Other Illness May Precede Worst Cases of Swine Flu ~ NYT

[mzmolly]

May 9, 2009

Other Illness May Precede Worst Cases of Swine Flu
By DONALD G. McNEIL Jr.

Underlying conditions like asthma, diabetes, heart disease or tuberculosis appear to put swine flu victims at greater risk of hospitalization or death, doctors from the World Health Organization and the Centers for Disease Control and Prevention said Friday.

Health officials emphasized that the observations were preliminary and based on discussion of only about 40 deaths in Mexico and half of the 57 hospitalizations in the United States. But a few trends have begun to emerge.

Some of the serious cases involve healthy young people, and the reasons for that are still unexplained. Many of the patients went into rapid decline and died of viral pneumonia, not bacterial pneumonia, said Dr. Sylvie Briand, a W.H.O. flu expert. Viral pneumonia may be a result of the “cytokine storm,” in which the body’s own immune reaction to a new virus floods the lungs with fluid. It can progress faster and be harder to treat than bacterial pneumonia.

Dr. Richard E. Besser, the acting director of the C.D.C., said most of the hospitalized Americans had an additional health problem. In seven cases it was asthma, which is worrying because asthma has become quite common in the United States. So has diabetes, which is linked to America’s epidemic of obesity, he said. Seasonal flu has always been dangerous for those with cardiovascular problems, which are unusual among the young.

Active tuberculosis is much less common in the United States than in poor countries.

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