You are correct about pneumonia as the cause of death. However, as I understand, H1N1 can immediately cause pneumonia as a primary infection rather than having pneumonia as a secondary infection in other flus. I think the mystery may be what factors lead to pneumonia as a primary infection when H1N1 occurs.
I agree with you 100% !
This article was posted today and has some interesting info .
MI
http://www.annarbor.com/news/hospitals-local-physicians-respond-to-influx-of-swine-flu-patients/
(snip)
Some legitimate, some due to the paranoia surrounding the H1N1 virus.
And for a fraction of that population, the flu has led to extremely serious infections that can cause failure of a patient’s lungs.
These are the people who have been seeing Napolitano, chief of acute-care surgery at the U-M. She is among the physicians treating the “worst of the worst” cases of H1N1 complications in the region and has been alarmed by the severity of those cases.
snip
Local health officials say their alarm has to do with the unpredictability of who might be severely sickened by the virus, the severity of those potential complications and how easily it has been spreading through the population.
And the Ann Arbor area has been ripe with flu in recent weeks.
Several times already this year, county epidemiologist Laura Bauman has had to increase the scale of the chart on which she reports local flu statistics after the number of reported flu cases kept doubling.
“I’ve never seen levels like this,” Bauman said.
There were more than 80 lab-confirmed flu cases, presumably from the H1N1 virus, in the county the week ending Oct. 31. More than 70 out of every 1000 students in the county were out sick with respiratory illnesses that week.
This time of year, there are usually few, if any, confirmed cases of any kind of flu.
snip
“The majority of cases are mild, the data bears that out. But it is still deadly and unpredictable,” Dwyer said.
snip
Among that small minority of patients who do end up in the ICU, the prognosis does not look good.
It only happens in about 1 percent of the population that gets the flu virus, but some who become ill with the H1N1 virus end up developing a life threatening respiratory condition called acute respiratory distress syndrome.
The syndrome caused when the lungs fail to work properly can lead to low blood oxygen levels and organ failure. About 20 percent to 30 percent of the patients who do end up there due to H1N1 complications do not survive.
“That means one out of every three or five (patients hospitalized in the ICU from H1N1) dies despite our aggressive therapy,” Napolitano said.
Treatments doctors try on patients in the ICU includes the use of inhaled nitric oxide, ventilators, oscillator’s and even flipping the patient onto their stomachs to aid breathing.
About half of the ICU is taken up by patients with H1N1, Napolitano said during an interview last week. There hasn’t been a strain on equipment like the ventilators yet.
Survival Flight helicopters are now equipped with ventilators and crews are now trained to begin treatment for respiratory problems en route to the hospital.
snip
The deaths from H1N1 raise so many questions from devastated family members who, many who may have gotten the flu themselves, want to know why their loved one got as sick as they did. It’s a frustrating part of Napolitano’s job.
“We don’t have answers for them at the current time,” she said.
Health experts around the world have been scrambling to best define who is at the most risk for developing complications and understand why.
Napolitano herself published a report in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly report earlier this year on the believed link between obesity and H1N1 flu risks. The report was based on 10 swine flu patients. Of the group, nine were obese and seven of those patients were morbidly obese.
“It has something to do with the lungs’ immune system not being able to effectively fight this,” or in some cases, to overreact to the infection, she said.
She recently had a 28-year-old male patient die from H1N1 complications.
It reminds her again what makes the H1N1 virus so different from the seasonal flu, even though it has similar mortality and hospitalization rates: Unlike the typical flu that puts the elderly and the already sick at greatest risk, it’s young, and healthy people who seem to be dying from this.
“A 28-year old male who is otherwise healthy, with no underlying conditions, is really striking,” Napolitano said.
The below comment from the Chief Doctor again say’s why H1N1 is different then the seasonal flu . Young healthy people don’t die from the seasonal flu .
MI
http://www.annarbor.com/news/hospitals-local-physicians-respond-to-influx-of-swine-flu-patients/
She recently had a 28-year-old male patient die from H1N1 complications.
It reminds her again what makes the H1N1 virus so different from the seasonal flu, even though it has similar mortality and hospitalization rates: Unlike the typical flu that puts the elderly and the already sick at greatest risk, it’s young, and healthy people who seem to be dying from this.
“A 28-year old male who is otherwise healthy, with no underlying conditions, is really striking,” Napolitano said.
Pulmonary fibrosis induced by H5N1 viral infection in mice
http://7thspace.com/headlines/325370/pulmonary_fibrosis_induced_by_h5n1_viral_infection_in_mice.html
Inflammatory process results in lung injury that may lead to pulmonary fibrosis (PF). Here, we described PF in mice infected with H5N1 virus.
Methods: Eight-week-old BALB/c mice were inoculated intranasally with 1 x 101 MID50 of A/Chicken/Hebei/108/2002(H5N1) viruses.
Lung injury/fibrosis was evaluated by observation of hydroxyproline concentrations, lung indexes, and histopathology on days 7, 14, and 30 postinoculation.
Results: H5N1-inoculated mice presented two stages of pulmonary disease over a 30-d period after infection. At acute stage, infected-mice showed typical diffuse pneumonia with inflammatory cellular infiltration, alveolar and interstitial edema and hemorrhage on day 7 postinoculation.
At restoration stage, most infected-mice developed PF of different severities on day 30 postinoculation, and 18% of the survived mice underwent severe interstitial and intra-alveolar fibrosis with thickened alveolar walls, collapsed alveoli and large fibrotic areas. The dramatically elevated hydroxyproline levels in H5N1-infected mice showed deposition of collagen in lungs, and confirmed fibrosis of lungs.
The dry lung-to-body weight ratio was significantly increased in infected group, which might be associated with the formation of PF in H5N1-infected mice.
Conclusion: Our findings show that H5N1-infected mice develop the typical PF during restoration period, which will contribute to the investigation of fibrogenesis and potential therapeutic intervention in human H5N1 disease.
Author: Jian QiaoMiaojie ZhangJianmin BiXun WangGuancun DengGuimei HeZhihua LuanNana LvTong XuLihong Zhao
Credits/Source: Respiratory Research 2009, 10:107
comment - thickened alveolar walls sounds like what they describe in patients in Ukraine.