Many of the articles here and elsewhere about H1N1 have noted that relatively few of the thousands of students with H1N1 or its symptoms have required hospitalization and that there have been no student deaths. Sadly, the latter statement is no longer true.

Andrew Salter, a freshman at Troy University, died Friday. News reports said that he had been treated for flu-like symptoms believed to be H1N1 and had been thought to be on the way to recovery. But apparently in a weakened state from the H1N1, he contracted pneumonia and was admitted to a hospital, where he died. Also, a continuing student at the University of Nebraska at Omaha died from H1N1 complications last month, but she had yet to arrive on campus for the fall semester when she died, The Omaha World-Herald reported. This student had significant and serious health problems before contracting H1N1, the newspaper said.

James Turner, president of the American College Health Association and executive director of student health at the University of Virginia, said in an interview he was "not surprised" that there have been fatalities related to H1N1. Turner stressed that he had no direct knowledge of the medical situations of these students. But in talking generally about what is known about H1N1, he said in past cases of dangerous flu outbreaks, many of the deaths have not been directly from the flu, but from pneumonia or other illnesses contracted while someone has the flu or is recovering from it.

Further, he said that people with serious health problems are much more likely than others to be hit hard by H1N1.

At the same time, he noted that at his campus (where there have been 34 cases in recent weeks, none serious enough to require hospitalization) and elsewhere, most students are recovering and doing so quickly. "We need to emphasize that the risk of something bad happening remains very low. It's not zero, but it remains low," he said.

Herbert Reeves, dean of students at Troy, said that the student who died had never sought treatment at the campus health center, but went home for treatment when he became ill. Since classes started for the fall semester three weeks ago, he said that the campus health center has been diagnosing five or six cases of flu each day. At the beginning, the center was sending swabs to state public health officials to confirm H1N1, but the public health centers are so overwhelmed that they told the university to stop sending the swabs and to just treat all of the cases as H1N1.

Most of the students have "self isolated," either by going home or staying in their rooms, Reeves said.

Reeves said he had last spoken with the father of the student who died a day before he passed away, so he had been hopeful that the student would recover. The university has been spreading the word since the semester started about the importance of preventing the spread of H1N1, and would continue those efforts.

One of the largest outbreaks to date was reported late last week at Washington State University, where more than 2,000 students are sick with H1N1-like symptoms, The Spokesman-Review reported. No students have been so sick as to require hospitalization.