eliminate the practice of unnecessary early induction.”

“One other issue is the use of breast implants for augmentation purposes, totally elective not for reconstruction after breast surgery. The figures are startling, especially among younger women who are going to the Web and getting misinformed. We are trying to reach younger women with the actual evidence. There is a filmmaker who produced a very balanced film called Absolutely Safe that we’re trying to show in more colleges.”

The winning video was unveiled at George Mason University, which has a “handful of cases” of flu-like illness.

Dr. John Clarke, a New York physician and father of two children, rapped his way to the top with his hip-hop prevention message to wash your hands. He ended his acceptance speech at George Mason with a rap, “Long term outcome…never sick again from the H1N1.”

His video will be shown nationally and he gets $2,500. Clarke said his wife encouraged him to make the video.

People voted on YouTube, where all the finalists were featured.

Questions and answers from the CDC Web site.

•How do I sign up?
Send a text message with the word HEALTH in the body of the message to 87000.
•Is there a cost?
CDC does not charge subscribers to participate in this pilot program. Standard text messaging rates from your wireless carrier may apply.
•How many messages will I receive?
When you sign up, you will receive four introductory messages/questions. After that, you should expect to receive three health tips each week.
•How do I opt out?
You can opt out at any time by sending a reply with the word HEALTH QUIT in the body of the message.

“Isn’t this remarkable,“ said Dr. Donald Stern, Richmond City Health District director, at a quarterly meeting of the Richmond Healthy Start Initiative Consortium.

There were 36 infant deaths in 2008, compared to 41 in 2007, dropping the city’s infant mortality rate form 12.4 deaths per 1,000 live births to 10.6, still higher than the state rate of 6.6

Consortium partners include other city agencies – including mental health, parks and recreation, social services — and community agencies such as the March of Times, VCU and others.

Read more in tomorrow’s Richmond Times-Dispatch.

Consortium members network at their quarterly meeting held at the Pine Camp Cultural Arts & Recreation Center.