No Prior Existing Conditions but Dead Anyway

[indigo girl]

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

Who would think that a normally healthy woman would die so swiftly from influenza in June?

Could you ever have imagined such a thing? No wonder her family and friends are in shock.

So why did it happen?

Barbara Davis, 48, was healthy just a week ago. She had dinner with her mother Josephine last Friday night. But just hours after that dinner, Josephine got a phone call.

"My friend, he called me and told me Barbara was real sick. And I said, "Well, she wasn't sick when I left, so what's the matter?" Josephine Davis said.

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.

The Milwaukee Health Department confirmed on Friday a Milwaukee adult with no underlying medical conditions died from swine flu, though they haven't confirmed Barbara Davis was that victim.

Barbara's family knows all too well how serious swine flu can be.

"Everybody is just in a shock. The people that I talked to today, they are frightened. Because it happened all of a sudden," Josephine Davis said.

More than 1,800 people have caught swine flu in Milwaukee alone. The city's Health Department is stressing that if you are mildly ill with flu symptoms, you should call your doctor. If your symptoms are serious or if you have mild symptoms that are getting worse, you should see a doctor right away.

http://www.wisn.com/health/19751526/detail.html

The Milwaukee County Medical Examiner said 48-year-old Barbara Davis died Thursday in the ICU after being diagnosed with the flu strain.

The health department said, unlike Milwaukee's first swine flu victim, Davis did not have any "underlying medical conditions" that would have put her at a greater risk for the disease.

http://www.flutrackers.com/forum/showpost.php?p=248304&postcount=7

This post was written by Dr. Gratten Woodsen, MD commenting over at flutrackers on this unfortunate woman's case.

The decedent is described as having fulminate multi-organ failure that developed rapidly resulting in death 48 hours after onset and despite intensive medical therapy in an ICU including all the bells and whistles.

The attending physicians told the mother that they had never seen anything like this before and I believe them. So did she. No one has seen anything like this since 1918. In 1918 many doctors said the say thing after dealing with their first cases of Spanish Flu and for them too it was a great surprise at least until those that didn't die from the virus themselves had seen it so many times that it was no longer unique.

There are numerous descriptions from the 1918 pandemic that match the one above but no where else in medical history do we find anything remotely similar. This is why the doctors in Milwaukee were so shocked by what they saw.

How many other North American victims had similar pathology? Why have the autopsy and clinical findings from the deaths in Mexico, the US and Canada been suppressed?

I know from press reports that there have been other US deaths where multi-organ failure was present. Is this common among those who have died of Swine Flu or rare? Are the findings similar to those seen in 1918 or not?

(hat tip flutrackers/skatman)

[indigo girl]

Calgary, Alberta, Canada

She is recovering. Like so many others randomly hit, her fiance wonders why her? There is still no good answer.

http://www.flutrackers.com/forum/showthread.php?t=132647

http://www.vancouversun.com/health/Healthy+Calgary+woman+sent+into+coma+H1N1+infection/2212085/story.html

In only a few days, Jaclyn Bates went from the picture of health to a medically induced coma after being diagnosed with the H1N1 swine flu.

The fast deterioration of the 27-year-old mother of two was shocking, said her fiance Rob Pearce.

"She's the epitome of health," he said. "She just went from being perfectly healthy to ridiculously sick in a very short period of time and the doctors aren't even sure why that is."

(hat tip crofsblog)

[lamazeteacher]

WOW! Indigogirl, medically induced coma may be the answer to the scarcity of ECMO units!! I hope someone at CDC or NIH is keeping stats on this.

[NotReady4PrimeTime, RN]

Umm... lamazeteacher there's no way a medically induced coma can replace ECMO. How much do you understand about how ECMO works? For influenza such as this, the ECMO circuit pulls blood from the patient, circulates it through an oxygenator that acts as an artificial lung (puts oxygen in, takes carbon dioxide out) and returns the blood to the body. Putting someone in a coma can't do that. Severe H1N1 causes the person's lungs to basically shut down so there is virtually no gas exchange happening there at all. The last patient we put on ECMO for H1N1 had pO2s in the 40's and pCO2s in the 140s while on high freqency oscillation ventilation on 100% oxygen. After 118 hours of complete lung rest there was enough recovery that we could take the patient off ECMO. How could a medically-induced coma done that?

[lamazeteacher]

umm... lamazeteacher there's no way a medically induced coma can replace ecmo. how much do you understand about how ecmo works?

oops, you caught me. i've never seen ecmo, but thanks to all nurses, i did know much of what you explained, though with less hauteur.

for influenza such as this, the ecmo circuit pulls blood from the patient, circulates it through an oxygenator that acts as an artificial lung (puts oxygen in, takes carbon dioxide out) and returns the blood to the body. putting someone in a coma can't do that. severe h1n1 causes the person's lungs to basically shut down so there is virtually no gas exchange happening there at all. the last patient we put on ecmo for h1n1 had po2s in the 40's and pco2s in the 140s while on high freqency oscillation ventilation on 100% oxygen. after 118 hours of complete lung rest there was enough recovery that we could take the patient off ecmo. how could a medically-induced coma done that?

what i meant, was that if the induced coma was done earlier than resp failure with lack of perfusion occurred, it might lower the pulse rate accordingly, providing time for the body to recoup somewhat; and gather its resources to fight off the virus and it bacterial sequelae, providing antibodies, etc. also the debilitating stress that occurs when someone is conscious of their decompensation, would be circumvented, giving the cardiopulmonary and neurological symptoms less hassle.

[indigo girl]

Ottawa, Ontario, Canada

http://www.cbc.ca/canada/ottawa/story/2009/11/12/ottawa-university-professor-dies-swine-flu.html

http://www.thestarphoenix.com/technology/H1N1+eyed+chemist+death/2231428/story.html

According to a press release sent out by the university, Dr. Keith Fagnou, a professor of chemistry in the faculty of science, passed away suddenly on Wednesday. CBC News has confirmed that he died of H1N1-related illness.

According to university officials, Fagnou had no underlying health conditions.

Fagnou held the University of Ottawa's research chair in the development of novel catalytic transformations. According to the university, he was an exceptional researcher who won several prestigious chemistry awards, including the Polanyi Prize, during his brief career.

(hat tip pfi/miker)

[indigo girl]

Topeka, Kansas

http://www.ktka.com/news/2009/nov/12/topeka-woman-h1n1-dies/

A 48-year-old woman from the Topeka area has died from infection with the H1N1 virus. That announcement came from the Kansas Department of Health and Environment today.

The KDHE says the woman's infection was confirmed on November 10, and her death was reported on November 7. She did not have any underlying health conditions.

(hat tip pfi/homebody)

[CrunchRN, ADN, RN]

I am so glad I decided to get the H1N1 vaccination. Made my husband get it to.

[indigo girl]

Rensselaer County, New York

http://www.wten.com/Global/story.asp?S=11516609

Rensselaer County Officials have confirmed the death of a County resident from the H1N1 flu.

Officials say the victim is an adult who died within the past few days, and had no apparent underlying health conditions.

This is Rensselaer County’s second death from H1N1, also known as swine flu. The first happened this past spring.

[indigo girl]

Bauxite, Arkansas

http://www.kfsm.com/news/sns-ap-ar--swineflu-death,0,7443591.story

Authorities say a Bauxite man has died after testing positive for swine flu.

Pulaski County Coroner Garland Camper says 37-year-old Jeffery Rollinson died Wednesday night at Baptist Health Medical Center in Little Rock.

Camper says he wasn't aware of Rollinson suffering from any pre-existing illnesses before he was diagnosed with swine flu on Nov. 7.

(hat tip pfi/monotreme)

[indigo girl]

Niagara County, New York

http://www.wivb.com/dpp/news/health/Teenager-died-from-H1N1-virus

News 4 met with the boy's father, who told us that his son had been fighting the flu for nearly two weeks at Womens & Childrens Hospital.

Tears flowed easily when Pavel Nichiporuk opened up the family albums to show News 4 some photographs of his son, Paul.

Paul's father told News 4 his son was a healthy teen with no known underlying medical condition when he fell ill with the flu.

(hat tip pfi/pixie)

[lamazeteacher]

Channel 4 went on to quote the family further:

"Elena Panasyuk, the sister of the teen said, "He was a very timid quiet typical teenager."

It was difficult for her to talk about her little brother just two days after his death. 14-year-old Paul Nichiporuk was hospitalized for over two weeks before he passed away on Monday.

Elena says it wasn't just the H1N1 virus that killed him.

"What really killed him was MRSA, and the power of MRSA and the H1N1...the two powers combined is what hit him," she explained."

To make matters worse....... a possibly nosocomial additional infection. 2 weeks in the hospital, especially in ICU, makes it a distinctly possible nosocomial infection, which makes me wonder if the antibiotics with which this boy must have been treated, were known to work on MRSA. This brings out the Infection Control Nurse in me.

[NotReady4PrimeTime, RN]

Our sole documented H1N1 death to date was also a combination of MRSA toxic shock and H1N1. The media is reporting that this child had pre-existing health problems, but the only thing other than the flu that she had was MRSA, suggesting community-acquired infection. (Our nosocomial multi-drug resistant organism rates are extremely low. At the time of her admission we had no MRSA positive patients on the unit.) She was treated with appropriate antibiotics but the combination of pathogens created a situation that resulted in complication after complication until she was removed from ECMO and died.