Swine Flu News

[LuvOrlando]

Are there any Dr's out there who know if the Prednisone often given to calm down an Asthmatic flare up (by shutting down the immune system) would make an Asthmatic less capable of fighting off the flu? In particular THIS flu?

I've been pondering this lately and haven't come across anything remotely connected to the point. It could be that the Asthma creates a more imminent threat but still, maybe dosages could be/should be modified??? I REALLY hope we don't have to wait for trial and error to sort this out. I'd be lying if I said I wasn't growing more and more concerned as we inch closer to the Fall with very little information trickling out.

 

[C.Ann]

Are there any Dr's out there who know if the Prednisone often given to calm down an Asthmatic flare up (by shutting down the immune system) would make an Asthmatic less capable of fighting off the flu? In particular THIS flu?

I've been pondering this lately and haven't come across anything remotely connected to the point. It could be that the Asthma creates a more imminent threat but still, maybe dosages could be/should be modified??? I REALLY hope we don't have to wait for trial and error to sort this out. I'd be lying if I said I wasn't growing more and more concerned as we inch closer to the Fall with very little information trickling out.

What concerns me the most - as of today - is that there is a chance that FEMA will be involved.. We all saw how well that worked out with Hurricane Katrina..

As to your question - isn't the problem with this flu the fact that it causes strong immune systems to overcompensate - which in turns cause the lungs to fill with fluid and result in death? Perhaps a "weakened" or "compromised" immune system - such as mine and your asthmatic children's might be a saving grace.. At this point there are far more "questions" than "answers"..

 

[heynow1234]

That's great to hear! It would be awesome if that were the case for everyone, but unfortunately it isn't - and for those of us with serious health problems already, we can't adopt the "no big deal" attitude.. If a simple cold could land us in the hospital, imagine what this flu would result in.. Not pretty..

I'm really happy for you though that you have dealt with it - and hopefully won't have a "second go-round"..

Sorry if i made it sound like you shouldn't care cabout getting it, of course you should take all precautions, and it is terrible that some people have died. I just wanted to let people know that its not always serious, and that they should not live in extreme fear of getting it.

 

[MickeyMomTo2]

What concerns me the most - as of today - is that there is a chance that FEMA will be involved.. We all saw how well that worked out with Hurricane Katrina..

As to your question - isn't the problem with this flu the fact that it causes strong immune systems to overcompensate - which in turns cause the lungs to fill with fluid and result in death? Perhaps a "weakened" or "compromised" immune system - such as mine and your asthmatic children's might be a saving grace.. At this point there are far more "questions" than "answers"..

I think this was the problem in 1918. Strong immune systems over compensated, and healthy people basically drowned in their own secretions. I don't think there has been evidence of this now. Right now, people with immune problems seem more affected.

However, I do think that this is the concern with using an adjuvant in a vaccine. Adjuvants increase the immune response, and although you do want your body to recognize the virus, you don't want a response that is so heightened that it could kill you.

 

[DisneyBamaFan]

Sorry if i made it sound like you shouldn't care cabout getting it, of course you should take all precautions, and it is terrible that some people have died. I just wanted to let people know that its not always serious, and that they should not live in extreme fear of getting it.

Compared to the standard strains, the current swine flu strain is very mild. There have been just over 300 deaths in the US from Swine Flu (per the CDC). 36,000 people die every year from the standard strains. That is 692 per week.

Keep it in perspective. I really think that the media is hyping this for ratings (like West Nile a few years ago)...

 

[MickeyMomTo2]

According to the CDC today, July 29th, these people will be at the front of the line for the vaccine (or on the Disboards we could say they get a Fastpass).

"With limited H1N1 swine flu vaccines likely to be available, the CDC now has put certain groups at the front of the line. Pregnant women, healthcare workers, people from 6 months to 24 years old, caregivers for infants under six months and adults 24 to 64 with medical conditions that would put them at a high risk for complications. All groups now affected more frequently and severely than the general population."

My kids and I fit into these categories (my super healthy husband does not), but I do hope some information from the trials will emerge quickly. Although I think we would get a pure vaccine with few reservations, I am concerned about them using an adjuvant.

 

[JessicaR]

Are there any Dr's out there who know if the Prednisone often given to calm down an Asthmatic flare up (by shutting down the immune system) would make an Asthmatic less capable of fighting off the flu? In particular THIS flu?

I've been pondering this lately and haven't come across anything remotely connected to the point. It could be that the Asthma creates a more imminent threat but still, maybe dosages could be/should be modified??? I REALLY hope we don't have to wait for trial and error to sort this out. I'd be lying if I said I wasn't growing more and more concerned as we inch closer to the Fall with very little information trickling out.

This specifically addresses your question. I think it makes a difference if a person is on steroids long term as opposed to the occasional burst. http://abcnews.go.com/Health/SwineFluSymptoms/story?id=7677622

 

[luvmy3]

Are there any Dr's out there who know if the Prednisone often given to calm down an Asthmatic flare up (by shutting down the immune system) would make an Asthmatic less capable of fighting off the flu? In particular THIS flu?

I've been pondering this lately and haven't come across anything remotely connected to the point. It could be that the Asthma creates a more imminent threat but still, maybe dosages could be/should be modified??? I REALLY hope we don't have to wait for trial and error to sort this out. I'd be lying if I said I wasn't growing more and more concerned as we inch closer to the Fall with very little information trickling out.

This is exactly what has me worried about my ds. He uses Pulmicort daily (off it just for summer), he is seeing his pulminologist tomorrow and will probably be put back on it due to daily asthma flare-ups for at least a week. Since Pulmicort is a steroid it can supress his immune system. I want to dh to ask about this since he is taking him to the appt but he thinks I'm over reacting and being my worrisome self. Hopefully he will and whatever I find out I will post here later.

 

[luvmy3]

Compared to the standard strains, the current swine flu strain is very mild. There have been just over 300 deaths in the US from Swine Flu (per the CDC). 36,000 people die every year from the standard strains. That is 692 per week.

Keep it in perspective. I really think that the media is hyping this for ratings (like West Nile a few years ago)...

What I'm keeping in perspective is that H1N1 hasn't been spreading for a year, and hasn't even gone through a regular flu season. I'll be interested in comparing number of deaths per year in April 2010.
Also seasonal flu kills 36000 a year but I'm not sure its just one strain that kills all those people, its various ones throughout the year. I hope someone will correct me if I'm wrong.

 

[Tinijocaro]

Are there any Dr's out there who know if the Prednisone often given to calm down an Asthmatic flare up (by shutting down the immune system) would make an Asthmatic less capable of fighting off the flu? In particular THIS flu?

I've been pondering this lately and haven't come across anything remotely connected to the point. It could be that the Asthma creates a more imminent threat but still, maybe dosages could be/should be modified??? I REALLY hope we don't have to wait for trial and error to sort this out. I'd be lying if I said I wasn't growing more and more concerned as we inch closer to the Fall with very little information trickling out.

I did read once that prednisone supresses the immune system, which could make it harder to fight this flu. I have a dd with asthma so I need to look into this too..

 

[Tinijocaro]

Compared to the standard strains, the current swine flu strain is very mild. There have been just over 300 deaths in the US from Swine Flu (per the CDC). 36,000 people die every year from the standard strains. That is 692 per week.

Keep it in perspective. I really think that the media is hyping this for ratings (like West Nile a few years ago)...

Problem is, come fall, we could have two flus occuring simultaneously-swine flu which is predicted to be twice or more as bad as seasonal flu, and the regular seasonal flu.

Also, keep in mind that seasonal flu does not continue into the summer, nor does it usually kill people besides the very young and the very old.

Don't let them fool you with all this "underlying conditions" talk either. These were not people who were going to dying some time soon anyways-and that's how they want it to sound. I have a robust 7 year old dd who lives a very full, active normal life, who happens to have asthma. If she were to die from swine flu, they would say she had underlying conditions. I think they say this to not panic us into thinking "regular people" can die from this. Have an extra 50 pounds to lose? There's your underlying condition.

We are counting deaths that happen in the summer-for the flu!! It will be interesting to see what happens to those numbers in the fall when school resumes.

 

[JessicaR]

This is exactly what has me worried about my ds. He uses Pulmicort regularly (off it just for summer), he is seeing his pulminologist tomorrow and will probably be put back on it due to daily asthma flare-ups for at least a week. Since Pulmicort is a steroid it can supress his immune system. I want to dh to ask about this since he is taking him to the appt but he thinks I'm over reacting and being my worrisome self. Hopefully he will and whatever I find out I will post here later.

Patients not receiving systemic Corticosteroids are not at the same risks as those that do. Pulmicort is inhaled. Inhaled Steroids target the lungs with little systemic effect.

Myth: Steroids hurt your immune system.

Fact: It requires fairly high doses of steroids by mouth for prolonged periods of time to limit the body’s ability to fight infection. Even then the immune system gets back to normal once the patient is off steroids. One potentially concerning situation is when a child who has not had chickenpox or been vaccinated is exposed to chickenpox while on oral steroids. In this case, the child’s physician should be informed immediately. Inhaled steroids carry a similar warning, although the actual risk is likely very small. Children in general, but particularly children with asthma, should routinely receive the chickenpox vaccine.

http://www.aaaai.org/patients/advocate/2004/summer/steroid.stm

 

[luvmy3]

Patients not receiving systemic Corticosteroids are not at the same risks as those that do. Pulmicort is inhaled. Inhaled Steroids target the lungs with little systemic effect.

Myth: Steroids hurt your immune system.

Fact: It requires fairly high doses of steroids by mouth for prolonged periods of time to limit the body’s ability to fight infection. Even then the immune system gets back to normal once the patient is off steroids. One potentially concerning situation is when a child who has not had chickenpox or been vaccinated is exposed to chickenpox while on oral steroids. In this case, the child’s physician should be informed immediately. Inhaled steroids carry a similar warning, although the actual risk is likely very small. Children in general, but particularly children with asthma, should routinely receive the chickenpox vaccine.

http://www.aaaai.org/patients/advocate/2004/summer/steroid.stm

Thank you so much for this info and the link. DS has only been on Prednisone once and because his asthma is usually controlled by the Pulmicort we haven't have any more epsiodes where he needed it.

You have definitely put my mind alittle more at ease and saved me from looking all crazy and paranoid in front of dh

 

[Tinijocaro]

http://www.recombinomics.com/News/07290901/H1N1_V252M.html

Sorry-I realize this is a bit technical, but it shows that the virus is changing in Brazil, which you can see on this map: http://www.newfluwiki2.com/upload/maps 3/SA_728.gif

Genetic Changes in Pandemic H1N1 in Brazil Raise Concerns
Recombinomics Commentary 19:40
July 29, 2009
"The family Laguna had eight other cases of swine flu confirmed: mother, father, younger brother, three cousins, grandmother and an aunt of the girl. .

The above translation describes pandemic H1N1 infections in family members of the first confirmed H1N1 fatality in the Sao Paulo metropolitan region. The 11 year old girl, from Osasco (see map) died on June 30 and H1N1 was isolated from her blood on July 3. The HA sequence of the isolate, A/Sao Paulo/43812/2009, was released at Genbank and has three newly acquired polymorphisms. One polymorphism encodes for V252M (H3 numbering) and the nucleotide change is found in a limited number of sequences, including those from the 1918 pandemic. Other human H1N1 sequences include 2006 isolates from Peru and H1N1 isolates in circulation prior to the 1957 H2N2 pandemic. These human isolates have V252I. However, V252M is found in the 2001 swine isolate from Hong Kong, A/swine/Hong Kong/NS1659/2001 (see list here).

The second change also is non-synonymous (Q296H), and is found in multiple 2009 pandemic sequences identified worldwide (see list here), including an earlier isolate from Sao Paulo, A/Sao Paulo/2233/2009.

The third change is synonymous and also found in 2009 pandemic sequences (see list here), which are distinct from the isolates sharing the second polymorphisms. However, the synonymous polymorphism is also in the Hong Kong swine isolate providing additional evidence for acquisition via recombination.

This Sao Paulo isolate is the most recent isolate from Brazil, and may represent a change associated with the dramatic rise in fatalities in the region. Almost all of the fatalities in Brazil are in the southern region, and a high rate of fatalities has also been reported for adjacent locations in Argentina (see map). This concentration of fatal cases in southern Brazil and the Buenos Aires / Santa Fe region in Argentina and locations to the north, raise concerns that the fatalities may be linked to genetic changes in the pandemic virus circulating in the area. The present of the novel polymorphism, V252M, increases those concerns.

Recent reports from Argentina indicated there were 8 amino acid changes in recent isolates, presumably spread across all eight gene segments. The relationship of these changes to the newly acquired polymorphism in the Sao Paulo isolate would be of interest.

Release of recent sequences from isolates in Brazil, Argentina, Uraguay, and Paraguay would be useful.

 

[LuvOrlando]

Patients not receiving systemic Corticosteroids are not at the same risks as those that do. Pulmicort is inhaled. Inhaled Steroids target the lungs with little systemic effect.

Myth: Steroids hurt your immune system.

Fact: It requires fairly high doses of steroids by mouth for prolonged periods of time to limit the body’s ability to fight infection. Even then the immune system gets back to normal once the patient is off steroids. One potentially concerning situation is when a child who has not had chickenpox or been vaccinated is exposed to chickenpox while on oral steroids. In this case, the child’s physician should be informed immediately. Inhaled steroids carry a similar warning, although the actual risk is likely very small. Children in general, but particularly children with asthma, should routinely receive the chickenpox vaccine.

http://www.aaaai.org/patients/advocate/2004/summer/steroid.stm

Thanks for your posts but this particular one can be a bit misleading.

The word 'hurt' is what I find misleading because the whole reason prednisone is prescribed is to reduce your immune response and make it less effective. That's the drugs job and it is used when auto-immune responses become dangerous for the person with the problem such as Asthmatics, MS sufferers, Chrons or Ulcerative colitis... the list is pretty long. So to say it won't 'hurt' your immune system is true in the sense it will not cause any lasting damage beyond usage, but the notion that it doesn't effect your immune system at all is wholly off the mark. No flames here, these aren't your words. I wasn't going to say anything but then I realized how many people would be reading this and if they have a kid on steroids and didn't take any additional precautions... well that would be bad.

That said, I like the idea of using an anti-viral for a short while if a person is on a steroid for a short period. This particular hint is excellent, as long as the antiviral doesn't conflict with the other medicines used to get Asthma under control. I have Prednisone on hand all the time and think the Tamiflu would be good to have right next to it in my medicine cabinet.

 

[sbell111]

I surely am wondering if I did indeed have the swine flu. Fever for 7 days, cough and then into pneumonia.

It really scares me. I am wondering if this makes me more apt to get it during flu season or less--like I might have a bit of resistance to it. Of course, since I do not know what I had, for sure, I don't and won't know.

If you did, indeed, have H1N1, you will not get it again in teh fall, unless the strain significantly changes.

While you might be right, tell that to the people who have died from this--or their families.

A) Flying is pretty safe.

B) Tell that to the families of the people who have died on plane crashes.

The second comment doesn't change the accuracy of the first one.

What concerns me the most - as of today - is that there is a chance that FEMA will be involved.. We all saw how well that worked out with Hurricane Katrina..

The are the Federal Emargency Management Agency. Their mission is to "support citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards."

Of course they should be involved.

As to your question - isn't the problem with this flu the fact that it causes strong immune systems to overcompensate - which in turns cause the lungs to fill with fluid and result in death? Perhaps a "weakened" or "compromised" immune system - such as mine and your asthmatic children's might be a saving grace.. At this point there are far more "questions" than "answers"..

No.

What I'm keeping in perspective is that H1N1 hasn't been spreading for a year, and hasn't even gone through a regular flu season. I'll be interested in comparing number of deaths per year in April 2010.
Also seasonal flu kills 36000 a year but I'm not sure its just one strain that kills all those people, its various ones throughout the year. I hope someone will correct me if I'm wrong.

Actually, I'm pretty sure that the seasonal flu is generally one strain each year. The thing about this flu is that it isn't hitting just within the normal flu window which may or moy not result in a larger number of deaths. Certainly, a person has a longer time during whichj to avoid this flu, but given that people can only get it once (as long as it doesn't significantly mutate), we may be spared a huge incidence of this flu later in the fall simply because so many people will have already been previously exposed to it. Fewer people will be able to catch it and pass it on to you.

 

[rie'smom]

The second comment doesn't change the accuracy of the first one.
The are the Federal Emargency Management Agency. Their mission is to "support citizens and first responders to ensure that as a nation we work together to build, sustain, and improve our capability to prepare for, protect against, respond to, recover from, and mitigate all hazards."

Of course they should be involved.

If FEMA gets involved, look out. The disaster will get worse. Their acronym should be WOCT-Waste Of Citizen's Taxes. We saw first hand the way they screwed up in New Orleans and then last year with Gustav and Ike. They don't improve a thing and mitigate disasters? That's the best joke that I've seen in a long time. I'm not saying FEMA is totally responsible for the mess in New Orleans-Mayor Nagin, then Governor Blanco, and the people who didn't evacuate have to share blame too.

 

[AlexWyattMommy]

Actually, I'm pretty sure that the seasonal flu is generally one strain each year. The thing about this flu is that it isn't hitting just within the normal flu window which may or moy not result in a larger number of deaths. Certainly, a person has a longer time during whichj to avoid this flu, but given that people can only get it once (as long as it doesn't significantly mutate), we may be spared a huge incidence of this flu later in the fall simply because so many people will have already been previously exposed to it. Fewer people will be able to catch it and pass it on to you.

FYI - the seasonal flu shot has THREE strains in it. But more strains do circulate during the flu season. The current season flu shot information from the CDC -

http://www.fda.gov/BiologicsBloodVa...st-MarketActivities/LotReleases/ucm162050.htm

The panel recommended that vaccines to be used in the 2009-2010 influenza season in the U.S. contain the following:
an A/Brisbane/59/2007 (H1N1)-like virus; *
an A/Brisbane/10/2007 (H3N2)-like virus; **
a B/Brisbane/60/2008-like virus.
*A/Brisbane/59/2007 is a current vaccine virus; A/South Dakota/6/2007 (an A/Brisbane/59/2007-like virus) is a current vaccine virus used in live attenuated vaccines.
**A/Brisbane/10/2007 and A/Uruguay/716/2007 (an A/Brisbane/10/2007-like virus) are current vaccine viruses.
The influenza vaccine composition to be used in the 2009-2010 influenza season in the U.S. is identical to that recommended by the World Health Organization on February 12, 2009, for the Northern Hemisphere's 2009-2010 influenza season.

 

[gottaluvPluto]

If FEMA gets involved, look out. The disaster will get worse. Their acronym should be WOCT-Waste Of Citizen's Taxes. We saw first hand the way they screwed up in New Orleans and then last year with Gustav and Ike. They don't improve a thing and mitigate disasters? That's the best joke that I've seen in a long time. I'm not saying FEMA is totally responsible for the mess in New Orleans-Mayor Nagin, then Governor Blanco, and the people who didn't evacuate have to share blame too.

I live in Pensacola and think FEMA was awesome during Ivan and Dennis. Also, our state and local governments did a great job - maybe that is the difference.

 

[C.Ann]

If you did, indeed, have H1N1, you will not get it again in teh fall, unless the strain significantly changes..

I haven't seen this information yet.. Could you provide a link that states if you have already had H1N1 you will not get it again?

Thanks!

If FEMA gets involved, look out. The disaster will get worse. Their acronym should be WOCT-Waste Of Citizen's Taxes. We saw first hand the way they screwed up in New Orleans and then last year with Gustav and Ike. They don't improve a thing and mitigate disasters? That's the best joke that I've seen in a long time. I'm not saying FEMA is totally responsible for the mess in New Orleans-Mayor Nagin, then Governor Blanco, and the people who didn't evacuate have to share blame too.

I have to agree.. I just finished reading "The Great Deluge - Hurricane Katrina, New Orleans, and the Mississippi Gulf
Coast" by Douglas Brinkley - a fact based account.. FEMA did not only drop the ball for NOLA - but ALL of the Mississippi coast.. There were also serious problems with FEMA during the first 2 hurricanes my brother went through when he first moved to Florida a number of years ago..

I would be hard pressed to rely on FEMA to insure my safety - or that of my family..