US swine flu victims had chronic health problems

Nurses COVID

Published

Specializes in CCU, Geriatrics, Critical Care, Tele.

ATLANTA -America's two swine flu deaths-a toddler and a pregnant woman-each suffered from several other illnesses when they were infected with the virus, according to a study released Thursday.

The report by the Centers for Disease Control and Prevention presented a clearer picture of the complicated medical situations faced by those who have gotten swine flu and had the most serious cases so far.

The Mexican toddler had a chronic muscle weakness called myasthenia gravis, a heart defect, a swallowing problem and lack of oxygen. Little Miguel Tejada Vazquez fell ill and died during a family visit to Texas.

The pregnant woman, Judy Trunnell, 33, was hospitalized for two weeks until she died Tuesday. The teacher was in a coma, and her baby girl was delivered by cesarean section. According to the report, she had asthma, rheumatoid arthritis, a skin condition called psoriasis and was 35 weeks pregnant.

People with chronic illnesses are at greatest risk for severe illness from the flu, along with the elderly and young children. So far, most of those with the swine flu in the U.S. and Mexico have been young adults.

Full Story: http://www.google.com/hostednews/ap/article/ALeqM5gD1ZJvhHO6wfvF42FQf6V4E9eISgD981MJA02

Thank you Brian! :up:

steph

Specializes in Acute Care Psych, DNP Student.

So both of the deceased had autoimmune diseases, not reduced immunity.

Very interesting.

Specializes in School Nursing.

Does anyone have any info on the demographics and health status of the people who died in Mexico? I have been very curious about their ages and any possible comorbidities but I have been unable to find anything.

Specializes in OB, HH, ADMIN, IC, ED, QI.
So both of the deceased had autoimmune diseases, not reduced immunity.

Very interesting.

There is a connection between autoimmune diseases and reduced immunity.

Autoimmune diseases have the characteristic of predisposing those who suffer from them, to infections. Diabetes is a case in point. Psorriatic arthritis is another. Those who must take prednisone for long periods of time due to chronis illness are at greater risk for communicable diseases. Usually they have an autoimmune disease, with reduced resistance to infections.

Specializes in Too many to list.

Alberta woman Canada's first H1N1-related death

The story is somewhat confusing. Are there 3 victims, are just 2?

http://www.theglobeandmail.com/servlet/story/RTGAM.20090508.wflualberta0508/BNStory/National/home

A deceased Alberta woman has become Canada's first confirmed death associated with the influenza A/H1N1 virus, provincial health officials said today.

"It's not clear what role the H1N1 virus played in the fatality, which took place April 28," Dr. Andre Corriveau, Alberta's Chief Medical Officer of Health, said in statement.

A source said it was originally believed the woman died from an asthma attack.

The deceased woman was in her 30s and, as far as officials know, had no prior travel history to Mexico, Dr. Corriveau told reporters in Edmonton.

Her case only came to the attention of health officials this week when an elderly woman in northern Alberta tested positive for the virus, which prompted a trace out to all her contacts.

Officials discovered that woman had been at a funeral of a close relative earlier this week, which was attended by about 300 people, many of whom would have been in close contact through hugging and kissing. Officials also turned their attention to the dead woman, who had been hospitalized before she died, and lived in the same house as the elderly woman.

"It came to light to us that the death was although unexpected at the time had been attributed most probably to be associated with preexisting, chronic medical conditions. There was no talk at the time of the death that flu had anything to do with the cause of death," Dr. Corriveau said.

On Thursday night, tests on tissues taking during an autopsy of the young woman confirmed the presence of the virus.

It appears the elderly relative likely contracted the virus from the deceased woman, officials said.

Specializes in Acute Care Psych, DNP Student.
There is a connection between autoimmune diseases and reduced immunity.

Autoimmune diseases have the characteristic of predisposing those who suffer from them, to infections. Diabetes is a case in point. Psorriatic arthritis is another. Those who must take prednisone for long periods of time due to chronis illness are at greater risk for communicable diseases. Usually they have an autoimmune disease, with reduced resistance to infections.

I believe there are different mechanisms.

Specializes in ED/trauma.

I must say though the reports have done wonders for the ED recession

Specializes in OB, HH, ADMIN, IC, ED, QI.

I didn't see a 3rd person in the Globe and Mail's article. The mention of an elderly northern Alberta woman was separated from the rest of the story, but she turned out to be a relative of the 30 year old woman who had asthma and died, and later A/H1N1 was discovered.

Specializes in Too many to list.

Swine flu appears to target the young and healthy in Mexico

Does anyone have any info on the demographics and health status of the people who died in Mexico? I have been very curious about their ages and any possible comorbidities but I have been unable to find anything.

http://www.usatoday.com/news/health/2009-05-08-swineflu-H1N1-virus-behavior_N.htm

I just read this, and remembered your question. Of course, not all of the facts are in yet, and though this is not specifically about deaths, it is about severe cases in Mexico.

Note you have to scroll down below the picture of the pig to read this link.

The World Health Organization and other health officials held a conference call Thursday with doctors and medical workers in Mexico in which they reviewed every patient who has become severely ill there from H1N1. This painstaking case-by-case analysis yielded interesting results.

"We were able to differentiate two types of people at risk for severe illness," says Sylvie Briand, acting director of WHO's global influenza program.

One was previously healthy young people, the second was people-as is the case with seasonal flu-with underlying chronic conditions such as diabetes, tuberculosis, heart disease, cancer, Briand says.

In the healthy young people, "one important factor was that these people arrived very late to health care facilities" and therefore treatment came very late in the course of the disease, Briand says. That could explain the severity.

Also, those cases were early ones, before the disease was fully understood.

Most deaths resulted from severe viral pneumonia. The good news, says Briand, is that pneumonia responds to even simple, widely-available therapies such as oxygen.

In the USA, the CDC is seeing that this new flu strain seems to have a higher rates of vomiting and diarrhea associated with it than seasonal flu does.

CDC's Besser cautioned those who were ill "don't think that just because you have the symptoms of a stomach flu that you don't" have influenza."

Another clue to knowing if an illness is the flu is whether it begins with a sudden onset fever of over 100.4, which almost all H1N1 flu sufferers have had as their first symptom, according to the Pan American Health Organization.

There continues to be no evidence that the influenza has become established outside of North America, Briand says. Most cases outside of North America "are in returning travelers or those who have had close contact with them."

Specializes in OB, HH, ADMIN, IC, ED, QI.
I believe there are different mechanisms.

It would be helpful if you researched your belief and shared your findings.

Here is what I found at google, when I searched under "autoimmune and immunity".

"The genetics and mechanisms of autoimmunity are major thematic areas within the Departments of Medicine, Pathology, Haematology and the Cambridge Institute for Medical research. The role of T cells in causing autoimmune diseases and the potential for specific targeting to halt autoimmune pathology is being studied in a range of conditions. Animal models of autoimmune diabetes are a particular focus. Major programmes are focussed on immune mechanisms leading to failure of self tolerance and tissue destruction and on the analysis of genetic susceptibility to diabetes. Basic, clinical and translational research in autoimmune diseases such as multiple sclerosis and arthritis are major themes within the Department of Medicine. Transplantation immunology is an important area of clinical research and the availability of strong histopathological expertise underpins clinical immunological research.

Studies of the immune system in health and disease lead to advances in understanding the mechanisms of immunity to infection and the role of the immune system in autoimmune diseases such as diabetes, multiple sclerosis and rheumatoid arthritis and the vasculitides. An understanding of the genes, molecules and cells of the immune system has led to developments in biotechnology, vaccine research, cancer therapy, and the treatment of infectious diseases, allergy, immune deficiency, autoimmunity and cancer."

Specializes in OB, HH, ADMIN, IC, ED, QI.

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This is in a newsletter produced by the Stanford school of Medicine

Immunity, Transplantation, and Infection:

Harnessing the Body's Natural Defenses

If the body were a country, the immune system would be its national guard. And it couldn't ask for a better homeland defense. The immune system is remarkably effective at protecting us against the millions of pathogens that threaten us daily. We have only to see what happens when our immune system is compromised--from disease, for instance, or by immunosuppressant drugs following organ transplantation--to understand the power it wields when it's operating at full strength.

Tolerance for Transplants

When the Stanford's Liver Transplant Program was established 10 years ago, it focused on merging scientific insights with customized treatment plans. Today the Program is made up of a community of nephrologists, surgeons, pathologists, and immunologists who are applying creative research to clinical problems in pursuit of ways to improve patient care.

"Liver transplantation has come a long way over the years and there are plenty of opportunities at Stanford to advance the field," says Carlos Esquivel, MD, PhD, chief of the Division of Transplantation, director of Stanford's Liver Transplant Program, and the Arnold and Barbara Silverman Professor in Pediatric Transplantation. "Our next steps involve using donor stem cells to induce tolerance, creating an artificial liver as an external back-up system, and developing better mechanisms for preserving the organ."

There is no doubt that we have made tremendous progress in understanding how the immune system responds to disease, enabling us to develop vaccines for so many of the illnesses, like polio, smallpox, and whooping cough, that once haunted us.

But infectious diseases we thought we had conquered, like tuberculosis, are returning in new guises that resist standard treatments. And those that have emerged in the past few decades and the more recent past, like toxic shock syndrome, drug-resistant staphylococcus, and avian flu, present dangerous new challenges.

At the Stanford Institute for Immunity, Transplantation, and Infection (ITI), our goal is to understand and ultimately control how the immune system defends the body at the molecular and cellular levels. ITI teams, comprised of immunologists, pathologists, microbiologists, infectious disease experts, surgeons, scientists, and clinicians, are attacking these challenges from dozens of different avenues, pooling their talents and pouring their energies into four key objectives:

Developing more powerful vaccines for old and new threats

Every year, 15 million people around the world die from infectious diseases--many we thought we had vanquished long ago. Stanford researchers are racing to learn why microbes develop resistance to drugs, creating new strategies to combat the deadliest infections, collaborating to identify new targets for prevention, and halting the progression of aggressive or emerging diseases.

Reenergizing the immune system

When we hit middle age, our immune systems decline precipitously. Why is this? And how can we reverse or even prevent the process? We are launching a major new effort to develop effective measures to treat and prevent the diseases that affect us as we grow older.

Eliminating chronic autoimmune diseases

As we learn more about the basic mechanisms of the immune system, we are seeking to put our new knowledge to work to effectively combat autoimmune diseases like arthritis, lupus, and multiple sclerosis in which the body's defense system turns on itself and attacks its own cells, tissues, and organs.

Revolutionizing transplantation

The ability to regenerate cells may offer the most promising advance in transplantation medicine since the introduction of the powerful immunosuppressive drugs that prevent rejection of a transplanted liver, kidney, or heart. Working closely with members of the Institute for Stem Cell Biology and Regenerative Medicine, for example, ITI researchers hope to create new techniques to stimulate the growth of active cells in failing organs.

Looking Forward

A generation ago, the field of immunology could be taught in a single day of medical school. Today we recognize the immense power of the immune system and its potential both to protect us and to fail us. As we seek to fully understand the complex machinery of infection and immunity, we are working to quickly translate that knowledge into treatments for the benefit of people around the world.

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