H1N1 attacks deep in the lungs....

[djwayne]

http://www.cnn.com/2009/HEALTH/12/08...ngs/index.html

New York (CNN) -- In the rare cases when the H1N1 virus kills, scientists have found, it penetrates deep into the lungs, creating widespread damage -- a pattern similar to what killed millions during previous flu pandemics in 1918 and 1957.

The New York Office of Chief Medical Examiner examined medical records, autopsy reports and microscopic slides of 34 people with H1N1 who died between May 15 and July 9, 2009, during the early days of the pandemic.

The report found that among those deaths, inflammation and damage in the lungs extended all the way to the alveoli, tiny sacs at the farthest end of the lungs' airways.

"Generally, flu stays in the upper airways," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "What this shows is clearly this virus has capability of infecting and causing inflammation and destruction of cells from the trachea, all the way down into smaller cells of the lungs.

"The cells of the lung get directly attacked by the virus," said Fauci.

[Sunnynj]

Originally Posted by djwayne

http://www.cnn.com/2009/HEALTH/12/08...ngs/index.html

New York (CNN) -- In the rare cases when the H1N1 virus kills, scientists have found, it penetrates deep into the lungs, creating widespread damage -- a pattern similar to what killed millions during previous flu pandemics in 1918 and 1957.

The New York Office of Chief Medical Examiner examined medical records, autopsy reports and microscopic slides of 34 people with H1N1 who died between May 15 and July 9, 2009, during the early days of the pandemic.

The report found that among those deaths, inflammation and damage in the lungs extended all the way to the alveoli, tiny sacs at the farthest end of the lungs' airways.

"Generally, flu stays in the upper airways," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "What this shows is clearly this virus has capability of infecting and causing inflammation and destruction of cells from the trachea, all the way down into smaller cells of the lungs.

"The cells of the lung get directly attacked by the virus," said Fauci.

Yeah thanks CNN for this in depth report. No need to mention that the flu that is attacking the lungs has different sequences than the first wave of H1N1. Oh and keep quiet that the current vaccination won't help you if you catch the "shifted" flu. In fact it might just make it worse. (google "original antigenic sin")

That said, I am pleased that someone, somewhere in the mass media has not forgotten H1N1 exists.

[Grumble69]

Unfortunately I had not heard about original antigenic sin (OAS) until D225G was fingered in the Ukraine outbreak. Most flu years, it's just not that big of an issue.

For those unfamiliar with the effect--Let's say you were infected with swine flu earlier in the year. Most people with have immunity to that exact strain. But now lets say there's a very minor change in the virus that let's it bind deeper in the lungs and cause more damage (e.g. D225G). Intuitively you might think that you have some type of partial immunity, if not complete immunity, because it's so similar. But that's not always the case. When you are exposed to a very similar looking virus, the body will respond with antibodies that it originally saw from the first infection (hence the reference to original sin). Depending on the binding nature of the mutation, it's possible that the new strain will completely evade the antibodies produced.

[killzen]

http://www.virology.ws/2009/11/24/th...not-a-concern/

[GardenSERF]

Some key points from the article need to be noted here:

More than half of the deaths were caused by bacterial pneumonia.

Furthermore:

"The secondary bacterial infection evokes inflammation," said Dr. William Schaffner, professor in the Division of Infectious Diseases at Vanderbilt University School of Medicine. "It socks it in the lung and all of a sudden the lung as an organ can't do its principal job."

Obesity was a factor in 72 percent of H1N1 deaths, a finding that has caused concern among infectious disease experts. [emphasis by GardenSERF who has been emphasizing diet and exercise]

"That was a striking finding," said Schaffner. "It contributes in a very material way to what we know about risks for a severe outcome with H1N1 infection. We are keeping an eye on obesity as a risk factor for H1N1 death."

Not at all striking.

[123Testing]

So Baxter found a way to solve the Obesity problem... interesting.

[Grumble69]

Originally Posted by GardenSERF

More than half of the deaths were caused by bacterial pneumonia.

The pneumonia would never set-in if the lungs were not so ravaged from the influenza. It's like getting shot and listing the cause of death as blood loss.

http://www.virology.ws/2009/11/24/th...not-a-concern/

And I'm not sure what to make of that. The title clearly states that D225G is not a concern. It cites that transmission will be inefficient. But yet it's still popping up around the world. So I'm not quite sure how they arrive at the conclusion that "it's not a concern". Maybe they're right, but they didn't exactly prove it to me in that terse one page piece.

[KarlMarx]

Speaking from experience here. Worst case symptom progression:

Infection>Viral Pneumonia>Respiratory Arrest>Cardiac Arrest. Happened to my wife in <48 hrs from first symptom onset. I wound up giving her CPR until the ambulance arrived. If you have vaccines available, get one, if you are in the high risk group (Chronic disease, respiratory issues like COPD or Asthma)

[Dean B]

Originally Posted by KarlMarx

Speaking from experience here. Worst case symptom progression:

Infection>Viral Pneumonia>Respiratory Arrest>Cardiac Arrest. Happened to my wife in <48 hrs from first symptom onset. I wound up giving her CPR until the ambulance arrived. If you have vaccines available, get one, if you are in the high risk group (Chronic disease, respiratory issues like COPD or Asthma)

How is she doing now?

Hoping for a speedy recovery, KarlMarx.

[KarlMarx]

Originally Posted by Dean B

How is she doing now?

Hoping for a speedy recovery, KarlMarx.

She's doing great. 7 days in the CCU, though, and 4 days afer downgrade to a regular room and we got lucky. Minimal heart muscle damage (Angiogram survey to visually check the heart muscle). She's a tough gal, I can tell ya. It didn't occur to me util after that I'd just radically exposed myself, as well, but what ya gonna do? She's my wife after all, so it wasn't like I really had an option.

[Dean B]

Originally Posted by KarlMarx

She's doing great. 7 days in the CCU, though, and 4 days afer downgrade to a regular room and we got lucky. Minimal heart muscle damage (Angiogram survey to visually check the heart muscle). She's a tough gal, I can tell ya. It didn't occur to me util after that I'd just radically exposed myself, as well, but what ya gonna do? She's my wife after all, so it wasn't like I really had an option.

Great news!

One of the things we've found with 2009 H1N1 is that when it goes bad, it goes bad quick and stays bad for awhile. The typical ICU time for this disease is above the norm and so is the need for specialized care.

7 days with your wife in CCU must've been gut-wrenching. I'm glad that's over for you.

BTW, did they give her Tamiflu?

[Grumble69]

That's a prime example of why the swine flu is so concerning--the length of time you may be in an ICU. Most hospitals do not have that many to begin with. And when they get filled up, people can be there for a while. In the meantime, the swine flu doesn't go on break until the ICU clears. If you need a bed and there aren't any, then it's not simply "Oh well SOL". The ramification is that you go from a "modern-day, treatable case" to primitive 3rd world medical care.

Another side note--when the CDC said there were 10K deaths, they acknowledged that they were counting the pneumonia deaths (due to influenza) but not the cardiacs yet.

[KarlMarx]

No, O2, cardiac monitoring, and other appropriate meds, but not Tamiflu.

Originally Posted by Dean B

Great news!

One of the things we've found with 2009 H1N1 is that when it goes bad, it goes bad quick and stays bad for awhile. The typical ICU time for this disease is above the norm and so is the need for specialized care.

7 days with your wife in CCU must've been gut-wrenching. I'm glad that's over for you.

BTW, did they give her Tamiflu?

[djwayne]

Ya, this H1N1 flu ain't nothing to mess around with, it can be deadly, or even very expensive....I'd hate to have to pay a bill of 7 days in ICU.

Glad to her she came thru it !!

[Kclinton2]

I'm a swine flu survivor. must say it wasnt terrible...did get me out of classes for a week. lots of call of duty

[toolman]

Yeah I know, the hard way. I had it a day before the shot arrived in my town. 2 months later still tired and not in aroebic shape.

[pbwalker]

Originally Posted by Kclinton2

I'm a swine flu survivor. must say it wasnt terrible...did get me out of classes for a week. lots of call of duty

same here...Spiked a 103.8 fever last night and it has broken and gone back up a few times. Aside from that, I feel fine. No aches, chills, etc. Slight sore throat, headache, and the fever are the only symptoms.

What concerns me most is my 15 month old girl and pregnant wife.

[Grumble69]

Among my friends at least, there seems to be a recent uptick. One person said she's been at the ER for the past 6 hours with her mother who has pneumonia and they've been waiting on a room.