Thursday, January 14, 2010

Swine Flu Sequelae

 

 

 

# 4253

 

While it is abundantly clear that for the vast majority of those infected, the H1N1 virus produces a mild-to-moderate illness with no long lasting effects, for a small percentage the virus can be far more serious.

 

Last month in  Cytokine Storm Warnings I wrote about a study that was to appear in American Thoracic Society's American Journal of Respiratory and Critical Care Medicine, that looks at the autopsy results of 21 pandemic flu victims.

 

Researchers found three separate types of severe lung damage, and point to signs of a cytokine storm response in some of these cases.

 

In October, in a blog entitled Severely Ill H1N1 Patients At Risk Of PE  I wrote of a study in the American Journal of Roentgenology, which described(in detail of most interest to pulmonologists and radiologists) computed tomography (CT) scans of patients with severe H1N1 infection.

 

In September, Jason Gale of Bloomberg wrote about what must surely be the worst acronym of this pandemic FLAARDS (Flu A-Associated Acute Respiratory Disease Syndrome )  in:

 

Inflamed, Flooded Lungs Trigger Death by Swine Flu, Study Says

By Jason Gale

Sept. 29 (Bloomberg) -- Swine flu is most dangerous when it causes the lungs to become inflamed, flood with fluid and fail to function, doctors in Australia and New Zealand found.

 

(Continue. . . )

 

 

And that same month, I wrote about the use of ECMO (Extracorporeal Membrane Oxygenation) in the treatment of severe lung injury in H1N1 victims in The ECMO Option.

 

Today we can add this report from Finland, which describes permanent lung damage observed in a small minority of H1N1 victims.

 

 

 

Swine Flu Caused Permanent Lung Damage in Some

 

published today 11:59 AM, updated today 12:04 PM

This machine is measuring a patient's pulse and oxygen saturation.

This machine is measuring a patient's pulse and oxygen saturation.

Image: YLE / Savo

Swine flu has caused permanent pulmonary damage to some patients in Finland. In Kuopio, five people who were in intensive care with the H1N1 virus developed serious lung problems.

 

Some people with these complications were basically healthy before they contracted swine flu, and were not in any risk group. For example, one healthy 40-year-old woman's lungs have been incurably damaged.

 

In these patients, the H1N1 virus caused viral pneumonia, which caused their lungs to fill up with liquid. When the infection recedes, the lungs can have fibrosis, or basically damaged and hardened tissue.

 

Kuopio's University Hospital plans to bring every swine flu patient who was treated in their pulmonary ward back for further testing. A total of 17 people were admitted to the intensive care unit during the epidemic, and 52 people ended up in the pulmonary ward.

 

Physicians Make Case for Flu Shot

 

Irma Koivula, an infectious diseases specialist at the Kuopio University Hospital, says that anyone who contracts H1N1 virus is at risk for the same kind of lung damage. She stresses how important it is to get the swine flu shot, which is being offered to everyone at public health care centres.

 

"The more people that get the vaccine, the fewer people will be susceptible to it and the epidemic will disappear on its own," she says.

 

"If a lot of people don't get vaccinated, they could get the virus again and spread the disease. Especially people they come into contact with who are in risk groups, like overweight and pregnant people, they are at a larger risk of developing serious lung damage."