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Indian Journal of Cancer, Vol. 47, No. 2, April-June, 2010, pp. 231 Letter To Editor Swine flu: High mortality in cancer patients Wiwanitkit V Wiwanitkit House, Bangkhae, Bangkok, 10160, Thailand Correspondence Address: Prof. Viroj Wiwanitkit, Wiwanitkit House, Bangkhae, Bangkok, 10160, Thailand wviroj@yahoo.com Code Number: cn10059 PMID: 20448399 DOI: 10.4103/0019-509X.63015 Sir, Swine flu is a new emerging infectious disease that has just emerged since early 2009. [1],[2] Starting from its primary foci in Mexico, the new disease is currently spread around the world (July 2009). The new disease is accepted as a new variant of influenza virus infection. It is an atypical influenza caused by a new strain of H1N1 influenza virus infection. Similar to classical influenza, death can be the outcome of this new emerging infection. In this specific paper, the author hereby reports and discusses on the high mortality of cancer patients with swine flu based on the scenario from Thailand. The author hereby reviews on the reports of swine flu in Thailand from several sources (both international journals and local journals and official reports) in Thailand and focuses on the morbidity and mortality data. According to this study, in July 2009, there were 4,057 infected cases of swine flu in Thailand with 24 death cases (according to the report of the Ministry of Public Health Thailand, 14 July 2009). There are only two reported cancerous patients who ended up with death (a case is an 8-year-old patient with leukemia and the other is a 67-years-old patient with end-stage lung cancer). The prevalence of death outcome in cases that are infected with swine flu is equal to 100%. Death in cancer patients due to superimposed infection, especially in patients who are on chemotherapy, is well described. [3] However, classical influenza is not classified as a possible superimposed opportunistic infection in this case. There is no doubt that there are only two cases infected with swine flu in the scenario of Thailand since the ratio of cancer patients to the overall infected patients reflects the normal ratio of cancer cases to the general population in Thailand. Of interest, the important notification is that all cancer cases with swine flu ended in death. This rate is also significantly higher than that seen in cancer patients with classical influenza, which is < 15%. [4],[5] Special closed management of cancer patients with swine flu is recommended. However, this work is only a preliminary report and the author suggests for more clinical observations to set the finalized conclusion. References
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