Health officials can't explain 1st San Diego swine flu death

[Shiloh]

Source: http://www.modbee.com/state/story/748868.html

ednesday, Jun. 17, 2009
Health officials can't explain SD swine flu death
The Associated Press


SAN DIEGO -- San Diego County health officials are investigating the swine flu death of a 20-year-old Escondido woman, trying to determine why the virus quickly became fatal to a seemingly healthy person.

Palomar Medical Center director Dr. Don Herip said Wednesday that the woman, identified by the coroner's office as Adela Chevalier, began experiencing mild flu symptoms on Friday, including a cough and fatigue. He says by Monday she was running a high fever, having trouble breathing and suffering severe muscle aches. She died at the hospital's emergency room later that night.

County health officials say tests also were being conducted Wednesday night on a specimen taken from a young man who died recently. They suspect he also was infected with swine flu.

* http://www.signonsandiego.com

Information from: The San Diego Union-Tribune, http://www.signonsandiego.com

 

[AlaskaDenise]

Re: Health officials can't explain 1st San Diego swine flu death

San Diego County health officials are investigating the swine flu death of a 20-year-old Escondido woman, trying to determine why the virus quickly became fatal to a seemingly healthy person.

Have any of these healthy-people deaths been investigated utilizing an autopsy?

.

 

[wotan]

Re: Health officials can't explain 1st San Diego swine flu death

Have any of these healthy-people deaths been investigated utilizing an autopsy?

.

Are they sequencing the virions from any of these?

 

[AlaskaDenise]

Re: Health officials can't explain 1st San Diego swine flu death

Are they sequencing the virions from any of these?

I think so, but as valuable as that is, they need extensive testing and possibly an autopsy to ascertain exactly why an otherwise healthy person would have such a different outcome.

Protecting people from this disease without knowing the above is like trying to sail a boat without knowing which way the wind is blowing......impossible.

.

 

[tropical]

Re: Health officials can't explain 1st San Diego swine flu death

#1:...

Are we sure that they "don't know",
after years of terabits about the cytokine storm, and relations with the 1918 flu ...

They probably simple continued with the health emergency publishing news policy.

 

[Shiloh]

Re: Health officials can't explain 1st San Diego swine flu death

Source: http://www3.signonsandiego.com/stor...lu-baffles-experts/?northcounty&zIndex=119303

A fatal puzzle
Local woman's death from swine flu baffles experts
By Keith Darc?, Union-Tribune Staff Writer

2:00 a.m. June 19, 2009

Adela Chevalier didn't fit the profile of someone who might die of swine flu.

The Escondido woman was young, having turned 20 in January. She was active and worked two jobs. And she was healthy ? family members said she never had a serious illness before last weekend.

Statistics on swine-flu patients also were in her favor.

About 70 percent of people in the United States who have been hospitalized for the virus, also called H1N1 influenza A, suffered from some underlying health problem, such as asthma, diabetes, chronic heart disease or a weakened immune system, according to the federal Centers for Disease Control and Prevention.

But those factors weren't enough to save Chevalier on Monday, when she arrived at the emergency room of Palomar Medical Center in Escondido. Within a few hours, she had become San Diego County's first swine-flu fatality.

Chevalier's death has perplexed public-health officials and medical researchers. It also has panicked some county residents, especially in Escondido and San Marcos ? where the victim lived and worked.

?It's clearly very shocking,? biomedical researcher David Woodland, who directs the Trudeau Institute in Saranac Lake, N.Y., said yesterday.

?One of the things that we've all been very concerned about with the outbreak of a new flu is that the severity of the infection could be much worse than the normal seasonal flu,? Woodland said.

An excessive immune-system response that triggers a lethal molecular battle within the body could explain the deaths of Chevalier and the handful of other young, healthy swine-flu patients, some scientists and epidemiologists said.

?It may be that the severity of the disease is due to the robust immune response of younger individuals,? Dr. Daniel Jernigan, deputy director of the CDC's Influenza Division, said during the agency's swine-flu briefing yesterday.

In North County, Chevalier's death reignited fears that had largely subsided in the weeks since swine flu first surfaced locally and quickly morphed into an international pandemic.

About 80 people showed up at the Palomar emergency room Wednesday night ? hours after county officials and news media released information about Chevalier. An additional 100 had arrived by yesterday afternoon, said nurse Cathy Prante, the hospital's director of emergency services.

The deluge prompted Palomar officials to set up a pair of canopies outside the emergency room where potential flu patients were directed for initial evaluation.

Many of the visitors weren't sick. They were worried about having been exposed to the swine-flu virus, Prante said.

?We've seen people who worked at the places where (Chevalier) did, or they socialized with her family members,? the nurse said.

San Diego County's public-health officials yesterday urged people not to panic. They said emergency room visits should be reserved for those with serious flu symptoms such as breathing difficulties, stomach pain, dizziness and severe vomiting.

At Palomar, staffers are using a new system designed to quickly assess the condition of ER patients. A nurse stationed in the emergency room lobby briefly evaluates each incoming patient, looking for dizziness, breathing problems, high fever and other signs that urgent care is needed.

People fitting that description are sent to an ER bed for immediate treatment.

The system, dubbed ?Quick View,? was initiated Monday and used hours later with Chevalier.

Her case ?tested the system? and immediately proved its value, Prante said.

The county Medical Examiner's Office is still days away from releasing its autopsy report on Chevalier, and the bits of information made public so far aren't enough to explain how she died.

?We just don't know at this point,? said Dr. Glenn Wagner, the county's chief medical examiner. ?I know that she was reasonably healthy and a bit overweight.?

He also said Chevalier's lungs weighed more than normal, suggesting they were saturated with fluid.

The liquid might have come from intravenous fluid pumped into Chevalier by hospital workers as they fought to resuscitate her, or it could have come from her own body.

Medical examiners still must analyze tiny slices of Chevalier's lung tissue under a microscope to determine where the fluid originated and whether the volume was large enough to kill her, Wagner said.

If the fluid resulted from a battle spawned by her immune system, it might be evidence of a cytokine storm.

That potentially deadly process begins when an infection invades a person's respiratory tract. As viruses take over cells in the sinuses and lungs, the body releases messenger molecules known as cytokines to trigger an immune-system response.

Larger amounts of viruses cause more cytokines to activate, leading to a greater invasion of white blood cells that attack infected cells along with healthy ones that happen to be in the way.

Such collateral damage can be devastating to the lungs' delicate tissues, which allow oxygen molecules to mix with flowing blood.

?You've got damage caused by the virus itself, and damage caused by the immune response,? said Woodland, whose laboratory team studies how the immune system takes on viral and bacterial infections in the lungs.

When the fight is against a familiar infection, Woodland said, the immune system's barrage is typically measured. But with a novel disease, such as the H1N1 swine flu, the immune response might not occur until the lungs are filled with viruses. By then, a more massive counteroffensive can be disastrous.

?Fluid starts flooding into the lungs,? Woodland said. ?You basically drown.?

Scientists have theorized that a similar process was responsible for the deaths of a surprisingly large number of young people during the influenza pandemic of 1918-19, which killed an estimated 50 million worldwide.

Several years ago, researchers triggered a cytokine-storm response in mice by infecting them with a genetically reconstructed version of the 1918-19 flu. The results of their study were published in the October 2006 edition of the journal Nature .

Scientists studying the current strain of swine flu aren't close to determining whether the virus has the genetic structure needed to trigger a cytokine storm, said Dr. Douglas Richman, a professor of infectious diseases at UCSD Medical Center and the San Diego VA Healthcare System in La Jolla.

?The question is whether this flu is more virulent than the garden variety flu,? Richman said. ?The answer is that we don't know yet.?

Union-Tribune

Keith Darc?: (619) 293-1020;

 

[Lizw]

Re: Health officials can't explain 1st San Diego swine flu death

Source: http://www3.signonsandiego.com/stor...lu-baffles-experts/?northcounty&zIndex=119303

A fatal puzzle
Local woman's death from swine flu baffles experts
By Keith Darc?, Union-Tribune Staff Writer

An exceptionally well-informed article, for a change. And the writer clearly assumes that an autopsy will take place. I wonder whether that information comes from something he was told.

 

[The Mountains Voice]

Re: Health officials can't explain 1st San Diego swine flu death

?The question is whether this flu is more virulent than the garden variety flu,? Richman said. ?The answer is that we don't know yet.?[/B]

These people obviously don't follow FluTrackers. I think I'll send the reporter an email. As a matter of fact.... I think I will begin sending a LOT of reporters emails. Most internet stories show the reporter's name / email.

I believe perhaps it is time that FluTrackers became a little more proactive.

All emails should be calm & informative. Linking to sections/threads at the www.Flutracker.com website that offer supportive and helpful guidance, supporting information, etc.... because we wish to help said reporter in his/her investigative procedure.

Yes, I think it is time to go off the reservation, and invite people back to the reservation.

 

[tropical]

Re: Health officials can't explain 1st San Diego swine flu death

I agree.

Many from the health "caste", or their's news publishers seems to be enaugh uninformed what's going on widely, or they follow the policy of "silence".

In both the scenarios, more pushing evidence could maybe awake the media real taugh TV professionals to asses more equaly the population awareness.
This will contribute to slow the unneccessary people mingling ...

It is unbelievable how is deep the brainwashing where there are little cases, even if some news pop from TV - they live as the reality would shape itself to their "non-believe-that-silly-propaganda-news" posture.

These people obviously don't follow FluTrackers. I think I'll send the reporter an email. As a matter of fact.... I think I will begin sending a LOT of reporters emails. Most internet stories show the reporter's name / email.

I believe perhaps it is time that FluTrackers became a little more proactive.

All emails should be calm & informative. Linking to sections/threads at the www.Flutracker.com website that offer supportive and helpful guidance, supporting information, etc.... because we wish to help said reporter in his/her investigative procedure.

Yes, I think it is time to go off the reservation, and invite people back to the reservation.

 

[St Michael]

Re: Health officials can't explain 1st San Diego swine flu death

Source: http://www3.signonsandiego.com/stor...lu-baffles-experts/?northcounty&zIndex=119303

A fatal puzzle
Local woman's death from swine flu baffles experts
By Keith Darc?, Union-Tribune Staff Writer

2:00 a.m. June 19, 2009

...

Larger amounts of viruses cause more cytokines to activate, leading to a greater invasion of white blood cells that attack infected cells along with healthy ones that happen to be in the way.

Such collateral damage can be devastating to the lungs' delicate tissues, which allow oxygen molecules to mix with flowing blood.

?You've got damage caused by the virus itself, and damage caused by the immune response,? said Woodland, whose laboratory team studies how the immune system takes on viral and bacterial infections in the lungs.

When the fight is against a familiar infection, Woodland said, the immune system's barrage is typically measured. But with a novel disease, such as the H1N1 swine flu, the immune response might not occur until the lungs are filled with viruses. By then, a more massive counteroffensive can be disastrous.

?Fluid starts flooding into the lungs,? Woodland said. ?You basically drown.?[/B]

...

?The question is whether this flu is more virulent than the garden variety flu,? Richman said. ?The answer is that we don't know yet.?[/B]

That's a good summary, but if a healthy 20 year old just died of this flu, and that has become a pattern already, isn't that last question simply rhetorical?

 

[AlaskaDenise]

Re: Health officials can't explain 1st San Diego swine flu death

What a well-written article.

Can we help push it into the public's eye by clicking on the source link? I believe google (& other search engines) will pick up the increased traffic and it may automatically be placed in the google news home page.



I believe the writer provided an answer (in one quote) to a very important question (in another quote). Near the end he writes...

Scientists studying the current strain of swine flu aren't close to determining whether the virus has the genetic structure needed to trigger a cytokine storm,

But further back in the article he explains...

But with a novel disease, such as the H1N1 swine flu, the immune response might not occur until the lungs are filled with viruses. By then, a more massive counteroffensive can be disastrous.

So Woodland is providing the explanation that Richland says some scientists have yet to confirm, i.e., novel flu strains, by virtue of being novel, can cause cytokine storms. However, expert FT members have shown us how other factors contribute to the level of that reaction.

.

 

[Tea]

Re: Health officials can't explain 1st San Diego swine flu death

These people obviously don't follow FluTrackers. I think I'll send the reporter an email. As a matter of fact.... I think I will begin sending a LOT of reporters emails. Most internet stories show the reporter's name / email.

I believe perhaps it is time that FluTrackers became a little more proactive.

All emails should be calm & informative. Linking to sections/threads at the www.Flutracker.com website that offer supportive and helpful guidance, supporting information, etc.... because we wish to help said reporter in his/her investigative procedure.

Yes, I think it is time to go off the reservation, and invite people back to the reservation.

Guide to Media Sources for Print, Radio, Television and Cable Markets

Newspaper Links

well darn, originally Ron Paul had an EXCELLENT list to ALL print, radio and television markets.. It has since been removed.

I think you have a good idea TMV.

 

[tropical]

Re: Health officials can't explain 1st San Diego swine flu death

#12: ...

Watching this web ocean, it is more clear that all this became an "existing" population wide news only when it goes out from: CNN breakings, ..., main national countries TV news breakings coverages, etc., as noted here previously.

 

[Sammy]

Re: Health officials can't explain 1st San Diego swine flu death

Hi

Anything to stop Flu Trackers issuing a media release of its own making the connection, highlighting the need for people to be aware of the cause of the healthy deaths in 1918?

If you posted on PR Web or PR Wire or one of those online distribution services and you had an actual warm body who could speak to media in response to calls, you might do well. If nothing else, if you headline it well you will get lots of web hits of your own....

 

[tropical]

Re: Health officials can't explain 1st San Diego swine flu death

Hi

Anything to stop Flu Trackers issuing a media release of its own making the connection, highlighting the need for people to be aware of the cause of the healthy deaths in 1918? ...

I think that was already done, but the problem is how the recipients percept the "crying wolf" from an web site community of moniker posters, at the same time when the health structures minimizes the treat as easy treatable, and "normal" to see colateral victims, compared to the "prepared for" big one pandemic of "60% deaths" (no matter that we don't know what will happens further.

The majority of h.prof dismissed previously the actual pandemic events until now as "unthinkable or impossible now", and the vast portions of populations in areas not hardly infected not thinking about at all.

Flu web awareness sites for the above folks are mainly scaremongering strange sites, and the folks related to them they quoted as "freaks".

After so many denies of anything big happening, without knowing the named persons or cases at FT/... now happening in hard afected regions, looking the people actions and behaviour, I can even assure myself also that such awareness are bad dreams and not an worldwide nasty bug - until the local corner would be afected.