132 flu patients hit with brain disorders since July

[Treyfish]

<!--// headline_end //--><!--// byline_start //-->The Yomiuri Shimbun
<!--// byline_end //--><!--// article_start //--><!-- google_ad_region_start=region1 -->A total of 132 influenza patients in Tokyo and 27 prefectures have developed encephalopathy, or swelling of the brain, since July, according to the National Institute of Infectious Diseases.
Normally, only about 40 to 50 seasonal flu sufferers develop encephalopathy each year, meaning the latest figure has already more than doubled in four months since the new strain of flu began spreading.
Encephalopathy occurs when viruses cause the immune system to overreact, resulting in a swelling of the brain.
Though the ages of the 132 people in question range from 1 to 67, most were under 15.
By age, 7-year-olds constituted the largest group, with 22 sufferers. This is older than the average age for encephalopathy sufferers, who are most often aged between 1 and 3.
Further examination of 60 of the 132 patents revealed consciousness-related malfunctions.
The period over which these malfunctions occurred following the initial fever ranged from one day for 12 people, two days for 36 people, and four days for eight people.
The examination reconfirmed that in many cases, the serious symptoms occurred in the early stages of the disease.
Of 59 patients whose symptom development had ended, three, or 5 percent, died. Seven, or 12 percent, suffered aftereffects such as physical paralysis or mental or nerve disorders.
Forty-nine, or 83 percent, fully recovered.
Nobuhiko Okabe, chief of the institute's Infectious Disease Surveillance Center, said: "If a patient exhibits such symptoms as slow responses or saying strange things, encephalopathy could be the cause. In such cases, patients should see a doctor immediately."
(<!--// date_start //-->Nov. 24, 2009<!--// date_end //-->)http://www.yomiuri.co.jp/dy/national...24TDY03303.htm

[Gert van der Hoek]

Re: 132 flu patients hit with brain disorders since July

See also this thread:

http://www.flutrackers.com/forum/showthread.php?t=122423

Brain disorders could be Tamiflu induced?


I also remember a possible relation with Ibuprofen?

http://www.flutrackers.com/forum/sho...05&postcount=5 ?

[ming]

Re: 132 flu patients hit with brain disorders since July

Why is this only being reported from Japan ? Is it not happening anywhere else ?

[Roehl_JC]

Re: 132 flu patients hit with brain disorders since July

there's never smoke without fire ..... old folk saying

If there are that many cases of encephalopathy in Japan, it is a strong indicator that this is being repeated widely elsewhere as well. IMO

[Missouriwatcher]

Re: 132 flu patients hit with brain disorders since July

From SnowyOwl's find:
"Fatal neuropsychiatric adverse reactions to oseltamivir: Case series and overview of causal relationships
Rokuro Hama

Following restrictions on the use of NSAIDs as antipyretics for children in Japan in 2000 [37], the proportion of NSAIDs users among cases of Reye?s syndrome and/or influenza-associated encephalopathy decreased from about 30% to below 10% and the proportion of case fatalities resulting from influenza associated encephalopathy decreased from about 30% to about 10%. Two years (i.e. two winter seasons) elapsed during which the proportion of case fatality of influenza-associated encephalopathy decreased, before the marketing of Tamiflu dry syrup for children in Japan commenced in September 2002.

This new type of encephalopathy among infants was first found in the winter of 2002/2003 just after the marketing of Tamiflu dry syrup for children had started. However a similar adult case of sudden death had been already reported in March 2001 [MHLWB01-529], just after the Tamiflu capsule was marketed in February 2nd 2001 in Japan.

Times of onset of most sudden deaths and of neuropsychiatric symptoms are very similar. These facts also suggest that the majority of sudden deaths and neuropsychiatric symptoms after taking Tamiflu are different from the pattern observed with infection-associated encephalopathy including Reye?s syndrome and/or influenza-associated encephalopathy.

Epithelial Na+ channel (ENaC), Na+/K+-ATPase pumps, and several aquaporin water channels are the best described molecular transporters in the lung when pathological conditions lead to the development of pulmonary oedema. Lung oedema results from the impairment of alveolar cells and/or capillary endothelial cells, both of which actively transport fluids from the alveolar space to the blood vessels. In acute lung injury (ALI), especially in severe sepsis (systemic inflammatory response by infection), an inflammatory process damages the capillary endothelium rather than the alveolar epithelium, resulting in high permeability of the lung capillaries to fluid, which leads to clinical pulmonary oedema. In contrast to the endothelium, the alveolar epithelium is often spared in ALI, and the rate of alveolar fluid clearance (AFC) in ALI can therefore be maintained and perhaps even increased.

Although the role of Tamiflu in the development of lung oedema in two of the autopsied cases is not completely clarified, it is at least possible that severe hypoxia induced by the respiratory suppressive action of oseltamivir might have contributed to the induction of lung oedema just prior to respiratory arrest in both cases.

There is only one reported case of acute hemorrhagic colitis induced by Tamiflu but in that instance an allergic mechanism was involved. However, among the 80 fatal cases now known, bleeding episodes were described in eight, including one case without severe infection, sepsis or multiorgan failure.

One certainly cannot exclude the possibility that activation of normal human plasminogen by human neulaminidase (sialidase) might be inhibited by OCB, in which case normal fibrinolysis might be affected, resulting in abnormal coagulopathy including DIC.

After the submission of this paper, three investigators found equivocally that P-glycoprotein is the efflux transporter of oseltamivir at the BBB." http://www.npojip.org/english/published-paperJRS431.pdf

"Disseminated intravascular coagulation (DIC): leads to the formation of small blood clots inside the blood vessels throughout the body. As the small clots consume all the available coagulation proteins and platelets, normal coagulation is disrupted and abnormal bleeding occurs from the skin, the digestive tract, the respiratory tract and surgical wounds." http://en.wikipedia.org<br /> /wiki...ar_coagulation

[Roehl_JC]

Re: 132 flu patients hit with brain disorders since July

Chinese hospital's H1N1 flu patients develop meningitis; report
HONG KONG, Nov. 27 KYODO
At least six patients in China's Shenzhen who came down with the new H1N1 strain of influenza A have also developed meningitis, a complication that is rare though cases have been reported in other countries, mainland media reported Friday.

http://home.kyodo.co.jp/modules/fstStory/index.php?storyid=472816

comment: well at least something similar is happening in China

[ming]

Re: 132 flu patients hit with brain disorders since July

If that as happening over here , would we hear anything about it ?

[Missouriwatcher]

Re: 132 flu patients hit with brain disorders since July

That might be something to watch. According to MMWR's for 2007 AND 2008, meningococcal disease went DOWN when comparing monthly graphs. Looking at 2009, going down, then UP in weeks 29-32. Then down again until weeks 45 & 46.
NOTE: Not yet indicating "beyond historical limits"

http://www.cdc.gov/mmwr/weekcvol.html

[Emily]

Re: 132 flu patients hit with brain disorders since July

Just an anecdote, but I searched Twitter for 'swine flu meningitis' and found this report, (I think from the UK), about being misdiagnosed as meningitis and then it turned out to be severe swine flu. Sounds like some valuable time was wasted. You'll have to scroll around to find the posts on that topic.

http://twitter.com/TwitTommyG

ETA: Looking a bit more, I found this.

http://www.irishcentral.com/news/Irish-child-misdiagnosed-with-swine-flu-dies-70387287.html

Very bad to misdiagnosis either way, and it sounds like it can be difficult from the symptoms in severe cases.