Respiratory illness - adenovirus 14 -hits remote Alaska island - FluTrackers

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

No...no hunters that I know of. It's primarily affecting the Native people in Klawock. I don't know for sure how many have been medivaced--eight or ten perhaps.

It is not all that unusual to medivac people on the island -- weather conditions being what they are, they often err on the side of caution. They almost always medivac the elders--simply because if their condition does become serious and the weather turns, they have access to better medical care than what can be provided on the island.

Still, the care that can be provided on the island is pretty good.

Its not clear why the cdc would be involved, Do the native people hunt?

 

[sharon sanders]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Metlakatla -Again, thank you.

When patients are medivac, are they generally taken to Juneau or Seattle?

 

[Metlakatla]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

No, the Natives don't hunt much in this part of Alaska. They get their dietary protein needs met from the abundance of salmon. We don't have moose or caribou here--some people do hunt deer though. But most of the hunters are from the lower 48.

 

[Metlakatla]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Though I can say this--my most recent e-mail to my mom in Klawock just bounced back as undeliverable, same with my ex husband in Craig. My mother has her own satellite and the ex is on the local provider. This was ten minutes ago.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Though I can say this--my most recent e-mail to my mom in Klawock just bounced back as undeliverable, same with my ex husband in Craig. My mother has her own satellite and the ex is on the local provider. This was ten minutes ago.

I sent an e-mail to contacts on the other side of the island, and the e-mail did not bounce.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

No...no hunters that I know of. It's primarily affecting the Native people in Klawock. I don't know for sure how many have been medivaced--eight or ten perhaps.

It is not all that unusual to medivac people on the island -- weather conditions being what they are, they often err on the side of caution. They almost always medivac the elders--simply because if their condition does become serious and the weather turns, they have access to better medical care than what can be provided on the island.

Still, the care that can be provided on the island is pretty good.

I think two things may be happening simultaneously. I have a contact on the other side of the island, who has a project in Klawock. He has flu symptoms, as do many of his employees. However, he does not have a fever in excess of 101, and recently has been driving o Klawock each day, so he isn't that sick. He also says quite a few people have it.

However, I think there is something more that has led to the case definition that includes a fever above 101, a dry cough, and I suspect something else (maybe pneumonia). If only mild flu was in play, the CDC would not be involved, and there would not be an absence of a diagnosis. Seasonal flu is easy to diagnose, especially if there are dozens or hundreds that are ill. It is the more serious disease that has created a case definition and some "confirmed" cases, as well as some (or many) medevaced patients (which has been rumored to be as many as 50).

 

[Laidback Al]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Klawock was a major Tlingit settlement before historic contact. As noted by Metakatla aquatic resources are the basis of much of the subsistence economy. However hunting of terrestrial mammals and avifauna does occur. From a mid-1980s study:
<?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>

Without question, waterfowl traditionally were a significant category of resources for the Tlingit. . . . Areas west and north of St. Philip's Island and were usually exploited in conjunction with other harvest activities, such as deer hunting, but trips might be taken into these areas for the specific purpose of harvesting geese.
<o></o>
In terms of seasonality, contemporary informants report harvesting ducks in the fall (see Figure 11) although spring hunting was conducted in very recent past. Informants also reported the harvesting of sea gull eggs during the month of June. Based on data from the survey, six households reported harvesting ducks or geese, and one reported collecting seagull eggs in 1984, for total harvest and 94 pounds and 4.8 pounds respectively. . . .

<o></o>
Reference: Timber Management and Fish and Wildlife Use in Selected Southeastern Alaska Communities: Klawock, <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comffice:smarttags" /><st1:City w:st="on">Prince of Wales Island</st1:City>, <st1:State w:st="on">Alaska</st1:State> by Linda J Ellanna and George K. Sherrod Technical Paper 126, <st1:State w:st="on"><st1lace w:st="on">Alaska</st1lace></st1:State> Dept of Fish and Game, December 1987.
<o></o>
Link: http://www.subsistence.adfg.state.ak.us/TechPap/tp126.pdf

 

[AlaskaDenise]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

If you read the advertisements for local hunting guides, there are bear hunts, & other large mammals.

Guided hunters are from out of area. Since hunters can only get one bear per lifetime in parts of Europe, they are frequent customers of guided hunts - very pricey hunt!

.

 

[Giuseppe]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Hi. I am from Klawock, though I am not there right now. My mother is, and she just told me that the illness seems to be affecting people who are heavy drinkers.

A serotoninergic syndrome?

Toxic chemical in alcohol assumed with other cold drugs may cause serotoninergic syndrome (temperature >38?C, respiratory distress, loss of consciousness, delirium, GIT symptoms, hemorrhages); a complex clinical pattern.

 

[Gert van der Hoek]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Yes, alcohol seems very plausible in relation with respiratory illness, seems primarily due to depression of normal defense mechanisms. :

- snip -

A history of chronic alcohol abuse significantly increases the risk of developing acute respiratory distress syndrome (ARDS) in critically ill patients, regardless of the inciting illness.[69]

http://www.medscape.com/viewarticle/501977_3

 

[AlaskaDenise]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

We could add initial pulmonary TB infections to list of possibilities. Symptoms can be fever and dry cough.

Latest report on TB in Alaska at http://www.epi.alaska.gov/pubs/webtb/TBReport2007.pdf

.

Alcohol use increases odds of having TB.

.

 

[Giuseppe]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Alcohol PLUS common cold medicines (or amfetamine derivatives) may act as serotonin agonistic with development of hypertermia, acute respiratory distress syndrome, cutaneous rash etc.

http://en.wikipedia.org/wiki/Serotonin_syndrome

(...)
Diagnosis

There is no lab test for serotonin syndrome, so diagnosis is by symptom observation and the patient's history. Serotonin toxicity has a characteristic picture which is generally hard to confuse with other medical conditions, but in some situations it may go unrecognized because it may be mistaken for a viral illness, anxiety, neurological disorder, or worsening psychiatric condition.<sup id="cite_ref-22" class="reference">[23]</sup> The patients history and clonus (spontaneous, inducible and ocular) are the most important sign in the diagnosing serotonin syndrome.<sup id="cite_ref-Dunkley_4-3" class="reference">[5]</sup> Researchers in Australia have developed the Hunter Serotonin Toxicity Criteria for diagnosing serotonin syndrome.<sup id="cite_ref-Dunkley_4-4" class="reference">[5]</sup>
The Hunter Serotonin Toxicity Criteria suggests that in the presence of a serotonergic agent the patient has:

• Spontaneous clonus, or
• Inducible clonus or ocular clonus with agitation or diaphoresis, or
• Tremor and hyperreflexia, or
• Hypertonic and temperature > 38 ?C (100 ?F) and ocular clonus or inducible clonus

Then the diagnosis is serotonin syndrome. If these are not met then it is not serotonin syndrome.


(...) Interactions:



<table class="wikitable"><tbody><tr><th>Class</th> <th>Drugs</th> </tr> <tr> <td>Antidepressants</td> <td>Monoamine oxidase inhibitors (MAOIs), TCAs, SSRIs, SNRIs, bupropion</td> </tr> <tr> <td>Opioids</td> <td>tramadol, pethidine, fentanyl, pentazocine</td> </tr> <tr> <td>CNS stimulants</td> <td>phentermine, diethylpropion, amphetamines, sibutramine, methylphenidate, methamphetamine, cocaine</td> </tr> <tr> <td>5-HT₁ agonists</td> <td>triptans</td> </tr> <tr> <td>Psychedelics</td> <td>MDMA, MDA, MDEA, PMA, Psilocybin, LSD</td> </tr> <tr> <td>Herbs</td> <td>St John's Wort, Yohimbe, Boswellia, Panax ginseng</td> </tr> <tr> <td>Others</td> <td>tryptophan, valproate, montelukast, buspirone, kanna, lithium, linezolid, dextromethorphan, 5-Hydroxytryptophan, chlorpheniramine, risperidone, olanzapine, ondansetron, granisetron, metoclopramide</td></tr></tbody></table>

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

A serotoninergic syndrome?

Toxic chemical in alcohol assumed with other cold drugs may cause serotoninergic syndrome (temperature >38?C, respiratory distress, loss of consciousness, delirium, GIT symptoms, hemorrhages); a complex clinical pattern.

It seems that if the "confirmed" cases are serotoninergic syndrome involving flu (or whatever is "going around" on the island), it would be reported every year and would not lead to a cdc involvement (and the Alaska Dept of Health would have acknowledged that the "confirmed" cases were influenza positive).

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Yes, alcohol seems very plausible in relation with respiratory illness, seems primarily due to depression of normal defense mechanisms. :

- snip -

A history of chronic alcohol abuse significantly increases the risk of developing acute respiratory distress syndrome (ARDS) in critically ill patients, regardless of the inciting illness.[69]

http://www.medscape.com/viewarticle/501977_3

So alcohol and seasonal flu produces bird flu symptoms, but the CDC doesn't know what to say because the patients are influenza A positive and they are afraid to admit it?

 

[sharon sanders]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

That is a highly speculative comment. We do not know the level of CDC involvement. We do not know the diagnosis or how many are actually sick.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

That is a highly speculative comment. We do not know the level of CDC involvement. We do not know the diagnosis or how many are actually sick.

The first sentence of the Oct 1 story is "The State Health Department and U.S. Centers for Disease Control are investigating an outbreak of a respiratory illness on Prince of Whales Island."

 

[sharon sanders]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

"Investigating" could be anything from a phone call to Atlanta to a team in the area.

We do not know.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

"Investigating" could be anything from a phone call to Atlanta to a team in the area.

We do not know.

Sounds like pure speculation.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

I sent an e-mail to contacts on the other side of the island, and the e-mail did not bounce.

I received an e-mail this morning. Internet access on island is fine. He says the number of cases showing up at clinic is declining and the number medevaced is around 10 (not the 25 + 25 rumored earlier).
Lots or rumors on the island and still no (public) diagnosis.

 

[tropical]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

#1:
"... I found a nice lady to tell me this ..it is a regular flu and that people were gettin pneumonia ..."