Study provides clue to surviving Swine Flu
13 Oct 2009
HEALTH - Blood oxygenation appears to be the key to surviving swine flu for patients suffering respiratory failure, new research shows.
The observational study, carried out by New Zealand and Australian flu investigators between June 1 and August 31 this year, showed most patients who experienced respiratory failure after contracting swine flu survived if they were treated with extracorporeal membrane oxygenation (ECMO), a type of life support that adds oxygen to the blood.
The study focused on 68 patients with severe swine flu associated acute respiratory distress, who received ECMO in 15 intensive care units across New Zealand and Australia.
“We looked at a number of factors associated with patients receiving ECMO, such as the incidence, degree of lung dysfunction, clinical features, technical characteristics, duration, complications, and survival,” Auckland City Hospital’s cardiothoracic intensive care specialist Shay McGuinness said.
“By doing this we have established the importance of ECMO as a treatment option for patients with severe influenza A H1N1 (swine flu) associated acute respiratory distress.
“Despite the severity of their illness and the lengthy period of time on ECMO life-support most of these patients survived.”
Dr McGuinness said 54 of the 68 patients had survived and 14 had died. Six were still being treated in intensive care units.
“These findings are important to our colleagues all over the world and should be used to facilitate health care planning and clinical management for these complex patients during the ongoing pandemic,” Dr McGuinness said.
The study was due to be published in the Journal of the American Medical Association on November 4, but will be published early online because of the importance of its findings for public health.
NZPA
Link is http://www.nznewsuk.co.uk/news/?id=3963
Egypt Says Developing Own H1N1 Flu Vaccine For 2011
Published: Oct 13, 2009
by Edmund Blair
http://www.postchronicle.com/news/health/article_212261511.shtml?ref=rss
Egypt is developing its own vaccine against H1N1 swine flu for production in 2011 and, in the meantime, will import vaccines to inoculate school children and key public workers, the health minister said.
Experts fear a flu pandemic could have a devastating impact on Egypt, a country of 77 million people who mostly live in the densely packed Nile Valley. Many are in Cairo’s crowded slums.
Egypt, already hard hit by the more deadly H5N1 bird flu virus, has found about 1,030 cases of H1N1 flu, widely known as swine flu, and three people have died from the virus, Health Minister Hatem el-Gabali said late on Sunday.
“We have a plan to produce the first batch (of Egypt’s H1N1 flu vaccine) by April 2011,” Gabali said, speaking after a talk about healthcare reform.
A 35-strong team of experts had been assembled from around Egypt to develop the vaccine, the minister told Reuters.
“We are working now in the lab,” he said. “They (the team) were people working in independent institutions, around Egypt. They have trained overseas but they have not worked together as a team. They have the skills to develop the vaccine.”
“The production (of) the first batch will be about 6,000 units and it will be tested for efficacy around the second quarter of 2011,” he said.
Output from the factory, to be built in Sixth of October City on the outskirts of Cairo, would meet demand in Egypt but could also supply other countries in Africa, he said.
Oxygen deprivation because of ARDS has long been a concern. However, using ECMO is a high tech solution that is not available in enough numbers in a major epidemic to be practical. However, there might be a way around this problem.
“Oxygen therapeutics blood substitutes” are types of artificial blood that are being researched as blood replacements in emergency situations. However, they have one important difference with blood in that some kinds can carry *more* oxygen than can hemoglobin.
If someone’s lungs are damaged, so they cannot get enough oxygen to their internal organs, they will likely still be getting oxygen, just not enough.
So instead of using a lot of oxygen therapeutics blood substitute to *replace* their blood, why not use it to *augment* their blood? That is, so that their blood carries *more* oxygen through their bloodstream to their internal organs.
Instead of getting a pint of oxygen therapeutics in an IV, just a shot in the arm would have the same effect as increasing the amount of oxygen they are breathing in the air.
If they can still breathe on their own, they could be issued a common oxygen generator and given a shot of oxygen therapeutics in the arm, so even with some lung problems, there would still be a lot of oxygen getting to their internal organs.