Modesto Bee Article

By Garth Stapley, Modesto Bee Staff Writer
last updated: September 1, 2009


Unknown - Amanda De La Rosa, 19, who passed away August 27, 2009 at Doctors Medical Center in Modesto. Amanda De La Rosa worked at the Great Valley Academy and attended First Baptist Church of Modesto.

Swine flu killed a new mother and another woman last week, bringing to four the number of confirmed H1N1 virus victims in Stanislaus County, officials reported Monday.

Also Monday, the coroner's office announced that H1N1 probably was not to blame for the sudden death of a 19-year-old elementary school worker last week in Modesto. But authorities still don't know why she died.

The county's Health Services Agency released few details on the latest deaths from H1N1, saying only that a 29-year-old "postpartum female" and a 45-year-old woman, both hospitalized, died Wednesday.

"We are particularly concerned about pregnant women," said Cleopathia Moore, the agency's director of maternal, child and adolescent health. "It is important that they remain vigilant in protecting themselves from being exposed to the H1N1 virus."

Federal officials reported 8,843 hospitalizations and 556 deaths from H1N1 last week, up from 7,983 hospitalizations and 522 deaths the week before.

Local public health officials initially suspected Amanda De La Rosa may have fallen victim to the pandemic. But tests for H1N1 came back negative and an autopsy was inconclusive, Chief Deputy Coroner Kristi Ah You said Monday.

"We let the family know that in 2 percent of cases nationwide, sometimes a cause of death is undetermined," Ah You said. "We're going to do our best. We don't want to have the cause of death undetermined. But that is a possibility."

De La Rosa had cared for children before and after school at Great Valley Academy on Tully Road in Modesto, where her mother is a secretary. School administrators sent home some children exhibiting flulike symptoms after she died Thursday. Attendance was down by nearly one-half Friday after news spread that public health officials suspected H1N1.

The victim's mother, Neva De La Rosa, said heartbroken friends and family are mystified. Her daughter came down with flu symptoms Aug. 21 but recovered enough to return to work Aug. 25 and happily ate a grilled cheese sandwich and fries with ranch dressing that night, she said.

On Wednesday, she took her daughter to a doctors office and they were referred to a hospital emergency room, where family members spent a sleepless night. Amanda did not respond to treatment and died the next morning, her mother said.

"I go through all these questions in my head," Neva De La Rosa said. "I've got two (other) kids to live for. But how do you keep going? It's day to day."

Her ex-husband, Roger De La Rosa, said loved ones remain "at a loss."

More info in 2-3 weeks

The coroner's office expects results from further toxicology tests in two or three weeks, Ah You said. Extra tissue samples have been sent to state laboratories, which will screen them for several diseases.

Monday's negative result came from a "focus" swab. But "viral antigens may be sparsely distributed in patients with influenza; one area may be negative while another is positive," Ah You said.

"With the information available to us, we don't believe she had H1N1," she continued. "But because we don't have a cause of death, we're going forward with these tests to make absolutely sure. In the process, we may find she had a different type of influenza, or (something else)."

Great Valley Academy founder Eldon Rosenow said the young woman's death is "still tragic, but knowing it's not swine flu has settled our parents down a little." Attendance dipped to about half of the school's 500 students the day after De La Rosa's death but rebounded Monday, he said.

"Healthy children need to be in school," said Jane Johnston, assistant superintendent of the Stanislaus County Office of Education. "We are confident that our schools are taking appropriate steps to maintain safe and healthy environments."

Dr. John Walker, the county's public health officer, said no measure exists to pinpoint how quickly the virus is spreading. "We do use some surveillance techniques to get a sense of what's going on in the community," he said, "and I'm confident we have a fair amount of H1N1 activity going on. But the vast majority is outpatient," similar to seasonal flu.

More than half of the 40 or so people hospitalized with H1N1 in Stanislaus County were women and patients' median age is about 30, according to a Health Services Agency release. Pregnant women and children less than 5 are at higher risk for complications, the notice reads.

Vaccinations could be available in the fall.

Bee staff writer Garth Stapley can be reached at gstapley@modbee.com or 578-2390.