11 More children have died from H1N1 - reported in the past week..:(

[sbell111]

What are they dying of? I'm sorry if that is a dumb question. What I want to know is if it is secondary bacterial infections that could be treated or if there is no treatment for what happens to them.

It's a combination of pneumonia and cytokine storm, if memory serves.

 

[Christine]

Not a "dumb" question at all.. The article I linked doesn't discuss the specifics of that, but a little girl died yesterday (I believe) in CA who was perfectly healthy - with no underlying medical issues.. It all happened very, very quickly - which is not the first time I have heard of it progressing this way..

All I know for certain is that it attacks the lungs - thus the need for the vents.. Whether the flu then causes a specific bacterial infection in the lungs, I don't really know.. I'm sure someone else here might have a more definitive answer to that..

I wish they would give the information out on the deaths and what is going on with that. The one person's story that I knew of that died was a young man who got H1N1 and had to go to boot camp shortly after getting it. He didn't properly take care of himself, hid the illness, and it developed into pneumonia and he died.

As for some of the rapid cases of death, I'm thinking it is like what happened in the 1918 pandemic. Younger people would get the flu and it would cause a massive, overreaction of the immune system. White cells would flood the lungs to fight the infection and the response was so overwhelming that victims usually "drowned" within hours.

So, the actual flu is not really "lethal", it is more some people's immune response to this particular strain. While I'm not totally sold on flu shots (my son does get one), this is a particular case where an immune system exposure to a dead virus is really going to help you should you come into contact with the real thing.

 

[C.Ann]

I haven't stated that there reasons weren't valid. My point was that the fact that children are dying due to this flu does not make the decision to receive the vaccine more difficult, as you suggested in the OP. It makes it easier.

How so? Do you think that the parents that are still waffling - for whatever reason - are not aware that children are dying? If they aren't aware, then they must be living in a cave somewhere..

Maybe the number has to be higher for them to make that "easier" decision.. Maybe they are so afraid of the vaccine - and the notion that it hasn't been tested well enough - that they can't decide between that "rock and a hard place"..

My logic - and your logic - isn't necessarily the logic of others..

 

[minkydog]

I am very concerned about this H1N1 flu. We just had a 10yo girl in Georgia, not far from us, who had no pre-existing conditions. She went down like a rock! I believe I heard she died of respiratory failure, which could be anything from pneumonia to Respiratory Distress Syndrome. My DH has severely damaged lungs due to an autoimmune disorder and he takes high doses of steroids daily to manage his illness. His pulmonologist has put the fear of God in us--bring him in immediately if he exhibits flu symptoms and just know that he will be going straight to ICU! Believe this, we are ALLLLL getting our flu shots!

 

[C.Ann]

They just reported on the news that there is a "shortage" of the vaccine (shot) - thus the time lag in getting it out to the public - but "eventually" everyone who wants it, "should" be able to get it..

This is not satisfactory to me.. We can't get the mist - and by the time the "shots" are available in our area, Swine flu will be so widespread here it will be useless..

 

[Pennykay]

This is why I am worried that they will decide to use the adjuvants in the vaccines. They have a huge shortage and may conclude that they need to so that they can spread it out to all who need it. Yes, I realize that is is pure speculation, but it is on my mind.

 

[Feralpeg]

I have been watching on a daily basis for the availability of the vaccine in the area near my DD's school. So far, they are limiting it to pregnant woman and kids between 2 and 6 years of age. They have a very limited supply.

As soon as it is available, I will make sure that she gets it. She has had so many cases of bronchitis and pneumonia, this really scares me. It will be a long flu season!

 

[luvwinnie]

They just reported on the news that there is a "shortage" of the vaccine (shot) - thus the time lag in getting it out to the public - but "eventually" everyone who wants it, "should" be able to get it..

This is not satisfactory to me.. We can't get the mist - and by the time the "shots" are available in our area, Swine flu will be so widespread here it will be useless..

I agree! I am very frustrated by the delay. Seeing my pulmonologist Thursday. I'll see if he knows any more. I have asthma and I'm on an immunosuppressant (Enbrel). I have to go to Vegas for work (convention, lots of crowds) in Nov and I'm worried about getting sick while away.

 

[arminnie]

I was in Austin, TX this past weekend. It seemed like there was a child dying or in terrible shape everyday in the paper. Really made it hit home. The paper quoted some health agency as saying that extremely obese children were much more vulnerable to life-threatening complications.

My doctor's son had H1N1 about two weeks ago (12 years old). He is fine now - but his dad (the doctor) cancelled all of his appointments during this time to make sure he wasn't transmitting it to his patients.

He said that the main difference in swine flu and regular flu (if no complications) is that there are more intestinal problems.

 

[sandramaac]

Kids are dying from this flu. I can't imagine how this fact would make the decision whether to vaccinate MORE difficult.

Don't vaccinate = maybe die
Do vaccinate = don't die

Seems pretty simple.

It isn't that simple. The article mentions that the teenagers and children are being hit by a 'new strain' of the virus, meaning that the current vaccine will not be effective against it!! And this was a concern about this flu virus, that it does mutate very quickly. I do not think they are going to be able to keep up with how quickly this virus is going to change.

 

[monkeybug]

It isn't that simple. The article mentions that the teenagers and children are being hit by a 'new strain' of the virus, meaning that the current vaccine will not be effective against it!! And this was a concern about this flu virus, that it does mutate very quickly. I do not think they are going to be able to keep up with how quickly this virus is going to change.

I wonder though if getting the vaccine does offer limited immunity even if the virus mutates. Don't they say that they believe that the reason people of a certain age aren't getting hit as hard as they would with the seasonal flu is because many of them were either vaccinated or exposed during the last swine flu outbreak? This certainly isn't exactly the same strain as then, but they seem to have some protection.

 

[monkeybug]

It isn't that simple. The article mentions that the teenagers and children are being hit by a 'new strain' of the virus, meaning that the current vaccine will not be effective against it!! And this was a concern about this flu virus, that it does mutate very quickly. I do not think they are going to be able to keep up with how quickly this virus is going to change.

This is what it says on the WHO websites most current flu update-

All pandemic H1N1 2009 influenza viruses analyzed to date have been antigenically and genetically similar to A/California/7/2009-like pandemic H1N1 2009 virus.

It says something very similar on the CDC's. I'm pretty sure that if a new more serious strain had been detected the CDC and WHO would be aware of it.

 

[maroo]

What are they dying of? I'm sorry if that is a dumb question. What I want to know is if it is secondary bacterial infections that could be treated or if there is no treatment for what happens to them.

Here are some snipits from articles that are on the internet....



Article 1: ** This one made me cry...because she loved Disney. **

Alitza Ortiz Sanchez didn't have a high fever, cough, runny nose or sore throat.

That's why her parents, who live in Otay Mesa, didn't suspect swine flu when they first brought their sick 5-year-old daughter to a physician on the morning of Oct. 8.

But when the girl developed a terrible headache and purplish swelling around her eyes the next day, her parents knew something was wrong. Alitza was dead 35 hours later, becoming the first child in San Diego County to succumb to the H1N1 influenza virus.

Last night, mother Itzya Sanchez and father Miguel Ortiz joined family members at a funeral home near Tijuana's City Hall for a wake. Inside the coffin, Alitza wore a red princess dress modeled after an outfit in the Disney movie “Beauty and the Beast.”

“For Halloween, she wanted to be a princess, so we bought her a new one” for the funeral, Sanchez said. “We didn't think something like this could happen to us.”



Article 2: ** Some are dying from Pulmonary Embolism, normally not seen with seasonal flu **

The new pandemic H1N1 flu may cause blood clots and other unusual damage in the lungs and doctors need to be on the lookout, U.S. researchers reported on Thursday.

Two studies published in the American Journal of Roentgenology show the need to check X-rays and CT scans for unusual features, and also point out swine flu can be tricky to diagnose in some of the sickest patients.

H1N1 flu is causing a pandemic, and while it is not particularly deadly, it is sickening many younger adults and older children who usually escape the worst effects of seasonal flu.


Article 3:
WASHINGTON – The northern hemisphere should brace for a tough fight against swine flu, which "overwhelmed" hospitals in the southern hemisphere, a world flu expert said Friday.

Data presented at a three-day meeting of health professionals here showed that "this virus causes severe pneumonia compared to seasonal flu," World Health Organization (WHO) influenza expert Nikki Shindo told reporters.

The influenza A(H1N1) virus, she warned, could cause potentially life-threatening viral pneumonia far more often than the seasonal flu.

"This virus really likes the lower respiratory tract, which means this virus is more likely to cause viral pneumonia than seasonal pneumonia," Shindo warned.


Article 4:
"I feel awful. I feel like part of my soul has been crushed," said Benjamin's father Eric Oback. "It's the worst imaginable feeling to see your kid fall that quickly and to be that ill. The night that he went to the emergency room was the scariest moment I've had in my entire life."

It started out like a normal flu. On Sunday, Oct. 4, after riding his bike, Benjamin felt out of breath.

"On Sunday, he complained his chest hurt," said Oback.
'He Became Unresponsive'

"Benjamin was seen to have a minor case of the flu," his mother Julie Oback said. "I had taken Benjamin to his pediatrician Tuesday morning because he had a mild fever. His pediatrician listens to his lungs. He said his lungs were clear. I asked him about giving him Tamiflu, and he said, 'No, he's not that sick. He should be better by the end of the week.' Nine hours later, he took a turn for the worse, and he became unresponsive."

"This wasn't the normal course. Most people who get H1N1 are fine, but you don't know who's going to take a turn for the worse," said Julie Oback. "That's what's so scary about it."

"In Benjamin's case, the main symptom was that fluid built up on the outside of his lung rather than the inside of his lung, and I think that's probably why his pediatrician didn't catch it with a stethoscope, because the fluid on the outside doesn't gurgle when you breath," Benjamin's father said. "I think the fluid outside caused his lung to collapse and stop functioning."

As for some of the rapid cases of death, I'm thinking it is like what happened in the 1918 pandemic. Younger people would get the flu and it would cause a massive, overreaction of the immune system. White cells would flood the lungs to fight the infection and the response was so overwhelming that victims usually "drowned" within hours.

So, the actual flu is not really "lethal", it is more some people's immune response to this particular strain.

A bunch of people died in the 1918 Pandemic. They say between 20 and 40 million people. I certainly hope this strain does not even end up NEARLY that bad.


But there are several similarities.

Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients.

Another oddity was that the outbreak was widespread in the summer and autumn (in the Northern Hemisphere); influenza is usually worse in winter

I was in Austin, TX this past weekend. It seemed like there was a child dying or in terrible shape everyday in the paper. Really made it hit home. The paper quoted some health agency as saying that extremely obese children were much more vulnerable to life-threatening complications.

My doctor's son had H1N1 about two weeks ago (12 years old). He is fine now - but his dad (the doctor) cancelled all of his appointments during this time to make sure he wasn't transmitting it to his patients.

He said that the main difference in swine flu and regular flu (if no complications) is that there are more intestinal problems.

I am afraid that the ones you read about in the paper this week are not in the totals so far. The CDC is behind a week in reporting and the hospitals and such have a few days to get the paperwork to the CDC.



Here are some more tidbits from news sources...


ATLANTA -- The largest U.S. analysis of hospitalized adult swine flu patients has found almost half were healthy people who did not have asthma or any other chronic illnesses before they got sick.

Health officials released the surprising results at a news conference on Tuesday, noting that 46 percent of 1,400 hospitalized adults did not have a chronic underlying condition.



This is from a commentary article from a doctor in an ER:

I've been practicing medicine for 15 years, and I've never seen flu like this. They're coming in by the hundreds. Fevers of 103 or 104, shaking chills, misery. They wait for hours in the lobby or in the halls, and you know them because they're wearing the yellow masks we give them at the door.

The masks make everyone feel better. Whether they have an effect, however, is less certain.

I wear a mask too, as much as I can. It's uncomfortable and hard to talk through. I don't want to get this flu, though, and I especially don't want to bring it home to my 5-year-old son, so I wear it. I'm likely to get the flu anyway unless I am vaccinated soon, because my exposure, just like that of every other hospital worker in the United States right now, is extreme.

The vaccine, we're told, will arrive any day.

As I write this, the intensive care unit at our hospital has 10 critically ill patients on ventilators because of this flu. All of them are relatively young, healthy adults. I've never seen that before, either.

 

[Tinijocaro]

A main reason people question vaccinations is because they believe what Jenny mccarthy is spouting. She has no medical or scientific background, yet people believe her over all medical evidence that shows NO relationship between vaccinations and autism.

She obviously has no issues with botox, just vaccinations.

I feel sad for children who would normaly life a happy and healthy life but won't because of careless parents believing a D class actress over valid scientists.

Jenny has been talking about vaccines for what-two years? People have been questioning vaccines for many more years than that. Do you realize many doctors are not in favor of this H1N1 vaccine and recommend NOT getting it?

 

[alamode]

Jenny has been talking about vaccines for what-two years? People have been questioning vaccines for many more years than that. Do you realize many doctors are not in favor of this H1N1 vaccine and recommend NOT getting it?

The H1N1 vaccine IMHO (as a geneticist) has come out a bit early, so people have good reason to question it. Flu vaccines in general are have the lowest success rate, mainly due to the rapid changes in flu strains. Only vaccines for a specific strain works if you catch that particular one and it hasn't mutated too much.

I just get extremely aggravated when people question vaccines in general. While the risk of side effects from vaccines are there, they are quite minimal when compared to the extreme consequences of catching a life threatening disease.

 

[mefordis]

Is she giving her kid botox?

A main reason people question vaccinations is because they believe what Jenny mccarthy is spouting. She has no medical or scientific background, yet people believe her over all medical evidence that shows NO relationship between vaccinations and autism.

She obviously has no issues with botox, just vaccinations.

I feel sad for children who would normaly life a happy and healthy life but won't because of careless parents believing a D class actress over valid scientists.

 

[alizesmom]

Whether or not to get your child vaccinated is never clear-cut. If you choose not to do it and your child dies then it is something you'll regret forever. Unfortunately if you choose to give the vaccine and have a severe reaction then, again, you'll regret it forever. Never criticize someone else's choice. We all make our decisions based on our very individual circumstances. I, for one, nearly danced with joy as my 4yr old got her first H1N1 shot today (one more in a month) but that does not make my choice right for someone else nor does it remove my fear of a possible reaction. You do what is right for your child.

 

[Wonderlandmom]

It isn't that simple. The article mentions that the teenagers and children are being hit by a 'new strain' of the virus, meaning that the current vaccine will not be effective against it!! And this was a concern about this flu virus, that it does mutate very quickly. I do not think they are going to be able to keep up with how quickly this virus is going to change.

The article is written strangely. The "new virus" they talk of IS the H1N1. They are comparing it to the seasonal flu. Not a new strain of H1N1.

This new strain is different from regular winter flu because it strikes the young far more than the old, and child deaths are drawing particular attention.

 

[Pennykay]

I found this to be very informative.

Swine Flu Characteristics Becoming More Evident

Links to Pneumonia, Rapid Effects on Young Noted

By Rob Stein
Washington Post Staff Writer
Saturday, October 17, 2009
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/16/AR2009101601384.html

As swine flu continues to spread around the globe, a clearer and in some ways more unnerving picture of the most serious cases has started to emerge, indicating that the virus could pose a greater threat to some young, otherwise vibrant people.

The virus can cause life-threatening viral pneumonia much more commonly than the typical flu, prompting the World Health Organization on Friday to warn hospitals to prepare for a possible wave of very sick patients and to urge doctors to treat suspected cases quickly with antiviral drugs.

Experts stress that most people who get the H1N1 virus either never get sick or recover easily. But some young adults, possibly especially women, are falling seriously ill at an unexpectedly rapid pace and are showing up in intensive care units and dying in unusually high numbers, they say.

Although why a minority of patients become so sick remains a mystery, new research indicates that H1N1 is different from typical seasonal flu viruses in crucial ways -- most notably in its ability to penetrate deep into the lungs and cause viral pneumonia.

"It's not like seasonal influenza," Nikki Shindo of the World Health Organization said at the conclusion of a three-day meeting of more than 100 experts the WHO convened in Washington to review swine flu. "It can cause very severe disease in previously healthy young adults."

Meanwhile, the Centers for Disease Control and Prevention reported Friday that vaccine production was proceeding more slowly than hoped. Officials had predicted that about 40 million doses would be available by the end of October, but that projection will probably fall short by about 10 million to 12 million doses, said Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases.

"Eventually, anyone who wants to be vaccinated will be able to be, but the next couple of weeks will continue to be a slow start," she said. So far, 11.4 million doses have become available and states have ordered about 8 million doses, but the vaccine will not become available in large amounts until November, she said.

The WHO's warning came as U.S. health officials reported that the number of states reporting widespread flu activity was up to 41, including Maryland and Virginia, and that the death toll among children had climbed to 86. Maryland has reported 10 deaths and Virginia health officials say eight people, including one child, have died. There have been no reports of deaths among District residents.

So far, the virus does not seem to sicken or kill people more often than the typical flu. But the pattern of people getting seriously ill is far different than in typical flu seasons. The elderly, who are usually most vulnerable, are generally spared; children, teenagers, pregnant women and young adults are the most common victims.

Officials have been closely monitoring the virus for signs it has mutated into a more dangerous form, and they have also been testing animals for the virus because of fears that infected livestock could cause more-lethal mutations.

Federal agriculture officials said Friday that pigs from the Minnesota State Fair had tested positive for H1N1, which would make them the first documented pig infections in the United States, if follow-up tests confirm the results. But there are no signs that the pigs were sick or that the animals had infected any humans. Children staying near the fair had gotten the virus, but there was no sign they were infected by the pigs.

Seasonal flu viruses tend to infect primarily the upper respiratory system. But recent animal studies and autopsies on about 100 swine flu victims show that H1N1 infects both the upper respiratory tract, which makes it relatively easy to transmit, and also the lungs, which is more similar to the avian flu virus that has been circulating in Asia.

"It's like the avian flu on steroids," said Sherif Zaki, chief of Infectious Disease Pathology at the CDC. He noted that unusually large concentrations of the swine flu virus have been found in the lungs of victims: "It really is a new beast, so to speak."

About a third of patients who required intensive care had bacterial pneumonia, but H1N1's proclivity to infect lung cells makes it more likely than seasonal flu to cause viral pneumonia, which can lead to life-threatening lung damage.

"Remarkably different is this small subset of patients that presents very severe viral pneumonia," Shindo said.

One of those patients was Karen Ann Hays of Sacramento, Calif., an otherwise healthy nurse whose hobby was tackling grueling triathlons. Despite desperate measures to keep her alive, Hays, 51, died in July within days of coming down with swine flu.

"I have seen more cases like this in the last three months than I have in the last 30 years," said Peter Murphy, director of intensive care at the Mercy San Juan Medical Center in Carmichael, Calif., who tried to save Hays.

Although it remains unclear how frequently the virus makes people seriously ill, recent reports from Mexico, Canada, the United States, Australia and New Zealand indicate that perhaps 1 percent of patients who get infected require hospitalization. Between 12 to 30 percent of those hospitalized need intensive care, and 15 to 40 percent of those in intensive care die.

While about two-thirds of U.S. patients who were hospitalized in the spring had other medical conditions, the CDC reported this week that an analysis of more than 1,400 hospitalized victims found perhaps half had no serious health problems.

About one-third of those around the world who have died or became seriously ill from swine flu appear to have been vulnerable because they had heart or lung disease, chronic kidney problems, or other ailments that usually put people at risk. But others had conditions that many may not immediately associate with frailness, such as mild asthma, high blood pressure, high cholesterol and obesity.

"Many of these people look just like you or me," said Anand Kumar, an associate professor of critical care and infectious disease at the University of Manitoba in Winnipeg, Canada, which was hit hard by the pandemic's first wave last spring.

There appears to be no way to predict with certainty who may suffer serious, life-threatening complications, since some victims have had no other health problems.

For instance, Stacey Hernandez Speegle, 30, of Madison, Calif., who died in July, "was in great shape. She was on the softball team. She had two young children. She was renovating her house," said her mother, Tamara Brooks. "It's just so hard to believe."

Although it has been well publicized that pregnant women appear to be at increased risk, some evidence has started to suggest that being female may itself be a risk factor, for reasons that remain unclear.

"There's no question that women, and particularly young women, are getting hit disproportionately," said Kumar. He noted that women tend to have more fat tissue, which can help stimulate a dangerous inflammatory response to infections.

And some of those who develop serious illness deteriorate soon after starting to feel ill. They require oxygen masks, ventilator machines to pump oxygen into their lungs to keep them alive, and drastic, often rarely used measures to try to save them within days of the first fever, ache or cough.

"The rapidity of it is striking," said Andrew R. Davies, deputy director of intensive care at Alfred Hospital in Melbourne, Australia.

Some of the cases in Australia and New Zealand were so severe that doctors resorted to a much more aggressive, less commonly used treatment known as extracorporeal membrane oxygenation (ECMO). It involves siphoning patients' blood into a machine to remove carbon dioxide and then infuse it with oxygen before returning it to their bodies.

"It's quite an extreme form of treatment," said Steve Webb, a clinical associate professor at the Royal Perth Hospital in Australia.

Other doctors have tried administering nitric oxide and putting patients in a bed that turns them upside down to help their lungs work better. "Our back was against the wall," Murphy said, adding that after the deaths of patients such as Hays his hospital is working to make ECMO available.

"It's very difficult to get this double-barreled message out that: 'Yes, most cases are mild, but in a small percentage of cases these cases are disastrous,' " Vanderbilt University's William Schaffner said. "But the message is: Don't underestimate H1N1."

Of the at least 86 Americans younger than 18 who have died from H1N1, 11 deaths were reported in the past week. About half of the deaths in the past month were among teenagers, Schuchat said. Since Aug. 30, 43 pediatric deaths have been reported, including three in those younger than age 2, five among those ages 2 to 4, 16 in those ages 5 to 11, and 19 among those ages 12 to 17, she said.

"These are very sobering statistics," Schuchat said, noting that only about 40 or 50 children usually die during an entire flu season.

Virginia Health Commissioner Karen Remley said Friday that although the majority of H1N1 cases in the state are "mild and moderate," significant numbers have become seriously ill.

In Maryland, at least 257 people have been hospitalized with confirmed cases of H1N1 since June, health officials said.

At least 2,914 Americans have died from flu-related illnesses since the H1N1 began, the CDC said.

 

[Where'sPiglet?]

Question: Do people that have had H1N1 need the vaccine?

The vaccine puts H1N1 into you to expose your body to it, right? So then if you've already had it, you wouldn't need the vaccine?