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Wednesday, Jul. 08, 2009

Stanislaus County's first swine flu victim mourned by her family

H1N1 claims big sister helping to raise 4 siblings

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After her mother's death five years ago, Rosario Rivera took on the burden of watching her four younger siblings, making sure they ate breakfast and got to school.

The 21-year-old Ceres resident was attending school to become a medical assistant and better her life, proudly wearing the uniform the school gave her.

Rivera's chances were cut short last week, when she became the first to die from swine flu in Stanislaus County. She died July 1 from complications of pneumonia at Doctors Medical Center in Modesto.

Family members said they didn't know she was stricken with swine flu until a county public health nurse told them Monday.

"Even though she was struggling for money and food, you would always see her with a smile," an aunt said. "She never showed the stress she was going through."

Her death left family members wondering if they had been exposed to the influenza virus that has caused 170 deaths nationwide.

"About 100 people went to visit my daughter and the doctors never told us she was sick with that," said Guillermo Rivera, Rosario's father. He noted that relatives were hugging and kissing the young woman and "were with her until the end."

Rivera got sick about two weeks ago and went to the hospital June 26 because of a severe headache and pain in her stomach, her father said.

Her breathing became extremely labored at the hospital and the next day — her birthday — doctors put her in the intensive care unit at DMC for treatment of pneumonia.

Her father brought balloons and roses to the hospital but found doctors had put a tube in Rivera's throat and hooked her to a machine to help her breathe.

Rivera's condition steadily declined and she was pronounced dead July 1. The initial record of her death said she died from pneumonia caused by an "unknown organism." The family was making funeral arrangements Monday when county public health officials told Rivera's father it was swine flu.

Rivera was one of the four cases of H1N1 influenza in the county, all reported in the past three weeks. The other patients have recovered. County officials said they notified the Rivera family as soon as they got the test results, which came five days after her death.

Doctors Medical Center officials said they could not comment on the case because of patient confidentiality, but said the hospital follows the state's contagious disease guidelines for swine flu.

The hospital met with public health officials Monday and notified employees to reinforce the heightened level of awareness for H1N1, a spokeswoman said.

Dr. Eric Ramos, medical director at DMC, said a patient coming to the hospital may not have obvious signs of flu. If it's suspected they could have swine flu, those patients are put in rooms by themselves and given masks. Masks are worn by nurses attending to the patients.

People with flu symptoms are told not to visit patients in the hospital, and people visiting patients with the flu are advised to take precautions. "We are probably going to be using more masks as the number of cases increases," Ramos said.

Rivera's death leaves a void for three younger brothers and a sister who looked to her for guidance. Her brother Angel, 18, said at her funeral Tuesday that she became more than his big sister after their mother died in 2004, within a year of having heart surgery.

County health officials, who never released the patient's name, said the patient had pre-existing health conditions that made her more susceptible to swine flu. Rivera had diabetes, family members said, but she was energetic and excited when she started attending Kaplan College in Salida a month ago.