Utah's death toll from novel H1N1 influenza is now eight, including one in Davis County.

Hospitalizations have increased by 39 percent in the past week, although the 129 count is still well below what's typical with seasonal influenza. And Utah health officials are urging physicians not to wait for lab tests to treat patients for H1N1 if they have flu-like symptoms that can't otherwise be explained.

Utah is clearly being hit harder than neighboring states and possibly the entire rest of the country right now, says state epidemiologist Dr. Robert Rolfs. Experts agree there will be more hospitalizations and more deaths. But they also think it may be a matter of scale. For every so many people who get H1N1, some unknown percentage likely get very sick or even die. The larger the number of cases, the more severe cases.

And this pandemic seems to hit hardest a different demographic. Seasonal flu's most seriously ill victims are very young or older. H1N1 hits hard in the middle, although it's still most severe for those with existing chronic conditions.

Public-health officials are also struggling with how to get the "be careful" message across without over-hyping what's proving to be a somewhat moderate pandemic. It's a fine line, they say, between overemphasizing and failing to adequately warn.

"Early on, when novel H1N1 first hit the scene, I think there was maybe more alarming information than what the situation ultimately justified," said Davis County Health Department director Lewis Garrett. Severity of the illness was unknown, "so we had to assume the worst. … Had H1N1 been like bird flu, it would have been a catastrophe, and had we not all ramped up to put the word out, it would have been a bad mistake."

Such criticism is typical in any kind of outbreak, says Rolfs, who finds "some reassurance we're in the right place" when health officials are being criticized for too much and too little hype. "Pay attention to this and do what you can to protect yourself, then go ahead with your lives," is his advice.

He told a legislative committee that early steps such as closing schools in the state's initial outbreak site, Summit County, was not an overreaction. Little was then known about how severe the illness would be, and the precautions may have slowed transmission, as well. As experts gained more experience with H1N1, the precautions moderated.

But comparing H1N1 to a seasonal flu outbreak doesn't tell the whole story, says Salt Lake Valley Health Department director Gary Edwards. There's no handy vaccine for the pandemic flu, although it's probably coming. And at least some people have some immunity to seasonal flu, while that's not the case here, hence the "novel" in the name. H1N1 types have circulated before, but not this exact one, Rolfs says, although some similarity may be giving older people a bit of a break.

If a vaccine is developed, it will likely take two doses, not one: a howdy dose and an immune-building one.

The newly reported deaths include a Davis County man and a woman from Salt Lake County. Both were between the ages of 25 and 50 and died June 13. The six previously reported deaths, ranged from a child between the ages of 5 and 18 to a 58-year-old woman. Health officials say most of them of them had an identifiable underlying condition that made complications more likely. Those include being under age 5, pregnant or having certain chronic medical conditions.

More information is online at health.utah.gov/h1n1.

Contributing: James Thalman

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