SWINE FLU ---- airplanes + internet = pandemic hysteria

[Time to Punt]

Punt, truly nothing personal.

I have taken issue with others opining on health matters on this board, in some cases with extremely misguided, no, entirely wrong statements about such matters.

I apologize if I am being too harsh, but you know what?

I could care less if someone gets herpes in his dick or face because he is playing around with some harpie, without protection.

I could care less if someone wants to go buy some magic plants to eat so his weener gets bigger, longer, uncut. There's one born every minute.

I do care if uninformed opinion about matters that can have dire consequences is made here, and goes unchallenged.

I do care to keep my eyes on the W.H.O. website to what the real and true situation is regarding a potential pandemic or a disease (there's that word again, this time used properly) that can and does cause death.

I'm not a doctor, or a scientist by education. In all cases regarding health, there are good sources of information starting with your family doctor, your local health clinic or hospital, or the websites put up by agencies whose job it is to deal with this stuff.

If I want to know which escort is going to swallow my goo, or ride me like a bunny rabbit, I'll check MERB, but one of many places I wouldn't go for accurate health information is here.

Thanks for clarifying I haven't really changed my opinion though.

I'm feeling good about this, in that in all the Ontario reported cases no one has even required hospitalization. While it appears far more contagious than SARS the effects have been extremely mild - so far.

There are even stories now circulating( take them with a grain of salt because this is just reporters talking) that many of the Mexican deaths were not due to swine flu.

The differences between Canada and Mexico in the severity of the flu are puzzling to me - hope someone eventually answers this.

 

[EagerBeaver]

Severity of symptoms

From what I have read, the people at highest risk for severe symptoms/death from H1N1 are those who are the youngest and healthiest. This strain is very similar to the strain that caused the 1918 pandemic, which killed at least 20 million people worldwide, and most of the 1918 pandemic victims were young healthy adults. The reason for this is they die of cytokine storms which is basically an overreaction of a healthy immune system sending too many T cells to the perceived area of highest concentration of the infection, causing extreme fever, swelling and redness. Cytokine storms in the lungs, which are most vulnerable to this type of infection, will cause swelling of fluids, pneumonia and a blocking of the airways. This situation can result quickly and then deteriorate rapidly, and if the patient is not treated he/she will eventually choke and suffocate as the air passages are blocked.

I read that a 16 year old American girl who just recovered from H1N1 had a high fever that did not break for 5 days, severe burning in her throat to the point of not being able to swallow, and extreme difficulty breathing through her mouth. In essence, H1N1 will give you the same sensation that a waterboarding victim experiences, except that waterboarding can be easily stopped when the victim gives in and agrees to give the requested information. H1N1 will not stop when you ask it to.

If you are older your immune system is less likely to trigger a potentially fatal cytokine storm. Possibly the difference in the severity of the symptoms between those afflicted is a function of their age, health and the vigor of their immune systems or lack thereof.

If you are younger this does not mean a death sentence, it just means that until your immune system is tested your survivability in regards to H1N1 is unknown. If you have had severe reactions to other, more common flu strains, and you develop any of the symptoms noted above, obviously a prudent course of action would be to go to the Emergency Room.

 

[eastender]

Age

From what I have read, the people at highest risk for severe symptoms/death from H1N1 are those who are the youngest and healthiest. This strain is very similar to the strain that caused the 1918 pandemic, which killed at least 20 million people worldwide, and most of the 1918 pandemic victims were young healthy adults. The reason for this is they die of cytokine storms which is basically an overreaction of a healthy immune system sending too many T cells to the perceived area of highest concetration of the infection, causing extreme fever, swelling and redness. Cytokine storms in the lungs, which are most vulnerable to this type of infection, will cause swelling of fluids, pneumonia and a blocking of the airways. This situation can result quickly and then deteriorate rapidly, and if the patient is not treated he/she will eventually choke and suffocate as the air passages are blocked.

I read that a 16 year old American girl who just recovered from H1N1 had a high fever that did not break for 5 days, severe burning in her throat to the point of not being able to swallow, and extreme difficulty breathing through her mouth. In essence, H1N1 will give you the same sensation that a waterboarding victim experiences, except that waterboarding can be easily stopped when the victim gives in and agrees to give the requested information. H1N1 will not stop when you ask it to.

If you are older your immune system is less likely to trigger a potentially fatal cytokine storm. Possibly the difference in the severity of the symptoms between those afflicted is a function of their age, health and the vigor of their immune systems or lack thereof.

If you are younger this does not mean a death sentence, it just means that until your immune system is tested your survivability in regards to H1N1 is unknown. If you have had severe reactions to other, more common flu strains, and you develop any of the symptoms noted above, obviously a prudent course of action would be to go to the Emergency Room.

Welcome back EB. Thank you for the very informative post. Readers should be advised that in 1918 the average person lived to the age of 47-50. Today the average person lives to the age of 78- 81 and people have stronger immune systems.

So in 1918 the number of elderly was a much smaller percentage of the population. Regardless of your age people should be extra careful. Re-act to the most trivial symptom by visiting a health professional or your local CLSC or hospital.

 

[YouVantOption]

Welcome back EB. Thank you for the very informative post. Readers should be advised that in 1918 the average person lived to the age of 47-50. Today the average person lives to the age of 78- 81 and people have stronger immune systems.

So in 1918 the number of elderly was a much smaller percentage of the population. Regardless of your age people should be extra careful.

I was thinking about this from a comparative standpoint.

BACK THEN:

- less advanced and less available medical technologies
- more constrained travel, attenuating dissemination.

THESE DAYS:
- Better medicine much more readily available
- Far more international travel, allowing the disease to spread more easily

Seems like a wash, to me. No real way to tell if one negates the impact of the other, anyway.

 

[Time to Punt]

From what I have read, the people at highest risk for severe symptoms/death from H1N1 are those who are the youngest and healthiest. .

We seem to be having the opposite here. In fact most of the people that have been infected, particularly in the east and in BC, have been young and healthy and they all have what has been universally described as extremely mild symptoms.

 

[hormone]

20-50 yo more at risk, unlike usual flu

From what I have read, the people at highest risk for severe symptoms/death from H1N1 are those who are the youngest and healthiest.
(...) The reason for this is they die of cytokine storms which is basically an overreaction of a healthy immune system sending too many T cells to the perceived area of highest concentration of the infection, causing extreme fever, swelling and redness. Cytokine storms in the lungs, which are most vulnerable to this type of infection, will cause swelling of fluids, pneumonia and a blocking of the airways.

I read that a 16 year old American girl who just recovered from H1N1 had a high fever that did not break for 5 days, severe burning in her throat to the point of not being able to swallow, and extreme difficulty breathing through her mouth.

If you are older your immune system is less likely to trigger a potentially fatal cytokine storm. Possibly the difference in the severity of the symptoms between those afflicted is a function of their age, health and the vigor of their immune systems or lack thereof.

I am a little limited in my typing ability from a recently dislocated shoulder, but I want to make some short comments:

EB, I am not sure if you mistyped... but so far all the majority of deaths reported have been in the 20-50 yo population group... not the youngest and elder group, as with "classical" influenza A. Does not mean that the extremes of age are not at risk, but so far they are not the majority dying.

The rest of your explanation about the "healthy" immune system causing the damage is right though.

 

[hormone]

Overhyped???

This is being overhyped same as bird flu and SARS - just wash ur hands, stop 2-cheek kissing everyone you meet and don't watch CNN - you'll feel like building yourself a bomb shelter and hiding for 6 weeks...

I can't believe I still read "overhyped"...and comparisons to SARS in the same sentence. As correctly pointed out by metooo4, SARS was extremely contagious and health care personnel died from catching it-- some caught it even while wearing protective gear...

In "normal" times, people don't refrain from kissing and shaking hands and sharing things with people afected by "normal" flu... So this attention by the media is necessary to get people to be cautious... which decreases greatly the transmission.

 

[eastender]

Depends

I was thinking about this from a comparative standpoint.

BACK THEN:

- less advanced and less available medical technologies
- more constrained travel, attenuating dissemination.

THESE DAYS:
- Better medicine much more readily available
- Far more international travel, allowing the disease to spread more easily

Seems like a wash, to me. No real way to tell if one negates the impact of the other, anyway.

Depends on how quickly the strain multiplies. Regardless caution is the key.

 

[Time to Punt]

I am a little limited in my typing ability from a recently dislocated shoulder, but I want to make some short comments:

EB, I am not sure if you mistyped... but so far all the majority of deaths reported have been in the 20-50 yo population group... not the youngest and elder group, as with "classical" influenza A. Does not mean that the extremes of age are not at risk, but so far they are not the majority dying.

The rest of your explanation about the "healthy" immune system causing the damage is right though.

Let's not get things confused here. EB's post was referring to the 1918 flu as the one that killed in the 20 to 50 age range.

I have not seen an age breakdown from Mexico on their deaths so the pattern may not be the same at all. The young Canadian vacationers back from places like Cancun all have mild symptoms that have required no hospitalization so far.

Let's not jump to conclusions here.

 

[hormone]

Let's set some things straight...

People over-reacted then as they are now and I agree with dplus it is being way overhyped. The truth is that more people will die in Quebec and Ontario hospitals of c-difficile this year that they catch in the hospital than will die of swine flu.

I do laugh when I see pictures of people walking around with masks - UNLESS you are a customs agent meeting a plane from Mexico of course.

Your comparison to C-difficile is risky, at best. True that so far more people in Québec or Ontario have died of C-diff...
- because C-diff has not reached epidemic proportions outside of hospitals...
- because C-diff is not so easily transmitted as the flu...
- because healthy people such as yourself may contract C-diff and have either nothing or some diarrhea that will not kill you most likely...
- because C-diff has 2 strains: one that is acquired in the community, by healthier people and will not kill most immune competent hosts, and one that is mostly transmitted in hospitals, in already sick/debilitated patients and is resistant to standard treatment often...

Another difference is that disease "caught" in hospital are usually always worse than ones in the community. The strains of viruses or bacteria found in hospitals are usually more virulent, more resistant to treatment and affect sicker people.

In epidemiology, there are different stats you need to keep in mind, to make intelligent comparisons. Lay people so far seem to ignore these, especially when I read things like "over hyped"... Let me explain a few simple ones:

- transmission rate: of exposed people, how many will get sick
- death rate: of sick people, how many will die

When one speaks of total deaths, this is NOT the death rate. So it is stupid to compare the total SARS deaths in Canada with the total deaths of C-diff for example... A disease which has a lower death rate could still by far kill A LOT MORE people than another one which has a higher death rate, simply byhaving a much higher transmission rate. This may well be the case of H1N1 flu...

Finally: this "over reaction" is necessary to cut down transmission. Otherwise, people would not take precautions... From what we see now, H1N1 flu is less lethal than SARS. But the spread has been much faster...

And I am not taking my info from Wikipedia...

 

[Time to Punt]

Found this which does substantiate the 20 to 50 age bracket as having the highest death rate in Mexico

"Mexican Health Minister Jose Angel Cordova said the outbreak was now suspected to have killed 149 people and the number of cases would continue to rise.


Thirty-three million Mexican schoolchildren will be off school until the middle of next week as authorities seek to contain the outbreak. Schools in the sprawling capital had already been closed but the government ordered classes cancelled across the country until May 6.


Most of the those who died were between 20 and 50 years of age, Cordova said."

 

[hormone]

I am not jumping at all...

Let's not get things confused here. EB's post was referring to the 1918 flu as the one that killed in the 20 to 50 age range.

I have not seen an age breakdown from Mexico on their deaths so the pattern may not be the same at all. The young Canadian vacationers back from places like Cancun all have mild symptoms that have required no hospitalization so far.

Let's not jump to conclusions here.

Age breakdown stats on deaths: disproportionately 30-50 yo's.... (stats available). -- Thanks, you just posted about it!

We do not know yet why most people from outside of Mexico who have contracted the H1N1 (from travel to Mexico or exposure to someone who got it there) have only mild symptoms. It may be purely statistical (refer to my comment on death rate and transmission rate). This means either the death rate is too small for us to see many deaths with the few cases so far diagnosed outside of Mexico, or there are different strains of H1N1 with higher mortality rates than others (and maybe only the lesser virulent one has travelled outside of Mexico so far...). The second explanation being the less likely one.

 

[Time to Punt]

And I am not taking my info from Wikipedia...

Neither was I and the point of the comparison was to remark about a desease that one hopes would be more controllable causing all these deaths and receiving virtually no ongong media coverage. That's all

 

[hormone]

I was thinking about this from a comparative standpoint.

BACK THEN:

- less advanced and less available medical technologies
- more constrained travel, attenuating dissemination.

THESE DAYS:
- Better medicine much more readily available
- Far more international travel, allowing the disease to spread more easily

Seems like a wash, to me. No real way to tell if one negates the impact of the other, anyway.

Very interestig comparison... We could add for THESE DAYS:
- better transmission of info (which some people could call: better panicking capacity... ), allowing for better containement of epidemic once it has started to spread... Hopefully!

 

[hormone]

Neither was I and the point of the comparison was to remark about a desease that one hopes would be more controllable causing all these deaths and receiving virtually no ongong media coverage. That's all

Sorry my wiki comment was not targeted at you not anyone in particular, I did not mean to offend you! It was just to say that I kinda know what I am talking about, without telling too much about myself here...

And I agree with you about C Diff... if there were more "panic" about it in some areas, maybe we would see
- more isolation capacities in hospitals to decrease transmission
- less abuse of antibiotics in the medical community for non bacterial infections

And I agree that some things are hyped in the media: for example, the west nile virus "threat" was not a real threat at all... but this time I think journalists were quite "neutral" and appropriate in their treatment of H1N1... while the "authorities" were slow to respond...

 

[EagerBeaver]

hormone,

When I said healthy young adults I meant 20-50 years old. I myself fall into that group.

From what I read most of the victims of the 1918 pandemic were young adults 20-30 y.o. who died of cytokine storms, an overreaction of the healthy immune system to the infection causing the deaths. Many of the dead who did not seek or were not able to get swift medical attention were found with slightly bluish facial complexions, which is a sign of excessively deoxygenated cells caused by too much fluid in the lungs blocking air passages.

Another thing that happens is because of the immune response and the T cells dispatched to fight H1N1, opportunistic secondary bacterial infections threaten the body. This is where modern antibiotics come in. Antibiotics can be used to treat the secondary bacterial infections, but they will not effectively treat H1N1 which is a virus.

 

[hormone]

Fascinating topic... Some explanations

When I said healthy young adults I meant 20-50 years old. I myself fall into that group.

We both agree on this! On reading your post initially, I was sure you had written the ones most at risk were the at the younger and older ages of the spectrum-- maybe you did by mistake/mistyped and corrected it. Time to punt also responded by "correcting" you on this, saying "we seem to be having the opposite here"... Does not matter anyway, we all agree on who is at risk.

From what I read most of the victims of the 1918 pandemic were young adults 20-30 y.o. who died of cytokine storms, an overreaction of the healthy immune system to the infection causing the deaths.

True. This is one thing that happens with certain types of bad viral infections. It is the same as happens with many forms of hepatitis, by the way. The damage to the liver is not from the virus itself, but from one's own immune system reacting to the virus, attacking it and the collateral damage to the liver in that process.

Many of the dead who did not seek or were not able to get swift medical attention were found with slightly bluish facial complexions, which is a sign of excessively deoxygenated cells caused by too much fluid in the lungs blocking air passages.

This is called cyanosis. It hapens when insufficient oxygen gets to the red blood cells, as you mention. Causes are multiple, either from blockage of air passages, from impossibility of oxygen reaching the lungs to transfer to the blood, or inability of the blood cells to carry oxygen. It is mostly the second option that happens to people with these bad viral pneumonias... Oxygen transfer to the blood is hampered by very bad alveolar congestion by leaking fluid and/or damage to the alveoles/capillaries which perform the oxygen exchange. All this as a result of the over response of our immune system. In fact, immune modulators are probably a very interesting treatment option-- theoretically! Because they also lower your immunity and make you at risk for secondary bacterial infection, which disseminate into the blood and have their own consequences.

Another thing that happens is because of the immune response and the T cells dispatched to fight H1N1, opportunistic secondary bacterial infections threaten the body. This is where modern antibiotics come in. Antibiotics can be used to treat the secondary bacterial infections, but they will not effectively treat H1N1 which is a virus.

No antibiotics can treat VIRAL infections, you are right. Many of the opportunistic bacterial infections occur as a result of either viral/ one's own immune response induced damage to organs, which allow proliferation of bacteria in an area which otherwise would not have been infected. But there is now a portal of entry...
The immune system's responses to viral and bacterial infections are different. But the hyper activation of our immune system does damage our organs and as mentionned above, make them vulnerable to attack by bacteria, much more so than when "usual" contamination with bacteria occurs. And you are also facing what is called multiple system organ failure, with kidney, liver, lung, heart, brain and often gut damage induced by this immune response... this is what kills you-- even though you get the most appropriate antibiotics...

 

[EagerBeaver]

300 Quarantined in Hong Kong Hotel After Guest Confirmed With H1N1

Quarantine in Hong Kong Hotel after guest brings flu back from Mexico:

http://news.bbc.co.uk/2/hi/asia-pacific/8029871.stm

 

[BigStones]

My dream scenario

I'm staying at a 5 star hotel in Montreal. The hotel is fully booked. I have an afternoon rendezvous with my ATF. Ten minutes after our session ends, there is a knock on my door. My ATF says the hotel is quarantined, and no one can leave the hotel for a week. My first throughts are...

1. I hope the hotel ATM has alot of cash
2. I hope the hotel store has a large supply of condomns
3. How will I explain this to the bankruptcy judge?

 

[metoo4]

My dream scenario

I'm staying at a 5 star hotel in Montreal. The hotel is fully booked. I have an afternoon rendezvous with my ATF. Ten minutes after our session ends, there is a knock on my door. My ATF says the hotel is quarantined, and no one can leave the hotel for a week. My first throughts are...

1. I hope the hotel ATM has alot of cash
2. I hope the hotel store has a large supply of condomns
3. How will I explain this to the bankruptcy judge?

LOL!! This could be interesting...

Why would the ATM be full of cash? All you'll do is to shelter her until the crisis is resolved! That or a broom closet, unless you are an ass and but-ugly, the lady should have an easy choice! Of course, no free sex, unless you were to learn you are both infected and have only a few days to live... LOL!!