Tag Archives: h1n1

How many people does it take to make a baby really sick?

We have an interesting conundrum. Our offspring (______) is due on November 20th. This places the likely date of birth just prior to Thanksgiving. This causes many people to get very excited because they get to see and play with the new baby. I wonder how mad at me all those people are going to get when they find out I might not let that happen?
Continue reading How many people does it take to make a baby really sick?

How do we know how bad the Swine Flu is so far?

I spent about 45 minutes yesterday in the local HMO clinic. They had turned the main waiting room into a Pandemic Novel A/H1N1 Swine (nee Mexican) Influenza quarantine area, and I could feel the flu viruses poking at my skin looking for a way in the whole time I was there.

Continue reading How do we know how bad the Swine Flu is so far?

Is obesity a risk factor for H1N1 Novel Swine Flu infection?

… or is obesity simply Yet Another Risk Factor in severity of this illness?

Probably the latter, but health officials seem interested in the developing data.

From CTV:

… in a report released Friday, health officials detailed the cases of 10 Michigan patients who were very sick from swine flu in late May and early June and ended up at a specialized hospital in Ann Arbor. Three of them died.

Nine of the 10 were either obese or extremely obese. Only three of the 10 had other health problems. Two of the three that died had no other health conditions.

This hardly settles the question of whether obesity is its own risk factor for swine flu. It’s possible the patients had undiagnosed heart problems or other unidentified conditions.

The report is called Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection — Michigan, June 2009 and is published in MMWR, the CDC’s rapid turnaround publication for disease. The report warns:

This report describes the clinical findings of a limited series of patients with novel influenza A (H1N1) virus infection and refractory ARDS …. This patient group represents the most severely ill subset of persons with novel influenza A (H1N1) virus infection and is notable for the predominance of males, the high prevalence of obesity (especially extreme obesity), and the frequency of clinically significant pulmonary emboli and MODS. All required advanced mechanical ventilator support, reflecting severe pulmonary damage. The pulmonary compromise described in this report suggests that severe pulmonary damage occurred as a result of primary viral pneumonia. Although data are not available, this damage also might be attributable to secondary host immune responses (e.g., through cytokine dysregulation triggered by high viral replication). However, bacterial coinfection in the lung not identified by blood culture or bronchoalveolar lavage cannot be excluded.

The high prevalence of obesity in this case series is striking. Whether obesity is an independent risk factor for severe complications of novel influenza A (H1N1) virus infection is unknown. Obesity has not been identified previously as a risk factor for severe complications of seasonal influenza. ….

Further characterization of severe cases of novel influenza A (H1N1) virus infection in the United States and worldwide is needed to determine the frequency of the findings from this limited case-series.

You can read the report here.

Clearly this is very preliminary and I suspect that this will not develop. In other words, I suspect that existing poor health related to the cardiopulmonary system is a serious risk factor with any flu. But we shall see.

Flu Update: Millionth American Case, Scams, Prospects

The novel swine flu has affected its one millionth American. The first death in England has been recorded (a 9 year old girl). Yesterday, the first Brazilian death was recorded. When we look at the map of the disease, note that many regions of Africa are totally devoid of cases. Just so you know … this is not some special African immunity. This is simply because the global health network has failed Africa and we have no clue what is going on there, and never have had a clue.

A new wrinkle in the process for North Americans, possibly with parallels elsewhere, is the summer camp phenomenon. This is where we take children from multiple communities, only some of which have some dreaded disease, or perhaps just an annoying meme, and we ship them all to one location either every day for the whole day, or for weeks at a time overnight. In this way, the diseases or annoying memes can spread among them and all the children can bring them home!

There have been some summer camp closings.

Despite rumors to the contrary, the novel swine flu is roughly as deadly as the regular flu. I’m still seeing people, even experts, indicate that it is relatively mild. It is not. It is typical.

The novel swine flu seems to be affecting younger individuals in part because of an immunity found in older individuals, presumably from exposure to a similar flu in the past. This is interesting news if confirmed. This touches on another area of confusion. The 1918 pandemic flu was famous for being extra deadly for healthy individuals. This was for a very specific medical reason. The current flu seems to be affecting ‘healthy’ individuals more as well. This is for a totally different and utterly unrelated reason, probably.

This is subject to revision, but here’s the story:

The 1918 pandemic flu killed healthy people more because healthy = stronger immune system. These people were killed by the way their immune system reacted to the flu. A person with a strong immune system would be more strongly affected by the flu, possibly fatally.

The novel swine flu appears to be affecting healthy people more because healthy = younger than a certain age. That age cut off separates individuals (older) who have an immunity from prior exposure to a similar virus from younger individuals who don’t.

Again, this is subject to revision. This is subject to revision in two ways:

1) The assertion I make above about the 1918 flu is very likely true and well demonstrated, but the assertion I make about the novel swine flu is speculative at this time; and 2) the phenomenon seen in the 1918 pandemic flu, while apparently not happening with the current novel swine flu, could develop later on during the pandemic.

Why do I say that? Because that is what happened in 1918. The flu went around the world ‘off season’ (as the current flu is doing) and was typical in virtually every way but its timing. Then it went around the world again with this extra glitch of killing people with their own immune system.

The fact that the 1918 flu did this has flu experts worried, and they should be. However, I have yet to see a biological argument for why this flu should follow the same pattern in regards to this specific feature.

What is going to happen next? In late (?) September (+/-) there will be a flu vaccine available for the regular flu. Get one.

Later, maybe in October (?) there may be a vaccine available for the novel swine flu. This may be a two dose vaccine. Get it, get them both if there are two. There will be instructions as to who should get it and when. But since those instructions will be filtered through the usual sources, be careful what you pay attention to. The little people sitting at the colorful desk on the news show will not be giving you useful information. They never get this stuff right. You should rely on the blogosphere this time around, I think.

(People who have gotten the novel swine flu already seem to be immune but unless you know you had it from a clear test, I would not assume that.)

And speaking of people getting it all wrong … have you heard about any of the flu woo scams going around regarding the flu? There is a treatment in which photons are passed into your cells to kill the virus. There is an anti-flu vaccine. There is a ‘do it yourself’ flu vaccine kit, which involves you sending in your credit card number but then never hearing back from them.

Obviously, don’t fall for that.

CDC flu site