Cases of Multi-Organ Failure

indigo girl · Jun 16, 2009

http://www.freep.com/article/20090613/NEWS03/906130331

6/13/09 - Wisconsin

...Settlemoir had a history of asthma and hypertension, but the 28-year-old was otherwise healthy. Friday, he died unexpectedly.
Ryan Settlemoir, who became a Madison Heights officer in 2002, was hospitalized June 1 at Henry Ford Macomb Hospital in Clinton Township with flu symptoms and respiratory problems. He was airlifted to the U-M Medical Center on June 2, Sagan said.
According to officials from U-M, the general cause of death was lung failure, acute respiratory distress syndrome and multiple-organ failure.

6/14/09 - Jalisco, Mexico

http://www.flutrackers.com/forum/showpost.php?p=248547&postcount=14

Translated article:

Francisco died yesterday at 15:40 hours Saturday after spending a month and 24 days in hospital, according to the Civil Hospital yesterday in a statement, "for serious complications and sequelae introduced as a result of a severe pneumonia, a source of income Hospital registered last April 19. " He explained that the little one suffered multiple organ failures, as a consequence of a serious complication caused by their lung function fibrosis that was created, in turn, by pneumonia.
In the communiqué issued yesterday, the Civil Hospital with details describing the evolution of the child. Said that he was the April 19, but his medical history that had presented symptoms of respiratory problems since April 11. On admission, he was diagnosed with pneumonia, in principle operated as of bacterial origin.
The April 23 national alert was issued by the influenza A-H1N1 and Francisco came to be considered a probable case. Was reported to the Committee on Epidemiology of Civil, he took samples to test for immunofluorescence influenza type A and, as the results came in, he tried anyway, with the antiviral oseltamivir (Tamiflu), despite that this review was negative. Fifteen days later, in May, and completed the treatment with Tamiflu, came the diagnosis of Indre: positive.

indigo girl · Jun 16, 2009

http://www.todaystmj4.com/news/local/48007842.html

6/13/09 - Milwaukee, Wisconsin

Barbara Davis, 48, was healthy just a week ago.
Barbara told her mother that she was ok. But the next day, things got worse. She had trouble breathing, and she was shaking. She could barely walk into the hospital.
"She tried to talk to people, but she just couldn't talk," Josephine Davis said.
Doctors treated her for two days, but they couldn't save her. They believe she died from swine flu.

"They've never seen nothing like that, what she had. That infection just went through her body, attacking her kidney, her lungs, her liver. Everything," said Josephine Davis.

indigo girl · Jun 17, 2009

http://news.stv.tv/scotland/103146-swine-flu-did-kill-glasgow-mum/

We have already posted on this case as this woman had been pregnant. The new information is that she died of multi-organ failure, and the baby has died also. I believe that he was in the NICU. How very sad to hear this...

Officials have confirmed that the woman with swine flu who died after giving birth prematurely died from the H1N1 virus itself.
Jacqui Fleming, 38, of Glasgow, died in hospital in Paisley on Sunday, two weeks after giving birth.
Her baby son Jack died on Monday from complications but not from swine flu.
A statement from the Crown Office confirmed Ms Fleming died from swine flu.
It said: "The death of a 38-year-old woman, Jacqueline Fleming, at the Royal Alexandra Hospital, Paisley, on 14 June 2009 was reported to the Procurator Fiscal at Paisley.
"With the agreement of her family, we are able to confirm that the cause of death has been certified as multi-organ failure due to influenzal pneumonia (H1N1)."

indigo girl · Jun 17, 2009

Milwaukee teen is latest swine flu fatality in Wisconsin

http://www.fox6now.com/news/witi-090...,1839694.story

Posted also in the thread for cases without prior existing conditions. It is very hard to read about these cases.

Fourteen-year-old Tiara Mosely-Forrest died two weeks after being rushed to Children's Hospital of Wisconsin, unable to breathe. But her uncle, Vernon Mosely, tells FOX 6 News Tiara went from being a healthy high school sophomore to the latest H1N1 Swine Flu Virus fatality.
The 14-year-old had a complete physical, blood tests and immunizations in May. The doctor told her the she was in good health.
Tiara first started complaining of chest pain in late May. The pain got so bad her brothers had to rush her home from the movies May 31. By late evening June 1, she could not walk on her own.
She spent the last two weeks of her life on a ventilator in the intensive care unit, where doctors eventually confirmed she had the H1N1 Swine Flu Virus.
Her mother says Tiara died June 15 from influenza, pneumonia in the lungs, a staph infection and multiple organ failure.

ORTech2RN · Jun 18, 2009

Maybe multi organ failure is related to a secondary infection of Streptococcus Pneumonia? From what I've read, deaths in past pandemics (in young,healthy victims) were from Strep infections in virus damaged lungs. Not only would Strep account for dyspnea and cyanosis, but it could lead to Septicemia As we know know, once the bloodstream is infected, it's open season on the rest of our body. A couple of things to think about: Would a mass immunization of Pneumovax reduce the mortality rate of H1N1? Also, in probable Influenza cases, would it be a good idea to give an antibiotic as a prophylactic treatment?

indigo girl · Jun 18, 2009

Maybe multi organ failure is related to a secondary infection of Streptococcus Pneumonia? From what I've read, deaths in past pandemics (in young,healthy victims) were from Strep infections in virus damaged lungs. Not only would Strep account for dyspnea and cyanosis, but it could lead to Septicemia As we know know, once the bloodstream is infected, it's open season on the rest of our body. A couple of things to think about: Would a mass immunization of Pneumovax reduce the mortality rate of H1N1? Also, in probable Influenza cases, would it be a good idea to give an antibiotic as a prophylactic treatment?

The CDC is now recommending Pneumovax for all high risk groups as well as smokers, but it is not a bad idea for everyone since some are dying with no risk factors.

The antibiotics are a good idea as well, but they are going to want to culture, so I can not see them doing it prophylactically. It may not always be strep causing the pneumonia, but I bet the CDC has a good idea what organisms are involved.

And, of course, they must start Tamiflu within 48 hours.

I think that they will be working on the best clinical approaches from the affected countries to be shared with physicians from many countries. This is why the WHO sent in teams to Mexico. They needed to understand what happened there first in order to figure out how to treat elsewhere and what to expect.

ORTech2RN · Jun 18, 2009

The CDC is now recommending Pneumovax for all high risk groups as well as smokers, but it is not a bad idea for everyone since some are dying with no risk factors.
The antibiotics are a good idea as well, but they are going to want to culture, so I can not see them doing it prophylactically. It may not always be strep causing the pneumonia, but I bet the CDC has a good idea what organisms are involved.
And, of course, they must start Tamiflu within 48 hours.
I think that they will be working on the best clinical approaches from the affected countries to be shared with physicians from many countries. This is why the WHO sent in teams to Mexico. They needed to understand what happened there first in order to figure out how to treat elsewhere and what to expect.

I read a great article, and I need to find the link, about the 1918 Spanish Flu. Apparently, scientists feel that nearly 90 % of Flu related deaths were attributed to Bacterial Pneumonia, namely Strep. The article was carried by the Pittsburgh Post-Gazette and is fairly recent (1-2 weeks?).

By addressing secondary infections we can lower the number of deaths from H1N1 until an effective vaccine is distributes this fall. I understand the need to culture, however a delay in treatment could be costly. If nothing else, couldn't the MD's go with a broad spectrum or one that narrows in on Strep?

Another point, most of the deaths with underlying causes are related to Asthma/COPD. There are quite a few of us with reactive airway, whether its related to allergies or exercise. Perhaps the Pneumovax should be recommended towards that group as well, even folks with mild asthma.

indigo girl · Jun 18, 2009

../most of the deaths with underlying causes are related to Asthma/COPD. There are quite a few of us with reactive airway, whether its related to allergies or exercise. Perhaps the Pneumovax should be recommended towards that group as well, even folks with mild asthma.

All good points, ORTech. I think you will find them all addressed over at this previous link. The Pandemic Flu Forum is getting so large with so many different threads that I am starting to see articles repeated that have already been posted, not that this is bad. Some things could stand to be repeated. This link for example, will take you to Effect Measure, a site run by some irreverent epidemiologists. Their progressive views about our culture not withstanding, they are great educators about public health.

I am one of the folks with mild asthma as well, something I would not normally think twice about. Now, I find, I am seriously at risk according to the case histories. I do not look forward to the fall. I have already contacted my public health department. They do have pneumovax available, and I plan on getting it. I am going to drag a few of my colleagues that smoke along with me. Not many smokers on my unit, but there are a few. Just as long as they don't smoke in my car or anywhere near me, we are getting vaccinated together if I have to drag them in. I hate visiting friends in the hospital...I take it that you are as well? Seriously, everyone that is going to be working, should consider it.

I think that you will find everything that you brought up covered in this link:

https://allnurses.com/pandemic-flu-forum/pneumococcal-vaccine-399476.html