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New York City, USA - Queens Educator Dies With Swine Flu; 16 Schools Closed
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
Gout is an autoimmune disease. This has ramifications for host response if they are listing this as a causative factor in the serious disease progression of 2009 H1N1 in this individual.
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
From Weekly Epidemiological Record, vol. 84, no. 20, May 15, 2009:
A spectrum of illness similar to seasonal influenza has been observed for the new influenza A(H1N1) virus. It ranges from a mild illness to more severe disease leading to hospitalization and death in a small proportion of confirmed cases. Among those with self-limited disease, the predominant clinical picture appears to be an uncomplicated influenza-like illness not requiring antiviral treatment. Severe illness has been reported, both in people with and without risk factors for complications of seasonal influenza.
It is notable that a substantial proportion of cases with severe disease occurred among young and healthy adults. In contrast, the vast majority of deaths associated with seasonal influenza occur among the elderly. Most of the clinical complications associated with H1N1 infection, in both healthy individuals and those with underlying medical conditions, appear to be related to severe respiratory disease.
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
Queens Schools Closed After Flu Strikes Principal </NYT_HEADLINE><SCRIPT language=JavaScript type=text/JavaScript>function getSharePasskey() { return 'ex=1400126400&en=6a08f6728f1d336f&ei=5124';}</SCRIPT><SCRIPT language=JavaScript type=text/JavaScript>function getShareURL() { return encodeURIComponent('http://www.nytimes.com/2009/05/16/nyregion/16flu.html');}function getShareHeadline() { return encodeURIComponent('3 Queens Schools Closed After Flu Strikes Principal');}function getShareDescription() { return encodeURIComponent('An assistant principal was in critical condition with New York’s most serious case of the swine flu virus so far.');}function getShareKeywords() { return encodeURIComponent('Swine Influenza,Education and Schools');}function getShareSection() { return encodeURIComponent('nyregion');}function getShareSectionDisplay() { return encodeURIComponent('New York Region');}function getShareSubSection() { return encodeURIComponent('');}function getShareByline() { return encodeURIComponent('By ANEMONA HARTOCOLLIS');}function getSharePubdate() { return encodeURIComponent('May 16, 2009');}</SCRIPT>
<NYT_REPRINTS_FORM><SCRIPT language=javascript> <!-- function submitCCCForm(){ PopUp = window.open('', '_Icon','location=no,toolbar=no,status=no,width=65 0,height=550,scrollbars=yes,resizable=yes'); this.document.cccform.submit(); } // --> </SCRIPT><FORM name=cccform action=https://s100.copyright.com/CommonApp/LoadingApplication.jsp target=_Icon>By ANEMONA HARTOCOLLIS
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</NYT_BYLINE>Published: May 15, 2009
<!--NYT_INLINE_IMAGE_POSITION1 --><NYT_TEXT>Three public schools in Queens were being disinfected Friday morning after the city closed them because of outbreaks of swine flu. An assistant principal was in critical condition with the city?s most serious case of swine flu since the virus turned up here more than three weeks ago. Skip to next paragraph The New York Times
About two-dozen children who showed up at one of them, Public School 16 in Corona at 7:30 a.m. were met by officials from the Department of Education and directed to return home.
A note on the door of the school from the Department of Health and Mental Hygiene said that the school ? along with two middle schools in Queens ? would be closed for at least five days.
?These schools have experienced unusually high levels of influenza-like illness in recent days,? the note read. ?We are also seeing an increase in flu activity in Queens more generally. We hope that these temporary closures will prevent new infections and avoid unnecessary illness.?
Just as many New Yorkers were beginning to forget the threat of swine flu, which first showed up last month, Mayor Michael R. Bloomberg confirmed at a hastily called news conference on Thursday evening that the flu had re-emerged.
Colleagues identified the sick man as Mitchell Wiener, the assistant principal of Intermediate School 238 in Hollis, who on Friday was on a ventilator and being treated at Flushing Hospital Medical Center. His son, Adam Wiener, told The Associated Press on Friday that his father was suffering from kidney failure, dehydration and a lung infection.
Mr. Bloomberg said on Thurssday night that Mr. Wiener appeared to have had some health problems that could have made him more susceptible to the virusm and colleagues and friends of the educator said said he had diabetes and sometimes walked with a cane.
But on Friday morning, the younger Mr. Wiener told The A.P. that his father?s only pre-existing condition he had ?is gout, which is unrelated to complications he?s experienced now."
In addition to Mr. Wiener, who is in his 50s, four students at I.S. 238 have been confirmed as having swine flu, officials said. More than 50 students at the school have been sent home with influenza-like symptoms since May 6.
The Education Department decided on Thursday to close I.S. 238 as well as P.S. 16 after 29 students went to the nurse?s office with flu-like symptoms, and I.S. 5 in Elmhurst, where 241 students were reported absent. Officials said the plan is to reopen those schools next Friday.
There was some confusion outside P.S. 16 on Friday as parents and children who had apparently not heard about the closing began arriving. There are about 1,500 students at the school, according to the education department.
"I didn?t know," said Susana Cruz, the mother of Madelyne Vaca,7, one of the people who were outside of the school.. "It?s a little scary because everything was O.K. yesterday."
Ms. Cruz said she was unaware any children had become ill and said her daughter had no flu-like symptoms.
Madeline Bono, who has been a crossing guard at the school for 11 years and learned about the swine flu cases on Thursday, said: "I?m surprised there?s so many of them coming today. They must not be listening to the news."
Yolanda Rivera, a substitute teacher at P.S. 16, said there was nothing to be scared of and that the school had taken appropriate measures to keep the children safe.
?It?s going to be fine,? Ms. Rivera said. ?What else could they be doing? This is the first time this has happened, and they?re very organized."
Mr. Bloomberg said there was no clear connection among the three schools, which are, ?reasonably far apart, five or six miles,? He said they were being closed because the flu, whose formal name is A(H1N1), appeared to spread very rapidly.
The school closings came nearly a month after the first case of swine flu to surface in the United States was detected at St. Francis Preparatory School in Fresh Meadows, Queens, where several students had gone to Mexico on spring break. The flu spread rapidly there, infecting hundreds of students within days, though all have since recovered. Anxious New Yorkers, many without any symptoms, taxed hospital emergency rooms, and bought up supplies of hospital masks and Tamiflu from neighborhood pharmacies.
The mayor ? who was joined at the City Hall news conference on Thursday night by the city?s health commissioner, Dr. Thomas R. Frieden, and the schools chancellor, Joel I. Klein ? began by acknowledging that the new outbreak was somewhat unexpected.
?I am about to make an announcement that I had hoped we could avoid,? Mr. Bloomberg said. But he added the public health system had been effective in detecting the outbreak, and ?we are acting as promptly as the evidence requires us to do.?
Gov. David A. Paterson, who also joined the mayor Thursday night, urged the public ?to remain alert rather than alarmed,? And said Mr. Wiener ?is in our prayers.?
Jessica Scaperotti, a spokeswoman for the health department, said that 178 New York City residents had tested positive for swine flu as of Thursday, but that the number was deceptive because the city had scaled down its testing efforts as the symptoms in most people turned out to be mild and not much different from seasonal flu. The city continued, however, to look for patterns.
Teachers were visiting Mr. Wiener?s wife and three sons Thursday night at the hospital?s intensive care unit. ?He?s fighting for his life,? said one of Mr. Wiener?s sons, who declined to give his name. His colleagues said he was a popular and effective school administrator.
A neighbor of Mr. Wiener said that his wife, Bonnie, had said her husband was sick with swine flu as early as Tuesday. The neighbor, Donna Nieves, said she had seen Ms. Wiener in the laundry room about 7:30 p.m. Tuesday, and Ms. Wiener said, ?Oh, oh, Mitch is so sick with swine flu; half the school?s shut down because everyone?s getting sick.?
Ms. Nieves said she came back to the laundry room with disinfectant wipes and began wiping down the washers and dryers, saying to Ms. Wiener, ?I?m sorry, I just can?t afford to get sick.? She said that was the last time she saw her. On Wednesday morning, a neighbor told Ms. Nieves that Mr. Wiener, wearing a surgical mask, had been taken away by ambulance.
Kvon Williams-Sparks, 13, an eighth grader at I.S. 238, said that he had noticed that janitors were cleaning the rest rooms more often, and that Mr. Wiener had not been at work since Monday. ?On Monday, I found a notice in the library that said, ?If you are sick, you should stay home,? ? Kvon said. ?But nobody has otherwise talked to us.?
Asked if the city had let its guard down too soon, Mr. Bloomberg replied: ?Most people haven?t come down with it. You?ve got to remember, we?re talking about 4,500 students here in a city of 8.4 million. It may very well be that a lot of people have it and the symptoms are so minor that they don?t even know it. That?s one of the things we?ll be studying.?
<NYT_AUTHOR_ID>Reporting was contributed by Sewell Chan, Javier C. Hernandez, Angela Macropoulos, Mick Meenan, Kenny Porpora and Liz Robbins
Gout is an autoimmune disease. This has ramifications for host response if they are listing this as a causative factor in the serious disease progression of 2009 H1N1 in this individual.
Mr. Bloomberg said on Thurssday night that Mr. Wiener appeared to have had some health problems that could have made him more susceptible to the virusm and colleagues and friends of the educator said said he had diabetes and sometimes walked with a cane.
But on Friday morning, the younger Mr. Wiener told The A.P. that his father?s only pre-existing condition he had ?is gout, which is unrelated to complications he?s experienced now."
Gout is an autoimmune disease. This has ramifications for host response if they are listing this as a causative factor in the serious disease progression of 2009 H1N1 in this individual.
Gout is a metabolic disorder - antibodies aren't involved in the process. Now, and this is purely speculative, he could've been on steroids which decrease his immune response, but to say that gout alone gives him a "pre-existing condition" that makes him more susceptible to complications is ridiculous.
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
from MMWR April 29, 2009 - a woman with an autoimmune disease hospitalized for 7 says - not exactly a mild case.
".Imperial County, California. A woman aged 41 years with an autoimmuneillness who resided in Imperial County developed fever, headache, sore throat, diarrhea, vomiting, and myalgias on April 12. She was hospitalized on April 15. She recovered and was discharged on April 22. A respiratory specimen obtained April 16 was found to be influenza A positive by RT-PCR at the San Diego Country Health Department Laboratory, but could not be further subtyped. The woman had not been vaccinated against seasonal influenza viruses during the 2008--09 season. Three household contacts of the woman reported no recent respiratory illness...."
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
wikipedia
Gout is a disease hallmarked by elevated levels of uric acid in the bloodstream. In this condition, crystals of monosodium urate (MSU) or uric acid are deposited on the articular cartilage of joints, tendons and surrounding tissues. It is marked by transient painful attacks of acutearthritis initiated by crystallization of urates within and about the joints and eventually leads to chronic gouty arthritis and the deposition of masses of urates in joints and other sites, creating tophi. Gout results from a combination of prolonged elevation of uric acid and overall acidity in the bloodstream. In isolation, neither elevated uric acid nor acidity is sufficient to cause gout. <sup id="cite_ref-0" class="reference">[1]</sup>
Historically known to as the "The Disease of Kings" <sup id="cite_ref-1" class="reference">[2]</sup> or "Rich man's disease" <sup id="cite_ref-2" class="reference">[3]</sup> Causes
Gout may be primary (including idiopathic), or secondary to (a complication of) another condition.
<table class="metadata plainlinks ambox ambox-style" style=""> <tbody><tr> <td class="mbox-image">
</td> <td class="mbox-text" style="">This article may require cleanup to meet Wikipedia's quality standards. Please improve this article if you can. <small>(October 2008)</small></td> </tr> </tbody></table> About 10% of people with hyperuricemia develop gout.<sup id="cite_ref-pmid18327257_6-0" class="reference">[7]</sup>
The high levels of uric acid in the blood are caused by protein rich foods. Alcohol intake often causes acute attacks of gout and hereditary factors may contribute to the elevation of uric acid, e.g.inborn errors of purine-pyrimidine metabolism. Typically, persons with gout are obese, predisposed to diabetes and hypertension, and at higher risk of heart disease. Gout is more common in affluent societies due to a diet rich in proteins, fat, and alcohol. It is not rare, however, to find gout among the poorer classes, who drink large quantities of alcohol, and whose food is insufficient in quantity and quality. This is known as "poor man's gout." <sup id="cite_ref-7" class="reference">[8]</sup><sup id="cite_ref-8" class="reference">[9]</sup>
When it follows as a consequence of other health conditions such as renal failure, it is often regardless of the person's lifestyle.<sup id="cite_ref-isbn0-87477-986-3_9-0" class="reference">[10]</sup> Some studies have established a statistical connection between gout and lead poisoning,<sup id="cite_ref-pmid12459402_10-0" class="reference">[11]</sup> and a significant correlation between levels of lead in the body and urate excretion and gout.<sup id="cite_ref-pmid6434739_11-0" class="reference">[12]</sup> It is known that lead sugar was used to sweeten wine, and that chronic lead poisoning is a cause of gout,<sup id="cite_ref-pmid8035397_12-0" class="reference">[13]</sup><sup id="cite_ref-pmid10914856_13-0" class="reference">[14]</sup> and condition is then known as saturnine gout, because of its association with lead (Saturnus was the alchemists' term for the metal lead).<sup id="cite_ref-pmid4947583_14-0" class="reference">[15]</sup> Diuretics (particularly thiazide diuretics) have traditionally been blamed for precipitating attacks of gout because they compete at the same transporter, but a Dutch case-control study from 2006 appears to cast doubt on this conclusion.<sup id="cite_ref-pmid16291814_15-0" class="reference">[16]</sup>
Gout also can develop as a co-morbidity of other diseases, including polycythaemia, intake of cytotoxics, obesity, diabetes, hypertension, renal disorders, and hemolytic anemia. Gout is an important complication in a minority of solid organ transplant.<sup id="cite_ref-pmid16392875_16-0" class="reference">[17]</sup>
Because some approved treatments for these other conditions also reduce serum uric acid, individualized treatment of gout has the potential to improve outcome.<sup id="cite_ref-pmid16882587_17-0" class="reference">[18]</sup>
A day after the city abruptly closed three public schools in Queens after an explosion of new swine-flu cases, the wife of a critically ill assistant principal blasted officials for not doing enough sooner.
Bonnie Wiener, wife of Assistant Principal Mitchell Wiener, said her husband could have not fallen ill -- and ended up on a ventilator -- had the Health Department and Department of Education officials closed IS 238 in Hollis sooner.
"They're trying to make him into a sick, old man," Bonnie Wiener told The Post this morning.
She said her 55-year-old husband -- who has the most severe illness in the city from the virus to date -- had told officials last week that the school should be closed.
Bonnie Wiener said the city "lulled us into a false sense of security" when it came to the swine fever outbreak.
Contrary what Mayor Bloomberg reported yesterday, he does not have a preexisting condition, she said Wiener only suffers from controlled high blood pressure and is otherwise in good health.
"He's doing very badly," Bonnie Wiener, a reading teacher at the same school her husband works, said. "He's in critical, critical condition. It's a nightmare I can't wake up from."
The city did eventually take forceful action and closed the schools -- which affects nearly 4,500 students at Wiener's school, along with PS 16 in Corona and IS 5 in Elmhurst -- a stark reversal from what appeared to be waning concern citywide about the virus.
Wiener's kids also came to their father's defense, saying he's not a sick man.
"He does not have any diabetes and does not have any heart issues," said Adam Wiener, 23. "It was very rough last night... He's still in critical condition. I believe it all to be caused by swine flu."
Adam Weiner said because his father has infections in his lungs and has pneumonia, doctors could not inject him with the swine flu medication.
"The level of oxidation of his lungs are low... He does have kidney failure. We are not hopeless yet," he said.
By last night, a total of 178 confirmed cases of swine flu had been diagnosed in the city since it first hit last month.
On Thursday, Bloomberg stressed that officials didn't shut schools until they saw "a large cluster."
"There's always a certain percentage [of kids] that are sick, and you would close all your schools every day all year round -- and you have to wait until it gets abnormal, and then do it," he said.
"We're always looking for unusually high levels of flu-like illness, and we found that here at these three public schools," added Dr. Isaac Weisfuse, a city deputy health commissioner.
The three Queens schools will remain shut for at least five days.
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
Since there is some relationship between kidney failure and gout. From this we can't be sure if it is a result of gout or H1N1.
"I believe it to be all caused by swine flu, with infection in his lungs and pneumonia, as well as kidney failure so they can't inject the swine flu medication," the 23-year-old said.
Re: New York City, USA - Queens Educator Critically Ill With Swine Flu; 3 Schools Closed
Perhaps the patient and his family were not aware that he had gout. It is possible that they were not aware of this if he never had an attack before, and if his uric acid level was never tested. Of course, now they are testing him every way but Sunday.
They should ask his doctors if this is a new diagnosis.
Perhaps the patient and his family were not aware that he had gout. It is possible that they were not aware of this if he never had an attack before, and if his uric acid level was never tested. Of course, now they are testing him every way but Sunday.
They should ask his doctors if this is a new diagnosis.
One of the news articles mentioned that his co-workers had seen the man walking with a cane once and awhile. That fits with gout. My father had gout and when he had an attack, he had to walk with a cane to keep painful pressure off his foot.
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