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Young People at Risk for Severe H1N1 Swine Flu
October 19, 2009
Health officials sounded alarm bells over the weekend1 as it has become clear that the H1N1 swine flu can attack the lower lungs causing viral pneumonia. Deterioration can be unusually rapid2, starting at only 3-5 days into the illness and progressing to life-threatening within 24 hours. The virus can trigger clots3 in the lungs, meaning that standard ventilator care for pneumonia may not work.
Seasonal flu viruses tend to infect primarily the upper respiratory system. But recent animal studies and autopsies on about 100 swine flu victims show that H1N1 infects both the upper respiratory tract, which makes it relatively easy to transmit, and also the lungs, which is more similar to the avian flu virus that has been circulating in Asia.
“It's like the avian flu on steroids,” said Sherif Zaki, chief of Infectious Disease Pathology at the CDC. He noted that unusually large concentrations of the swine flu virus have been found in the lungs of victims: “It really is a new beast, so to speak.”
Although it remains unclear how frequently the virus makes people seriously ill, recent reports from Mexico, Canada, the United States, Australia and New Zealand indicate that perhaps 1 percent of patients who get infected require hospitalization. Between 12 to 30 percent of those hospitalized need intensive care, and 15 to 40 percent of those in intensive care die.
While about two-thirds of U.S. patients who were hospitalized in the spring had other medical conditions, the CDC reported this week that an analysis of more than 1,400 hospitalized victims found perhaps half had no serious health problems.
On Friday U.S. health officials reported that the number of states reporting widespread flu activity was up to 41 and that the death toll among children had climbed to 86. The pattern of people getting seriously ill is far different than in typical flu seasons. The elderly, who are usually most vulnerable, are generally spared; children, teenagers, pregnant women and young adults are the most common.
Seasonal flu viruses tend to infect primarily the upper respiratory system. But recent animal studies and autopsies on about 100 swine flu victims show that H1N1 infects both the upper respiratory tract, which makes it relatively easy to transmit, and also the lungs, which is more similar to the avian flu virus that has been circulating in Asia.
“It's like the avian flu on steroids,” said Sherif Zaki, chief of Infectious Disease Pathology at the CDC. He noted that unusually large concentrations of the swine flu virus have been found in the lungs of victims: “It really is a new beast, so to speak.”
Although it remains unclear how frequently the virus makes people seriously ill, recent reports from Mexico, Canada, the United States, Australia and New Zealand indicate that perhaps 1 percent of patients who get infected require hospitalization. Between 12 to 30 percent of those hospitalized need intensive care, and 15 to 40 percent of those in intensive care die.
While about two-thirds of U.S. patients who were hospitalized in the spring had other medical conditions, the CDC reported this week that an analysis of more than 1,400 hospitalized victims found perhaps half had no serious health problems.
On Friday U.S. health officials reported that the number of states reporting widespread flu activity was up to 41 and that the death toll among children had climbed to 86. The pattern of people getting seriously ill is far different than in typical flu seasons. The elderly, who are usually most vulnerable, are generally spared; children, teenagers, pregnant women and young adults are the most common.
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