H1N1. How does one die from it?

[missypie]

Confirmed H1N1. I guess for a while they were considering some experimental drug and to get that the patient has to have the extra lab work done to confirm H1N1.

 

[disney1990]

My friend died yesterday of complications of H1N1. He was absolutely healthy, 54 years old (so there goes the "safe if born before 1957 theory.")

Thurs Oct 8th - fine
Fri Oct 9th - started to cough, bad cough by the 10th
Monday the 12th - went to the doctor, was told it was flu, go home and drink liquids, etc.
Thursday the 15th - couldnt get rid of fever so he went back to the doctor; doctor told him to go to the ER -
Friday the 16th - severe pheunmonia/sepsus (sp) -put on a ventilator and into drug induced coma - over the weekend, other organs (liver, kidneys) in distress; heart rate and blood pressure low
Wednesday the 21st - put on ECMO machine; procedure went well; doctors were optimisic (also dialysis; had gained 60 lbs of retained fluid)
Sunday the 25th - despite the ECMO, couldn't get enough oxygen into his blood
Monday the 26th - disconnected from the machines and passed away 30 minutes later

This was a guy who hadn't taken a sick day in 25 years and who had terrific medical care from a large urban hospital.

I am so sorry to hear about your friend.

I had not heard the born before 1957 rule. What I heard was that people born before 1950 might have some protection. So basically, you would have to be about 60 years of age.

http://www.virology.ws/2009/10/21/severe-cases-of-pandemic-influenza/

 

[missypie]

I am so sorry to hear about your friend.

I had not heard the born before 1957 rule. What I heard was that people in their 60s might have some protection.

I've heard so many different things - people with parents who survived the 1918 flu had immunity passed down to them, people born before 1957 have immunity, people born after 1968 are at the biggest risk, etc. I think everyone is just trying to fit into a safe category so it won't be so worrisome.

 

[LuvOrlando]

It's important to keep in mind that in many cases it is not the primary disease that kills you. This happens not only with H1N1 but with other things like HIV, Leukemia, even Diabetes too. Here the H1N1 Flu renders your body less capable to fighting other opportunistic infections our bodies normally fight off every day. You may no realize it but we are all bombarded with Staph (even MRSA), Pneumonia, Strep on & on etc every day as we live our very regular lives. But every day our bodies swiftly and efficiently fight this stuff off so we don't get sick. Our immune systems really are elegant mechanisms.

But, if a wild card like H1N1 disrupts our lung function then those microbes can get a foothold. Once the microbes get a foothold the persons weakened body can't fight 2 infections at once and the system collapses. This is more dangerous in high risk populations because this sub group has bodies which are already strained by an underlying problem. Once you add the H1N1 you are already up to 2 stresses and then the opportunistic infection brings it up to 3 problems... obviously the more stress a body is under the less likely a good outcome. Sometimes medicine will help, sometimes it will not. Obviously, the faster you get help the less time the secondary infection has to overwhelm the system and the better the likely outcome.

The best thing anyone can do is watch someone with H1N1 VERY closely so that you can get help at the first sign of a secondary infection. This means ANY changes at all should be looked at. Did the fever just spike up? Does the cough suddenly sound different? Are there new symptoms? Of course, Dr's are overwhelmed so if you do see something changing MAKE SURE YOU ARE HEARD. The first words out of my mouth when I call my kids Dr's are "My DS or DD is a diagnosed hard to control Asthmatic" which immediately gets their attention. These people talk to dozens of people a day. If you have a concern state it clearly, write it out if you need to but do not ramble or they will stop listening. Remember your first contact with the office is not the Dr, or even the nurse. You are talking to a receptionist who is trained to listen for certain key words in order to triage the calls and bounce them up in order of severity.

As for me and my 2 high risk kids, I am monitoring their peak flow air flow meters and their temperatures twice a day. Once in the morning and once in the evening. If something changes, God forbid, hopefully I will have enough warning to get them the help they need quickly. All I can do is my best.

I hope your kids are lucky enough to just fight it off and be done with it.

PS- I do not think Pneumonia often starts out as the primary illness. It is much more likely to be a secondary infection.... not just with H1N1 but in general when someone gets Pneumonia there was something else wrong first that created a climate in which it could grow.

 

[Chelley00]

We have a friend who died from "complications relating to H1N1". He tested positive for swine flu, then contracted pneumonia, began multisystem organ failure, and died within 3 weeks.

 

[maroo]

My friend died yesterday of complications of H1N1. He was absolutely healthy, 54 years old (so there goes the "safe if born before 1957 theory.")

Thurs Oct 8th - fine
Fri Oct 9th - started to cough, bad cough by the 10th
Monday the 12th - went to the doctor, was told it was flu, go home and drink liquids, etc.
Thursday the 15th - couldnt get rid of fever so he went back to the doctor; doctor told him to go to the ER -
Friday the 16th - severe pheunmonia/sepsus (sp) -put on a ventilator and into drug induced coma - over the weekend, other organs (liver, kidneys) in distress; heart rate and blood pressure low
Wednesday the 21st - put on ECMO machine; procedure went well; doctors were optimisic (also dialysis; had gained 60 lbs of retained fluid)
Sunday the 25th - despite the ECMO, couldn't get enough oxygen into his blood
Monday the 26th - disconnected from the machines and passed away 30 minutes later

This was a guy who hadn't taken a sick day in 25 years and who had terrific medical care from a large urban hospital.

Still praying for you guys. Never taken a sick day. Wow.




This is the news from today:

I am not sure that this student died of H1N1, but the article does provide information about the cause of death for some people who have died of H1N1.



Student's sudden death fuels swine flu fears
By Edward Colimore
Inquirer Staff Writer

He went to classes at Rancocas Valley Regional High School in Mount Holly every day last week and showed no sign of illness, school officials said.

But on Saturday, 17-year-old Andre Mendez's temperature shot up to 104 degrees and he was having convulsions when paramedics arrived, according to the officials.

Mendez, a sophomore, died at Virtua Memorial Hospital in Mount Holly later that day, school authorities said, leaving health officials with a mystery they hope to solve today or tomorrow when lab tests are to be released by the state.

News of the death saddened students and parents and set off concerns yesterday that Mendez may have had the H1N1 virus that state health officials say has claimed 18 lives in New Jersey since the first case in June.

"Though there may be rumors, the cause of death is unconfirmed," said Michael Moskalski, the high school superintendent and principal. "H1N1 is a possibility, but we're awaiting the results from the cultures and testing."

Deaths involving the virus typically come days after a person is infected and are caused when his or her lungs fill with fluid, health officials said.

Those from the seasonal flu often occur one or two weeks after a person's initial infection, because the person has developed a secondary bacterial infection, such as a staph infection, according to the Centers for Disease Control and Prevention.

The test results will be released to the Burlington County Health Department, which will share them with school officials.

In the meantime, Moskalski said that he will ask the school board at a meeting tonight to authorize a school-based clinic to provide H1N1 vaccinations, probably in the gymnasium.

If approved, the shots would likely be given by the county health department by the end of November, he said.

"We have been sanitizing hard surfaces weekly and that will be increased to nightly so we can be sure the buildings will be clean," Moskalski said. But the flu "is spread through the air so that might not make a difference.

"We're doing everything that has been recommended," he said. "The goal this fall is to keep the schools open."

News of Mendez's death was shared with the students and staff members over the school intercom and counselors were made available.

"We have a crisis-intervention team that goes into place to provide the counseling services in a safe room for all grieving students," said Moskalski.

"If additional resources are needed, we can call on other districts to send people."

According to school staff, Mendez was in class all last week and appeared to be "fine on Friday. They didn't notice anything unusual and he didn't go to the nurse's office," the superintendent said.

The Burlington County health Department in Westampton will hold H1N1 flu shot clinics to vaccinate residents in priority groups from 2 to 4 p.m. on Nov. 6, 13 and 20, said Loretta O'Donnell, a county spokeswoman.

The groups include children 6 months to 5 years old, pregnant women, caregivers of children and health-care workers.

Vaccinations will be given throughout the Mount Laurel school system today through Thursday, O'Donnell said.

Additional clinics will be scheduled as the vaccine becomes available.

"This is a long-term campaign that will continue for months until everyone who wants an H1N1 vaccination has received one," said county Public Health Coordinator Robert Gogats.




--------------------------------------------------------------------------------

Contact staff writer Edward Colimore at 856-779-3833 or ecolimore@phillynews.com.

 

[cruisnfamily]

No reason to confirm with a test....the test isn't accurate even HALF of the time. Most dr's offices aren't bothering, for that reason. Also to protect the public. Confirmation does no good. If your dd doesn't have flu but some other bad respiratory virus, you Grandma shouldn't get exposed to THAT, either.

There is a 30-70% FALSE NEGATIVE rate. So it's still quite likely that she has it. That's why the doctors don't want to do the test - it's not reliable. I don't think your DD should be around your grandmother regardless of whether she truly has influenza, or some other viral illness that's making her sick. Anything of that nature can be very bad for an immunocompromised person.

I hope your DD is better soon.

Is the false negative thing related to the influenza A/B swab or specifically the swine flu? I thought it was the swine flu swab which had the false negatives but that the one testing for influenza A did not have the false negatives.

 

[snickerboo]

The article I just read says the American Journal of Medicine is saying that the blood de-oxygenates, cutting off the oxygen supply to the organs and causing organ failure.

http://thechronicleherald.ca/Opinion/1149653.html

• A recent study in the Journal of the American Medical Association found swine flu kills people by depriving their blood of oxygen, which, in the most severe cases, leads to organ failure and death.

The virus attacks the lungs, in many cases in young adults, which can lead to respiratory failure.

 

[maroo]

Is the false negative thing related to the influenza A/B swab or specifically the swine flu? I thought it was the swine flu swab which had the false negatives but that the one testing for influenza A did not have the false negatives.

Right now 99.6% of the cases of Influenza A are H1N1 (the ones testes by the CDC)...so the assumption right now is that all flu is indeed H1N1. It will be harder to tell as the season goes on (assuming that the "regular" flu arrives during the winter months).

The CDC has confirmed the false negatives for the rapid test in relation to swine flu cases.


This is directly from the CDC website (I didn't realize the test was as low as 10% accurate?)

The sensitivity of rapid tests in detecting 2009 H1N1 has ranged from 10% to 70%. Information on the use of rapid influenza diagnostic tests (RIDTs) can be found at http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm.

This is where I got it: http://www.cdc.gov/h1n1flu/recommendations.htm

 

[NotUrsula]

From what I understand it is either pneumonia or a cytokine storm that is responsible for most of the deaths.

Pneumonia is deadly serious; there are not many drugs that can quickly stop it if it gets well-established. If your body can't contribute to the fight you can get into deep trouble very fast. My mother died that way -- she went from her usual level of "fine" to dead in less than 72 hours. (Note that her death was not flu related, and she was in her 80's.)

This site has .wav files of the various lung sounds. It can be helpful for getting a sense of what approaching trouble sounds like: http://faculty.etsu.edu/arnall/www/public_html/heartlung/breathsounds/contents.html

Obviously, this is no substitute for skilled medical care -- if your spidey sense tells you that something is just not right, then insist on being seen.

 

[taximomfor4]

Is the false negative thing related to the influenza A/B swab or specifically the swine flu? I thought it was the swine flu swab which had the false negatives but that the one testing for influenza A did not have the false negatives.

There is no swab test for swine flu -- it has to be sent in and cultured. THAT test is accurate, but takes too long and too expensive to be of any use in treating patients.

The rapid test is just for Influenza. It has a terrible lack of accuracy for swine flu. Really, they have to diagnose based on symptoms and knowledge of what;s in the area at the time.

 

[laurie31]

There is no swab test for swine flu -- it has to be sent in and cultured. THAT test is accurate, but takes too long and too expensive to be of any use in treating patients.

The rapid test is just for Influenza. It has a terrible lack of accuracy for swine flu. Really, they have to diagnose based on symptoms and knowledge of what;s in the area at the time.

Yep!

The swab test is a viral respiratory panel (VRP). It tests for Influenza A, Influenza B, respiratory syncytial virus (RSV), parainfluenza virus 1, 2, and 3, and adenovirus.

If your test comes back positive for Influenza A, then there's a 99% chance you have H1N1, because that's about the only Type A flu "out there" right now. But if you DO have H1N1, the likelyhood that this test will be a false negative is VERY high, so just because you get a negative result, doesn't mean you don't have it.

The cultures are usually only done on hospitalized patients. If they cultured everyone, not only would it overwhelm the labs, but by the time the results get back, it's too late for Tamiflu. The physicians just have to diagnose the best they can based on symptoms and physical exam.

Just 4 days ago, a new drug was approved for treatment of severe H1N1 cases.

On October 23rd, the Food and Drug Administration (FDA) announced an emergency use authorization (EUA) for use of the unapproved "investigational antiviral drug peramivir intravenous (IV) in certain adult and pediatric patients" with "confirmed or suspected" severe H1N1 swine flu symptoms when hospitalized.


It seems that this has been issued as a treatment of last resort, for when all other options have failed severely ill patients with H1N1 swine flu symptoms.

Still, much of the wording is somewhat disturbing; "confirmed or suspected" swine flu symptoms perhaps most so.

http://www.examiner.com/x-18331-Nat...n-for-H1N1-Swine-Flu-symptoms-approved-by-FDA

 

[LUCiD]

Most people who died becasue of H1N1 had some other condition that made them more vulnerable to death. Two of these conditions being AIDs or pregnancy. Most people live, it's just that people with certain conditions are more prone to death than others.

 

[N&B'smom]

I'm so sorry to hear about those that died due to H1N1. It's so sad and so scary.

We believe my DD6 is at the tail end of H1N1. She was fine all day last Wednesday, came home from school and said she felt a little off. I took her temp and it was normal. About 2 hours later she suddenly had a fever of 103.5 (ear thermometer), it came out of nowhere. Thankfully it responded well to Motrin. We dealt with the fever for 5 days. Yesterday was her first fever free day. She now has a HORRIBLE sounding cough.

I called my Dr a couple of times during this time (including the first night the fever spiked up) so he knows what's up. I called yesterday about the cough and he prescribed some chewable cough medicine pills that she needs to take 3X a day and if it's not getting better by Thursday he said he needs to see her asap. My guess is because then he would be concerned about pneumonia.

Thankfully the pills are working. This morning she couldn't even eat breakfast because she was having coughing fits about every 5 seconds. Now she'll go 20-30 minutes without coughing. Thankfully. So far so good here.

Now I get to watch my DS10 who has asthma and make sure he doesn't end up with it too. It's so worrisome.

 

[Christine]

I'm so sorry to hear about those that died due to H1N1. It's so sad and so scary.

We believe my DD6 is at the tail end of H1N1. She was fine all day last Wednesday, came home from school and said she felt a little off. I took her temp and it was normal. About 2 hours later she suddenly had a fever of 103.5 (ear thermometer), it came out of nowhere. Thankfully it responded well to Motrin. We dealt with the fever for 5 days. Yesterday was her first fever free day. She now has a HORRIBLE sounding cough.

I called my Dr a couple of times during this time (including the first night the fever spiked up) so he knows what's up. I called yesterday about the cough and he prescribed some chewable cough medicine pills that she needs to take 3X a day and if it's not getting better by Thursday he said he needs to see her asap. My guess is because then he would be concerned about pneumonia.

Thankfully the pills are working. This morning she couldn't even eat breakfast because she was having coughing fits about every 5 seconds. Now she'll go 20-30 minutes without coughing. Thankfully. So far so good here.

Now I get to watch my DS10 who has asthma and make sure he doesn't end up with it too. It's so worrisome.

My son had the EXACT same illness. Once the fever left, he had a terrible cough. I hated sending him to school like that but what are you gonna do? His cough annoyed everyone around him for about 5 days. I thought it wasn't ever going to go away. I remember one Sunday (about 7 days after his fever was gone) we were in the mall and he was just coughing. It seemed like it was getting worse and I thought "Oh boy, we're going to have to go back to the doctor." And then the very next day it was totally gone. I mean totally. It didn't just taper off. I just stopped.

 

[C.Ann]

My friend died yesterday of complications of H1N1. He was absolutely healthy, 54 years old (so there goes the "safe if born before 1957 theory.")

Thurs Oct 8th - fine
Fri Oct 9th - started to cough, bad cough by the 10th
Monday the 12th - went to the doctor, was told it was flu, go home and drink liquids, etc.
Thursday the 15th - couldnt get rid of fever so he went back to the doctor; doctor told him to go to the ER -
Friday the 16th - severe pheunmonia/sepsus (sp) -put on a ventilator and into drug induced coma - over the weekend, other organs (liver, kidneys) in distress; heart rate and blood pressure low
Wednesday the 21st - put on ECMO machine; procedure went well; doctors were optimisic (also dialysis; had gained 60 lbs of retained fluid)
Sunday the 25th - despite the ECMO, couldn't get enough oxygen into his blood
Monday the 26th - disconnected from the machines and passed away 30 minutes later

This was a guy who hadn't taken a sick day in 25 years and who had terrific medical care from a large urban hospital.

We have a friend who died from "complications relating to H1N1". He tested positive for swine flu, then contracted pneumonia, began multisystem organ failure, and died within 3 weeks.

My condolences to both of you - and the families involved..

Most people who died becasue of H1N1 had some other condition that made them more vulnerable to death. Two of these conditions being AIDs or pregnancy. Most people live, it's just that people with certain conditions are more prone to death than others.

"Most" people had other underlying conditions that made them more vulnerable to death? Not an accurate statement at all.. "Most" have been extremely healthy - while "some" have had other health issues..

And since when is a perfectly normal, healthy pregnancy considered an "underlying health condition"? In all the years I've been around - even back when swine flu was here before - I never heard of women dying from it (or any other flu, for that matter) due to a healthy "pregnancy"..

 

[N&B'smom]

My son had the EXACT same illness. Once the fever left, he had a terrible cough. I hated sending him to school like that but what are you gonna do? His cough annoyed everyone around him for about 5 days. I thought it wasn't ever going to go away. I remember one Sunday (about 7 days after his fever was gone) we were in the mall and he was just coughing. It seemed like it was getting worse and I thought "Oh boy, we're going to have to go back to the doctor." And then the very next day it was totally gone. I mean totally. It didn't just taper off. I just stopped.

Thanks for the tip. I could tell my Dr was sort of 'on alert' when I mentioned how bad the cough was....I mean really, she could NOT eat. She's barely eaten over the last week. I'm praying the cough progresses like you said and just vanishes!

She's headed back to school tomorrow because it has improved, thankfully. But I'm told there were close to 80 kids absent today.

I'm glad your DS is all better!!

 

[QueenRocks]

Not H1N1, but a student of mine (I teach preschool) had a 13 year old cousin die from the flu 2 years ago. I couldn't believe it! I always thought that the very young or the very old died from the flu. The young girl had gone to a birthday party on the weekend, by Tuesday was in the hospital, and died the following weekend. She did not have an underlying condition. The fluid in her lungs was sent to the CDC. She died from the flu. So sad!

 

[Feralpeg]

My friend died yesterday of complications of H1N1. He was absolutely healthy, 54 years old (so there goes the "safe if born before 1957 theory.")

Thurs Oct 8th - fine
Fri Oct 9th - started to cough, bad cough by the 10th
Monday the 12th - went to the doctor, was told it was flu, go home and drink liquids, etc.
Thursday the 15th - couldnt get rid of fever so he went back to the doctor; doctor told him to go to the ER -
Friday the 16th - severe pheunmonia/sepsus (sp) -put on a ventilator and into drug induced coma - over the weekend, other organs (liver, kidneys) in distress; heart rate and blood pressure low
Wednesday the 21st - put on ECMO machine; procedure went well; doctors were optimisic (also dialysis; had gained 60 lbs of retained fluid)
Sunday the 25th - despite the ECMO, couldn't get enough oxygen into his blood
Monday the 26th - disconnected from the machines and passed away 30 minutes later

This was a guy who hadn't taken a sick day in 25 years and who had terrific medical care from a large urban hospital.

That is almost identical to what happened to my friend. He was 62 years old and had not medical issues prior to catching H1N1. Now, he's gone.

 

[LUCiD]

@C.Ann Sorry, I worded that wrong. I was told from a usually reliable source that if you are pregnant than Swine Flu is more fatal to you than it would be if you weren't pregnant. I'm not saying that being pregnant is a medical condition or anything of the sort. I'm sorry if I upset you.