Swine flu deaths show this flu is different: experts

By 
<http://blogs.reuters.com/search/journalist.php?edition=us&n=Maggie.Fox>Maggie 
Fox, 
<http://blogs.reuters.com/search/journalist.php?edition=us&n=Health.and>Health 
and 
<http://blogs.reuters.com/search/journalist.php?edition=us&n=Science.Editor>Science
 
Editor

http://www.reuters.com/article/healthNews/idUSTRE58E6NZ20090915

http://blogs.usatoday.com/ondeadline/2009/09/cdc-swine-flu-causing-deadly-lung-infections-like-avian-virus.html

WASHINGTON (Reuters) - Autopsies on people who 
have died from the new 
pandemic <http://www.reuters.com/news/globalcoverage/swineflu>H1N1 flu 
show this virus is different from seasonal 
influenza, even if it has not yet caused more 
deaths, experts told a meeting on Tuesday.

Americans who died 
from <http://www.reuters.com/news/globalcoverage/swineflu>swine 
flu had infections deep in their lungs, Dr. 
Sherif Zaki of the U.S. Centers for Disease 
Control and Prevention told a meeting of flu 
experts, including damage to the alveoli -- the 
structures in the lung that deliver oxygen to the 
blood.

This in turn caused what is known as acute 
respiratory distress syndrome -- an often fatal 
development that leaves patients gasping for 
breath.

The World Health Organization has confirmed 3,205 
deaths globally 
from<http://www.reuters.com/news/globalcoverage/swineflu>swine 
flu but experts agree all estimates of the extent 
of the pandemic are grossly understated because 
so few patients are ever actually tested.

Seasonal flu kills, too -- about 250,000 to 
500,000 cases a year globally, according to the 
WHO. But not in the same way 
as <http://www.reuters.com/news/globalcoverage/swineflu>swine 
flu, which unlike seasonal flu frequently causes 
severe disease in young adults and children.

"It is very rarely you see what we call diffuse 
alveolar damage in fatal seasonal influenza," 
Zaki told a meeting sponsored by the U.S. 
Institute of Medicine, which advises government 
on health matters.

Seasonal flu causes bronchitis and other upper 
respiratory disease. But Zaki, the chief 
infectious disease pathologist at CDC, said the 
new virus had burrowed into the lungs of the 90 
or so people he examined after they died, and 
they had huge amounts of the virus in their blood.

"This is almost exactly what we see with avian 
flu," Zaki said. "This looks like avian flu on 
steroids."

EXPERIMENTAL DRUGS

Dr. Yoshi Kawaoka of the University of Wisconsin 
said tests in monkeys showed the virus lives and 
replicates 1,000-fold better in the lungs than 
does seasonal flu.

He said the No. 1 drug of choice 
against <http://www.reuters.com/news/globalcoverage/swineflu>H1N1 -- 
Roche AG's and Gilead Sciences Inc's Tamiflu -- 
lowered the so-called viral load of virus in the 
lungs just enough to help the body fight back.

Experimental flu drugs lower it even more, 
notably Daiichi Sankyo Co Ltd's CS 8958 and 
another drug called T-705 or favipiravir, made by 
Fujifilm Holdings Corp unit Toyama Chemical Co, 
Kawaoka said.

Zaki said 90 percent of the fatalities he looked 
at had some condition that would predispose them 
to serious disease. They had a median age of 38 
and one victim was a two-month-old infant who 
died within a day of getting sick.

Nearly half -- 46 percent -- were obese, many had 
fatty liver disease, 27 percent had heart disease 
and 22 percent had asthma, he said.

Dr. Guillermo Ruiz-Palacios of Mexico's National 
Institute of Medical Sciences and Nutrition said 
many Mexican patients with severe disease were 
also obese. In addition, patients came in late 
for treatment and many were infected with a 
second common virus, called parainfluenza virus.

Fewer than a third of the U.S. deaths, 29 
percent, had a so-called secondary bacterial 
infection, usually Streptococcus pneumoniae, Zaki 
said.

Ruiz-Palacios also said the new virus can be 
found in the urine and feces of patients, 
something that may affect how it spreads.

(Editing by Cynthia Osterman)


© Thomson Reuters 2009 All rights reserved



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