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San Diego County reported its first swine flu death Monday, in a 20-year-old who was, as far as everyone knew, healthy, and who had not traveled recently. The flu also worsened very quickly in her, escalating over the weekend. Officials don't know what to think, and she could have had an undiagnosed condition. One to watch though, to see if something's changing about the flu.
by lychee on Thu Jun 18th, 2009 at 04:16:52 AM EST
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Cytokine storm - Wikipedia, the free encyclopedia
It is believed that cytokine storms were responsible for many of the deaths during the 1918 influenza pandemic, which killed a disproportionate number of young adults.[1] In this case, a healthy immune system may have been a liability rather than an asset. Preliminary research results from Hong Kong also indicated this as the probable reason for many deaths during the SARS epidemic in 2003.[6] Human deaths from the bird flu H5N1 usually involve cytokine storms as well.[7] Recent reports of high mortality among healthy young adults in the 2009 swine flu outbreak has led to speculation that cytokine storms could be responsible for these deaths.[8] However, the Centers for Disease Control and Prevention (CDC) have indicated that symptoms reported from this strain so far are similar to those of normal seasonal flu,[9] with the CDC stating that there is "insufficient information to date about clinical complications of this variant of swine-origin influenza A (H1N1) virus infection."[9]
(my emphasis)

The brainless should not be in banking. — Willem Buiter
by Migeru (migeru at eurotrib dot com) on Thu Jun 18th, 2009 at 04:41:24 AM EST
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We've been through that already. ;)

Officials are confused because the person who died did not match the other victims-- no underlying conditions, etc. It could have been a cytokine storm due to sudden mutation of the virus-- that would be bad, yes-- but it could also be that she had an undiagnosed heart or lung problem that led to the flu becoming much more severe for her. (They can't say much yet because one wrong word could set off a panic amongst those who've been waiting for their own little disaster flick.)

by lychee on Thu Jun 18th, 2009 at 04:50:17 AM EST
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Do you need a freshly mutated virus to get a cytokine storm? What is the connection?

lychee:

It could have been a cytokine storm due to sudden mutation of the virus


The brainless should not be in banking. — Willem Buiter
by Migeru (migeru at eurotrib dot com) on Thu Jun 18th, 2009 at 05:26:34 AM EST
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So far, other than in Mexico, the flu hasn't caused death in otherwise healthy people. To my knowledge, the only place where healthy people had a problem was in Mexico. While nothing's been proven, there was speculation that Mexico had it worse because of pollution and difficulty in getting health care. Regardless, the virus that had been circulating in SD County had not been doing much more than the regular flu. A sudden jump in severity would point to a) undiagnosed condition; b) poorer health than realized in the person (thus more susceptible to effects even though they seem healthy); or c) something's changed in the virus to make it more likely to become severe.
by lychee on Thu Jun 18th, 2009 at 05:47:18 AM EST
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Should be "poorer general health." Hey, it's 2:50 a.m. here.
by lychee on Thu Jun 18th, 2009 at 05:51:09 AM EST
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Link for the speculation about pollution, etc. I'm off to get some sleep.
by lychee on Thu Jun 18th, 2009 at 06:06:29 AM EST
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Does anybody know how often (if at all) regular flu kills people who are believed to be otherwise healthy? Without that information, it's hard to judge how significant cases like this are.
by gk (g k quattro due due sette "at" gmail.com) on Thu Jun 18th, 2009 at 06:10:46 AM EST
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The usual figure in the US is around 300,000 flu deaths per season. If just 1% of those are healthy adults - which seems to be pessimistic - there would be around 3,000 'healthy' deaths a year.

So far the UK has 1600 official cases and one death. The real number of cases is probably higher - there will be under-reporting because the illness is mild.

But assuming the 1600 cases are accurate, that's a case fatality rate of less than 0.1% - which would still make H1N1 much less dangerous than a typical annual flu round.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Thu Jun 18th, 2009 at 07:44:44 AM EST
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ThatBritGuy: which would still make H1N1 much less dangerous than a typical annual flu round.

That is good news for me!  I've had a flu since Monday and now it is pretty full blown.  I just called the U.S. Center for Disease Control to see if and when I should go get it checked out.  They told me that they have run out of the H1N1 test, but that I should go get a prescription for tamiflu.  Problem is, it's been more than 48 hours since symptoms kicked in, so tamiflu won't help at this point.

Since I hardly go out these days, the only place I can think I caught it was at the zoo last Saturday where there were lots of people.

In any case, I'm having my father go to the clinic to get a prescription for tamiflu, since he is not showing any symptoms of it, but better to minimize any chance that he contracts it from me.

Truth unfolds in time through a communal process.

by marco (cowannar at gmail punkt com) on Thu Jun 18th, 2009 at 08:51:02 AM EST
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Get some stock Vitamin D. It's been proven (as described in a SciAm feature) to calm the immune system and make a cytokine storm much less likely.

I take silly amounts of Ester C, especially when I'm feeling very tired and run down, and its ability to minimise or eliminate symptoms remains impressive.

But really, so far with this strain all of the data suggests that the chances of life-threatening reactions are incredibly tiny, and much lower than other everyday dangers.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Thu Jun 18th, 2009 at 09:18:12 AM EST
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Thanks for the tip.  Will "Calcium Plus Vitamin D" work?

Yeah, I'm not too worried about this flu getting out of hand in my case (though last night I had a pretty bad fever).  But I am worried about giving this to my father.  He is 68, gets very sick whenever he catches anything, and he has a long awaited and planned for vacation coming up in July, which would be horrible to spoil with the flu.

Truth unfolds in time through a communal process.

by marco (cowannar at gmail punkt com) on Thu Jun 18th, 2009 at 09:54:14 AM EST
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Zinc would be better than Calcium. Take the chelated form, it's easier to metabolise.

A useful dose for Vit D is 10-25ug/day. It's almost impossible to overdose on D - you'd need to eat an entire 90 capsule pack every day for a couple of months - so this is a safe basic intake.

You could try if you have symptoms and they're showing signs of getting serious.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Thu Jun 18th, 2009 at 12:10:08 PM EST
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ThatBritGuy:
I take silly amounts of Ester C,

how much, several grams per day?

it is a great infection fighter.

~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~

by melo (melometa4(at)gmail.com) on Thu Jun 18th, 2009 at 11:18:16 AM EST
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At least 2g every day, but sometimes more. When run down or on the edge of developing something unpleasant it's up to 1g/hr.
by ThatBritGuy (thatbritguy (at) googlemail.com) on Thu Jun 18th, 2009 at 12:05:59 PM EST
[ Parent ]
now that's what i call a power user!

linus pauling is surely proud of you.

wonderful stuff, if only it were used as generously as antibiotics..

~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~

by melo (melometa4(at)gmail.com) on Thu Jun 18th, 2009 at 05:19:42 PM EST
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If just 1% of those are healthy adults - which seems to be pessimistic

I agree that it's probably pessimistic, but I'm trying to find out what the real figure is. If no healthy adult ever dies from regular flu, then one or two deaths from this new strain might be a very serious sign. If a few do (or rather, for a precise comparison, a few who seemed beforehand to have no serious problem), then this indicates that H1N1 is not very dangerous at this point (just like the 1918 flu...).

by gk (g k quattro due due sette "at" gmail.com) on Thu Jun 18th, 2009 at 09:38:27 AM EST
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