http://www.telegram.com/article/20080319/NEWS/803190650/1116
Wednesday, March 19, 2008
Flu opens door for pneumonia
Drug-resistant infections pose danger
By Elizabeth Cooney TELEGRAM & GAZETTE STAFF
ecooney@telegram.com
Influenza is a total-body illness.
That?s why it makes muscles ache all over. But the flu virus, which also causes headache, fever and a dry cough, can lead to far greater damage. Influenza injures cells lining the airways that clear out potentially harmful bacteria before they reach the lungs. The flu undermines the body?s defense against potentially deadly infections such as pneumonia.
In two of the four flu-related fatalities of children in Massachusetts, a rare but serious form of pneumonia following influenza was to blame for the deaths.
According to the state Department of Public Health, the two most recent deaths occurred in children who had no previous health problems, unlike the first two children who died earlier this month. A 15-year-old boy from Newton died Friday and a 12-year-old girl from Webster died Sunday. A Webster funeral home confirmed Monday that Haleigh M. Hernandez of Webster was the girl who died.
The pneumonia was caused in both cases by an infection with methicillin-resistant Staphylococcus aureus, according to the DPH, an illness that over the past 20 years has spread from hospitals to the community. Both children were being treated for the drug-resistant strain, but even ?ordinary? staph infections can lead to the same outcome, said Dr. Alfred DeMaria, the state?s director of communicable disease control.
Last year, the U.S. Centers for Disease Control and Prevention warned that while rare, MRSA is a potentially fatal cause of pneumonia, especially during the flu season. Of 69 children who died from bacterial infections after influenza in the 2006-07 flu season, 22 had staph infections and 15 of those were MRSA infections, according to the CDC.
?Certainly the most common complication of influenza is bacterial pneumonia,? said Dr. Richard T. Ellison III, hospital epidemiologist at UMass Memorial Medical Center.
?Staph aureus pneumonia is a very serious kind of pneumonia and the community-acquired MRSA strain has been associated with serious cases of pneumonia.?
Dr. Anthony Esposito, an infectious disease specialist at St. Vincent Hospital, said cases involving MRSA are a reason to be concerned.
?If MRSA is now a cause of post-influenza pneumonia, then that changes the picture dramatically,? he said. ?There aren?t that many oral drugs we give for the usual pneumonia that would cover MRSA pneumonia.?
The CDC recommends two particular antibiotics if physicians suspect MRSA pneumonia.
If parents are concerned about a child with flu, they should seek medical help if there is any sign of difficulty breathing or trouble staying conscious.
A high fever would also be a reason to contact a physician.
Infections that follow the flu often come when the person is just beginning to recover, although the transition between viral flu and bacterial pneumonia isn?t always apparent.
?Most people have the flu, feel awful for 72 hours, and then feel a little bit better,? Dr. Esposito said.
?If that improvement isn?t coming after three or four days, then there?s a concern that a second problem may be evolving.?
A cough that was dry at first and then brings up phlegm after three to five days may be a sign of a bacterial infection and a reason to call a doctor, he said.
During an examination a doctor could listen to the lungs and order a chest X ray if something suggested pneumonia, which if confirmed could then be treated with antibiotics.
This year?s flu season will likely wind down in the next two or three weeks, making a flu vaccination still a possibility for adults.
Although the vaccine was not a good match for the strains circulating this year, it still offers some protection, health experts say. It takes 10 days to two weeks to become fully effective.
For children who have never had a flu shot, it might be difficult to benefit at this point.
They need to have two doses four weeks apart to gain protection the first time.
Wednesday, March 19, 2008
Flu opens door for pneumonia
Drug-resistant infections pose danger
By Elizabeth Cooney TELEGRAM & GAZETTE STAFF
ecooney@telegram.com
Influenza is a total-body illness.
That?s why it makes muscles ache all over. But the flu virus, which also causes headache, fever and a dry cough, can lead to far greater damage. Influenza injures cells lining the airways that clear out potentially harmful bacteria before they reach the lungs. The flu undermines the body?s defense against potentially deadly infections such as pneumonia.
In two of the four flu-related fatalities of children in Massachusetts, a rare but serious form of pneumonia following influenza was to blame for the deaths.
According to the state Department of Public Health, the two most recent deaths occurred in children who had no previous health problems, unlike the first two children who died earlier this month. A 15-year-old boy from Newton died Friday and a 12-year-old girl from Webster died Sunday. A Webster funeral home confirmed Monday that Haleigh M. Hernandez of Webster was the girl who died.
The pneumonia was caused in both cases by an infection with methicillin-resistant Staphylococcus aureus, according to the DPH, an illness that over the past 20 years has spread from hospitals to the community. Both children were being treated for the drug-resistant strain, but even ?ordinary? staph infections can lead to the same outcome, said Dr. Alfred DeMaria, the state?s director of communicable disease control.
Last year, the U.S. Centers for Disease Control and Prevention warned that while rare, MRSA is a potentially fatal cause of pneumonia, especially during the flu season. Of 69 children who died from bacterial infections after influenza in the 2006-07 flu season, 22 had staph infections and 15 of those were MRSA infections, according to the CDC.
?Certainly the most common complication of influenza is bacterial pneumonia,? said Dr. Richard T. Ellison III, hospital epidemiologist at UMass Memorial Medical Center.
?Staph aureus pneumonia is a very serious kind of pneumonia and the community-acquired MRSA strain has been associated with serious cases of pneumonia.?
Dr. Anthony Esposito, an infectious disease specialist at St. Vincent Hospital, said cases involving MRSA are a reason to be concerned.
?If MRSA is now a cause of post-influenza pneumonia, then that changes the picture dramatically,? he said. ?There aren?t that many oral drugs we give for the usual pneumonia that would cover MRSA pneumonia.?
The CDC recommends two particular antibiotics if physicians suspect MRSA pneumonia.
If parents are concerned about a child with flu, they should seek medical help if there is any sign of difficulty breathing or trouble staying conscious.
A high fever would also be a reason to contact a physician.
Infections that follow the flu often come when the person is just beginning to recover, although the transition between viral flu and bacterial pneumonia isn?t always apparent.
?Most people have the flu, feel awful for 72 hours, and then feel a little bit better,? Dr. Esposito said.
?If that improvement isn?t coming after three or four days, then there?s a concern that a second problem may be evolving.?
A cough that was dry at first and then brings up phlegm after three to five days may be a sign of a bacterial infection and a reason to call a doctor, he said.
During an examination a doctor could listen to the lungs and order a chest X ray if something suggested pneumonia, which if confirmed could then be treated with antibiotics.
This year?s flu season will likely wind down in the next two or three weeks, making a flu vaccination still a possibility for adults.
Although the vaccine was not a good match for the strains circulating this year, it still offers some protection, health experts say. It takes 10 days to two weeks to become fully effective.
For children who have never had a flu shot, it might be difficult to benefit at this point.
They need to have two doses four weeks apart to gain protection the first time.
