Severe Respiratory Failure

I had a mild heart-stopping moment just now when I was reviewing the WHO’s update on H1N1, published today on their web site, which hints at the real possibility of impending doom:

Severe respiratory failure

Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.

During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services. Some cities in these countries report that nearly 15 percent of hospitalized cases have required intensive care.

Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.

Vulnerable groups

An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.

Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.

When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.

Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.

Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.

Higher risk of hospitalization and death

Several early studies show a higher risk of hospitalization and death among certain subgroups, including minority groups and indigenous populations. In some studies, the risk in these groups is four to five times higher than in the general population.

Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension.

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13,398 Cases of Influenza A(H1N1) Infection, Including 95 Deaths World-Wide

Two more people from New York have died from the swine flu.  It is said they had underlying health conditions, but I think pretty much everyone has underlying health conditions so that doesn’t mean too much to me.

Also, stop going to the hospital in droves, people!  You are far more likely to get something nastier than the swine flu at a hospital so suck it up and if you don’t feel well, stay at home.

In New York, “hospitals that normally get about 200 visits to the emergency room each day are getting 2,000 per day…and more than 25,000 people have gone to emergency rooms over the past month.”  Seriously, that’s ridiculous.  “Of those who have gone to the emergency room, fewer than 1 in 50 needed to be admitted to the hospital.”

If I had the flu, the last thing I would want to do is spend hours in the ER, twiddling my thumbs and inhaling everyone’s sickly vapors.

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10,243 Cases of Influenza A(H1N1) Infection, Including 80 Deaths World-Wide

A 22 year old from Utah has died from complications resulting from the swine flu.  It is reported that the man was overweight (aren’t we all?) and had other chronic medical conditions.

Arizona has marked its 3rd death resulting from complications of swine flu; a 13 year old who had underlying medical conditions.

It turns out Japan was freaking out about the swine flu for good reason.  Tokyo has has reported its first 2 cases of swine flu in students, and the virus is expected to spread rapidly in such a dense and populated area.  The total number of cases in Japan is at 267, making it the world’s fourth most infected country after Mexico, U.S.A and Canada.

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World H1N1 toll nears 10,000

Pretty impressive!  Yesterday I was feeling a little achy and so I immediately suspected I was coming down with the swine flu.  Thankfully, I believe I was mistaken, but I am sure I will have several other “swine-flu scares” before it has run its course.

People still don’t really know what’s going on with this mysterious virus.  It was reported that the principal who died in NY had underlying medical conditions.  Yet, his wife says he only suffered from gout, a disease marked by acute attacks of arthritis.

Also, people have been criticizing the WHO’s pandemic levels. Because the phases represent the extent of the spread of the virus, and not the severity, several health experts think the current pandemic levels are not very useful.

“One of the better determinants is the incubation period,” said Robert I. Fields, chair of the department of health policy and public health at the University of the Sciences in Philadelphia.

Fields said a long incubation period with mild to no symptoms would allow the virus to spread quickly and widely before people quarantine themselves. Couple a long incubation period with a particularly deadly strain, and doctors have their “worst nightmare” of a flu virus, Fields said.

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A Couple Things

The aforementioned principal in New York has died from complications of the H1N1 virus. He is the 6th person to die from flu related complications.  It isn’t known if he had any pre-existing medical problems. Or if it is…no one’s saying anything. The city of New York is seeing a rise in flu reported illnesses.

Additionally, Japan is seeing an increase in swine flu cases, and is freaking out.

Kobe residents rushed to hospitals, where doctors in biohazard suits checked people for fever in tents set up in parking lots, Agence France-Presse reported. Transit workers and supermarket employees began wearing masks.

Japan is well known in public health circles for being exceptionally nervous about flu; it has an aging population and a national obsession with cleanliness that makes even Switzerland look messy.

Masks are common on subways because it is considered rude to lack one if you are sneezing. Before the outbreak began last month, Japan used about 60 percent of the world’s stock of the antiviral drug Tamiflu.

A biohazard suit in some kind of animal print might work for me, though.

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