US swine flu victims had chronic health problems

[Brian]

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

[indigo girl]

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.

I found another link quoting, Sylvie Briand, acting director of the WHO's Global Influenza Program on those severe cases in Mexican young people.

http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/may0809breaknews.html

Briand said viral pneumonia has played a role in the deaths, but bacterial pneumonia has been less of a factor, unlike in other pandemics. Authorities have found that causes of death are typically respiratory failure or organ failure.

Mention organ failure to me, and I think of a series of cascading events and cytokine storm, but they have not said that. I wish that they would elaborate more about what they mean by this.

[Multicollinearity, BSN, RN]

Since both of the dead in the US had autoimmune diseases, my speculation was that their over-active immune systems killed them when fighting the H1N1 virus.

I wonder if it was a cytokine storm in the lungs caused by an over-reaction of the immune system or other complement pathology? Who knows. I'll be watching medscape this summer to see if we learn more.

[Multicollinearity, BSN, RN]

teehee, Indigo! We were posting at the same time about the cytokine storm! Great minds think alike...

[indigo girl]

teehee, Indigo! We were posting at the same time about the cytokine storm! Great minds think alike...

That's funny!

Actually for those with co-morbidites though, I think not. I was reading at some other sites a few minutes ago, and came across more on what some of these other condition were for the Mexican cases.

http://ca.reuters.com/article/topNews/idCATRE5430S820090508?pageNumber=2&virtualBrandChannel=0&sp=true

In Mexico, where diabetes is the nation's leading cause of death, officials said 24 percent of the dead were obese and half of those were morbidly obese, meaning the patients were at least twice their ideal weight.

Diabetes was associated with many of the victims, as were cardiovascular problems such as angina and high blood pressure, Health Minister Jose Angel Cordova told a news conference.

These conditions can raise the risk of complications and death from seasonal influenza, which kills 250,000 to 500,000 people every year globally and 36,000 in the United States alone.

Now like you, I have asthma so I am paying attention to what happened to those severe cases. Every couple of years or so, I end up at Urgent Care with an ILI, and end up on steroids, Levaquin, and inhalers. It has never progressed to pneumonia for me though.

I am not going to be happy to catch what everyone is saying is a mild virus....

[indigo girl]

http://www.bloomberg.com/apps/news?pid=20601100&sid=abyGgjQe18_I

It is so hard to get all of the information about these cases in one place! I keep finding pieces here and there. It's frustrating.

Well, multicollinarity, here we have the cytokine storm actually mentioned! And, look over half of the victims were young...

You have to really wonder about why when not all of them had pre-exising health challenges. It's very unusual, and not at all like seasonal flu. This flu goes after the health challenged and those with the most robust immune systems? What's up with that? No wonder they are thinking cytokine storm.

Twenty-six, or 58 percent, of the 45 swine flu deaths in Mexico were people ages 20 to 39, Mexican health authorities said today.

Underlying Health Conditions

About 11 percent of all those who died had heart disease, and 24 percent had diabetes or were obese, conditions that might predispose patients to complications, before catching the virus, according to statistics provided today by the government's Ministry of Health. The ministry didn't give the ages of the people with the pre-existing health conditions.

Scientists have proposed that some deaths from flu are brought on in part by an extreme immune response, often called a "cytokine storm," that occurs when the immune systems of young, robust individuals overreact to infections. About 56 percent of people who died from flu in Mexico showed signs of a "hyper immune reaction" according to health ministry's figures. The ministry didn't give details such as the ages of patients suffering the reactions.

[lamazeteacher]

That's funny!

Actually for those with co-morbidites though, I think not. I was reading at some other sites a few minutes ago, and came across more on what some of these other condition were for the Mexican cases.

http://ca.reuters.com/article/topNews/idCATRE5430S820090508?pageNumber=2&virtualBrandChannel=0&sp=true

Now like you, I have asthma so I am paying attention to what happened to those severe cases. Every couple of years or so, I end up at Urgent Care with an ILI, and end up on steroids, Levaquin, and inhalers. It has never progressed to pneumonia for me though.

I am not going to be happy to catch what everyone is saying is a mild virus....

Well, as you know, I have it (maybe). This is my 4th day, my 2nd day on Tamiflu and Doxycycline and my URI symptoms and muscle aches have intensified, not much coughing though.

I'm staying home, trying to rest (hard for me, although participating on AllNurses.com keeps me in one place), drinking +++ fluids and watching TV.

I've had wheezing secondary to critical anemia in the past, and last year I was diagnosed as asthmatic, when I had pneumonia. So far my chest is clear and no wheezing has happened....... I sure am not happy, it's like living inside a time bomb....... (couldn't get that icon to play)

[lamazeteacher]

This alert just appeared:

Sat 9 May 2009 | 0:46 EDT

Canada reports first flu death as U.S. cases climb

Fri May 8, 2009 7:19pm EDT

By Daniel Trotta

MEXICO CITY (Reuters) - The new H1N1 flu killed its first patient in Canada, making it the third country after Mexico and the United States to report a death from the virus that has sickened more than 3,000 people in 27 countries.

Alberta's chief medical officer said on Friday that the woman in her 30s who died on April 28 had not traveled to Mexico, the epicenter of the swine flu outbreak, which suggests a more sustained spread of the infection.

Her death raised the confirmed global death toll to 48 from the virus, a strange coupling between a triple-hybrid virus with pig, human and bird elements and a European swine virus not seen before in North America.

Alberta was also where a herd of pigs became infected with the H1N1 swine flu, apparently infected by a man who had traveled to Mexico.

The World Health Organization kept its global pandemic alert at 5 out of 6 because the new virus was not spreading rapidly outside North America, where U.S. officials expect it to spread to all 50 states.

Japan reported its first three confirmed cases, a man in his 40s and two teenagers who had spent time in Canada. Italy also reported the first case of the H1N1 flu strain transmitted within the country -- a 70-year-old man in Rome caught the virus from his grandson, who returned from a holiday in Mexico.

In Mexico, authorities reported one more death, based on lab tests of patients who died in days past, to raise the total to 45. A quarter of the dead were obese, the government said.

The virus has also killed two people in the United States, where President Barack Obama said, "... we're seeing that the virus may not have been as virulent as we at first feared but we're not out of the woods yet."

Researchers have yet to determine where it originated.

The U.S. Centers for Disease Control and Prevention reported 1,639 U.S. cases on Friday, up from 896 on Thursday, a jump that has been expected as a backlog of lab tests were confirmed. The Mexican case total climbed to 1,364 from 1,204. That pushed the global figures to at least 3,413 cases, according to the WHO, the CDC and national health authorities.

But U.S. health officials were encouraged that more people were washing their hands as a result of the outbreak.

In Asia, countries whose health diplomacy skills were honed by SARS in 2003 and ongoing outbreaks of H5N1 avian influenza pledged to boost drug stockpiles, share essential supplies and tighten surveillance against what they called an "imminent health threat" to the region.

"We cannot afford to let our guard down," ASEAN Secretary General Surin Pitsuwan told a meeting of health ministers from the 10-member Association of South East Asian Nations plus China, Japan and South Korea.

In Hong Kong, authorities freed nearly 300 guests and staff of a hotel after quarantining them for a week.

POSSIBLE OBESITY, DIABETES LINK

In Mexico, where diabetes is the nation's leading cause of death, officials said 24 percent of the dead were obese and half of those were morbidly obese, meaning the patients were at least twice their ideal weight.

Diabetes was associated with many of the victims, as were cardiovascular problems such as angina and high blood pressure, Health Minister Jose Angel Cordova told a news conference.

These conditions can raise the risk of complications and death from seasonal influenza, which kills 250,000 to 500,000 people every year globally and 36,000 in the United States alone.

Officials said their fast implementation of social distancing, disinfecting public spaces and education about hand hygiene helped control the spread of the virus, which is acting much like a typical seasonal flu.

[imbrad07]

Swine Flu is a biggest threat nowadays.i think precautions is the best way to treat it.Be neat and clean to avoid various diseases and also swine flu.

[HonestRN]

There is a connection between autoimmune diseases and reduced immunity

As well as a connection between obesity and pregnancy and reduced immunity. In the case of obesity chronic inflammation predisposes one to other conditions i.e. diabetes and atherosclerosis.

Adipose tissue secreted products can be produced in excess in obesity as adipose tissue expands and the spill-over of these products into circulation can explain for example, at least in part, the development of hypertension associated with obesity. The production of a number of pro-inflammatory cytokines can explain the phenomenon of sub-clinical inflammation that is associated with both insulin resistance and the pathogenesis of type-2 diabetes. This is also a factor underlying the tendency for endothelial dysfunction in obesity. Finally ectopic adipose tissue in organs such as liver, muscle, heart and pancreatic islet cells can cause disease through its effects on the metabolic processes within those organs.

http://www.endocrine-abstracts.org/ea/0015/ea0015S39.htm

http://circ.ahajournals.org/cgi/content/full/111/11/1448

During pregnancy, your immune system changes so that it can protect both you and your baby from disease. Different parts of your immune system are enhanced while others are suppressed. This creates a balance that can prevent infection in the fetus without compromising the defenses that keep you healthy as well.

Changes in a woman's immune system during pregnancy include:

• increased production of macrophages (cells that destroy bacteria). this improves antibody response and helps to protect you against bacteria-though they do not guarantee protection against bacterial infections;
  
• decreased activity of NK cells ("natural killer" white blood cells, which kill cells that have been infected with a virus or that are part of a tumor);
  
• decreased activity of T cells, which help to control infections caused by viruses; and
  
• decreased production of cytokines (which are released from immune cells to recruit other cells to help fight infection).
  

These alterations protect your baby from your body's defenses because, in theory, your baby is like an organ transplant that your body sees as part "self" and part "foreign." However, due to depressed T cell function, you are more prone to opportunistic infections (those that do not cause disease when the immune system is normal) and viral infections. In fact, the incidence of viral illness, the intensity of viral attack, the severity of illness, and the rate of death are all higher in pregnant women than in non-pregnant women.

http://www.healthline.com/yodocontent/pregnancy/infections.html

I could be wrong however, it is my impression that increased immune responses as in autoimmune disorders and/or chronic inflammation makes one more susceptible to infections hence the increased severity of disease in the pregnant, obese and those with autoimmune disorders.

[indigo girl]

It is very clear by now that pregnancy all by itself is a hugh risk factor.

https://allnurses.com/pandemic-flu-forum/evidence-swine-flu-399332.html

I have not counted the number of cases noted in this link on pregnant women with fatal or severe consequences as a result swine flu infection. The thread has grown considerably, and is likely to grow further with the passing of time.

This is terribly sad.