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Argentina: unusual serious cases in young people
- Thread starter Shiloh
- Start date
the doctor
Retired 2010
Re: Argentina: unusual serious cases in young people
I agree with your interpretation Tropical. Apparently for some unexplainable reason the doctors are withholding antiviral treatment even when patients are presenting with severe ILI and trouble breathing that is severe enough to warrant their hospitalization.
This is a poorly conceived policy and in my opinion one that the government health authorities are probably scrambling to change even as I write. We can expect them to do so ASAP. The WHO should ship Argentina some of the Tamiflu they have on reserve in case that country has very little of the drug in their stockpile, a possible reason for their withholding it.
The US could send them some too.
Since the novel strain will very likely pick up the 274 polymorphism conveying Tamiflu resistance over the next month or two, we are probably in a Use it of Loose it" condition at the moment. At the present, the novel strain is sensitive to Tamiflu, so if we don't use it now, all those millions of courses stored in the strategic stockpiles within the US and EU nations will go to waste.
GW
I agree with your interpretation Tropical. Apparently for some unexplainable reason the doctors are withholding antiviral treatment even when patients are presenting with severe ILI and trouble breathing that is severe enough to warrant their hospitalization.
This is a poorly conceived policy and in my opinion one that the government health authorities are probably scrambling to change even as I write. We can expect them to do so ASAP. The WHO should ship Argentina some of the Tamiflu they have on reserve in case that country has very little of the drug in their stockpile, a possible reason for their withholding it.
The US could send them some too.
Since the novel strain will very likely pick up the 274 polymorphism conveying Tamiflu resistance over the next month or two, we are probably in a Use it of Loose it" condition at the moment. At the present, the novel strain is sensitive to Tamiflu, so if we don't use it now, all those millions of courses stored in the strategic stockpiles within the US and EU nations will go to waste.
GW
sharon sanders
Editor-in-Chief & President
Re: Argentina: unusual serious cases in young people
Thanks for the translation Tropicalgirl!
Thanks for the translation Tropicalgirl!
Giuseppe
Emeritus
Re: Argentina: unusual serious cases in young people
It could of some help the fact that among the most recent Italian H1N1v cases there are several Argentina imported cases.
For people used to manage with gene sequencing, it could be useful to track the most recent Italian deposited sequences at GenBank or GISAID.
About the hypertoxic infections in these Buenos Aires patients, it should be noted that antiviral drug oseltamivir alone probably would be of little or not help, if an updated treatment course will not be prepared soon, with the aim to reduce a bit the mortality rate.
Oseltamivir alone with a rapid evolutive clinical course may be too little and perhaps too late.
A comprehensive re-evaluation of both pathological evidences and possible treatment options is clearly urgently needed.
It could of some help the fact that among the most recent Italian H1N1v cases there are several Argentina imported cases.
For people used to manage with gene sequencing, it could be useful to track the most recent Italian deposited sequences at GenBank or GISAID.
About the hypertoxic infections in these Buenos Aires patients, it should be noted that antiviral drug oseltamivir alone probably would be of little or not help, if an updated treatment course will not be prepared soon, with the aim to reduce a bit the mortality rate.
Oseltamivir alone with a rapid evolutive clinical course may be too little and perhaps too late.
A comprehensive re-evaluation of both pathological evidences and possible treatment options is clearly urgently needed.
Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Re: Argentina: unusual serious cases in young people
My feeling is Tropical Girl has a good point.
The stories from Argentina remind me of the stories of patients who died from H5N1 in Indonesia. Typically these patients were treated late, too late. This combined with an illness developing very fast sometimes.
May be for some reason the H1N1 patients in Argentina are treated too late with Tamiflu.
Not much information on patients who died in the USA and Canada is published .
We see and hear a few stories through family members. There is mentioning of late treatment or even refusal of treatment with Oseltamivir. Both in the USA and Canada.
Fast and aggressive treatment with an anti-viral seems to be the thing to do .
My feeling is Tropical Girl has a good point.
The stories from Argentina remind me of the stories of patients who died from H5N1 in Indonesia. Typically these patients were treated late, too late. This combined with an illness developing very fast sometimes.
May be for some reason the H1N1 patients in Argentina are treated too late with Tamiflu.
Not much information on patients who died in the USA and Canada is published .
We see and hear a few stories through family members. There is mentioning of late treatment or even refusal of treatment with Oseltamivir. Both in the USA and Canada.
Fast and aggressive treatment with an anti-viral seems to be the thing to do .
tropicalgirl
Well-known member
Re: Argentina: unusual serious cases in young people
I just took a look on 2 major Argentina news sites
http://www.lanacion.com.ar/nota.asp?nota_id=1144269&pid=6756848&toi=6256
and
http://www.clarin.com/diario/2009/06/27/um/m-01947602.htm
They are not closing schools, public events, or any of these, the official recommendation is to wear masks and keep 2 meters distance. People sick should remain home.
Just yesterday the most affected cities suspended public and particular events...
Brazilians cities in the other side of the border affected by outbreakdecided to shut all the activities earlier in the week and we had no deaths in Brazil so far. Brazilian authorities recommend everyone in this affected city to stay home and avoid going out as much as possible. I can't understand why Argentina is taking so long to shut down schools, business and recommending everyone to stay home and so on with deaths happening there...
It seems to me that they are completely lost on what is the right thing to do, they don't wanna panic the population but they are not prepared also. They surely have economical issues and the politicians are not strong enough to make the hard decisions they have to (or they don't wanna do anything before elections taking place tomorrow?). They probably will declare national emergence soon... but nobody knows what does it means, since the minister says that does not mean that they will close schools and etc. (so surreal)
Too bad I'm not at the medical field (and don't have any researcher I can reach - if any is reading this
) but it would be lovely if anyone could check the virus of Brazilians infected in Argentina. I bet that they might be testing it already. But I'm not sure, since is too much going on now...
I just took a look on 2 major Argentina news sites
http://www.lanacion.com.ar/nota.asp?nota_id=1144269&pid=6756848&toi=6256
and
http://www.clarin.com/diario/2009/06/27/um/m-01947602.htm
They are not closing schools, public events, or any of these, the official recommendation is to wear masks and keep 2 meters distance. People sick should remain home.
Just yesterday the most affected cities suspended public and particular events...
Brazilians cities in the other side of the border affected by outbreakdecided to shut all the activities earlier in the week and we had no deaths in Brazil so far. Brazilian authorities recommend everyone in this affected city to stay home and avoid going out as much as possible. I can't understand why Argentina is taking so long to shut down schools, business and recommending everyone to stay home and so on with deaths happening there...
It seems to me that they are completely lost on what is the right thing to do, they don't wanna panic the population but they are not prepared also. They surely have economical issues and the politicians are not strong enough to make the hard decisions they have to (or they don't wanna do anything before elections taking place tomorrow?). They probably will declare national emergence soon... but nobody knows what does it means, since the minister says that does not mean that they will close schools and etc. (so surreal)
Too bad I'm not at the medical field (and don't have any researcher I can reach - if any is reading this
) but it would be lovely if anyone could check the virus of Brazilians infected in Argentina. I bet that they might be testing it already. But I'm not sure, since is too much going on now...
Giuseppe
Emeritus
Re: Argentina: unusual serious cases in young people
According the most recent Italian Ministry of Health update, (http://www.salastampa.ministerosalute.it/imgs/C_17_comunicati_2357_testo.rtf), among the fifteen imported cases, two were from Mexico, one from Argentina and all the other from USA.
I hope that the Argentina imported case viral sequence will be promptly available for evaluation by our flu experts.
According the most recent Italian Ministry of Health update, (http://www.salastampa.ministerosalute.it/imgs/C_17_comunicati_2357_testo.rtf), among the fifteen imported cases, two were from Mexico, one from Argentina and all the other from USA.
I hope that the Argentina imported case viral sequence will be promptly available for evaluation by our flu experts.
FrenchieGirl
Senior Moderator
Re: Argentina: unusual serious cases in young people
It looks like the policy is changing towards more aggressive treatment, viz:
Lungs to be "burned" in hours
There is a seriousness of patients' unusual '
"We're seeing the placement of young patients, between 15 and 50 years with pneumonia, some rapidly evolving towards a gravity which for many is unusual, in which the lung is' fire 'in a matter of hours," said Dr. Jorge San Juan, head of the Department of Intensive Care Hospital Mu?iz.
This has led to patients with these characteristics begin to be treated in an increasingly aggressive. THE NATION As reported yesterday, doctors from the Ministry of Health received the directive to take, from now on, all cases of influenza and potential influenza A (H1N1), with the recommendation to perform chest radiographs for patients with symptoms of fever and fatigue and internal quickly to all suffering from pneumonia.
"Today, it is known that the virus is circulating mass, the attitude we have with patients depends on clinical assessment made by the doctor not to become a serious case. It is not necessary to diagnose laboratory [confirming the new virus infection] to begin treatment, "said Dr. Vilma Savy, Chief of the Respiratory Virus Malbr?n institute.
Concern about how this attack some young flu was confirmed to the nation on a coroner that, in recent hours, conducted two autopsies on two people killed by influenza A.
"The bodies were viscera, meninges and brain swollen, a little common factor in death from influenza. Additionally, the lungs were in bad shape, with some spots we could not identify. The studies sent pathology, "said the coroner who asked not to publicize his name until the health authorities take note of it found.
Changes in strategies for care of patients arriving with flu tables advanced aiming to be more aggressive: treat, then see what happens; leapfrogging. "This form of serious patient care will change the trend and prevent more deaths and pneumonia, said Dr. John, coordinator of the Emergency Committee of the Ministry of Health Epidemiological Aires.
For severe pneumonia, said San Juan, today patients do not receive empirical antibiotics and antiviral drugs but also does not delay the use of mechanical ventilation. "While generally expect 24 hours to see how it evolves, we do not, and if decompensation quickly reach intubation," said San Juan.
The province of Buenos Aires will, from next week, with rapid diagnostic tests that will discriminate in just 15 minutes by means of swabs, if the person is a carrier of influenza A. Anyway, the final confirmation will institute Malbr?n. The new test will begin before the treatment, health authorities reported ranches.
It looks like the policy is changing towards more aggressive treatment, viz:
Lungs to be "burned" in hours
There is a seriousness of patients' unusual '
"We're seeing the placement of young patients, between 15 and 50 years with pneumonia, some rapidly evolving towards a gravity which for many is unusual, in which the lung is' fire 'in a matter of hours," said Dr. Jorge San Juan, head of the Department of Intensive Care Hospital Mu?iz.
This has led to patients with these characteristics begin to be treated in an increasingly aggressive. THE NATION As reported yesterday, doctors from the Ministry of Health received the directive to take, from now on, all cases of influenza and potential influenza A (H1N1), with the recommendation to perform chest radiographs for patients with symptoms of fever and fatigue and internal quickly to all suffering from pneumonia.
"Today, it is known that the virus is circulating mass, the attitude we have with patients depends on clinical assessment made by the doctor not to become a serious case. It is not necessary to diagnose laboratory [confirming the new virus infection] to begin treatment, "said Dr. Vilma Savy, Chief of the Respiratory Virus Malbr?n institute.
Concern about how this attack some young flu was confirmed to the nation on a coroner that, in recent hours, conducted two autopsies on two people killed by influenza A.
"The bodies were viscera, meninges and brain swollen, a little common factor in death from influenza. Additionally, the lungs were in bad shape, with some spots we could not identify. The studies sent pathology, "said the coroner who asked not to publicize his name until the health authorities take note of it found.
Changes in strategies for care of patients arriving with flu tables advanced aiming to be more aggressive: treat, then see what happens; leapfrogging. "This form of serious patient care will change the trend and prevent more deaths and pneumonia, said Dr. John, coordinator of the Emergency Committee of the Ministry of Health Epidemiological Aires.
For severe pneumonia, said San Juan, today patients do not receive empirical antibiotics and antiviral drugs but also does not delay the use of mechanical ventilation. "While generally expect 24 hours to see how it evolves, we do not, and if decompensation quickly reach intubation," said San Juan.
The province of Buenos Aires will, from next week, with rapid diagnostic tests that will discriminate in just 15 minutes by means of swabs, if the person is a carrier of influenza A. Anyway, the final confirmation will institute Malbr?n. The new test will begin before the treatment, health authorities reported ranches.
Re: Argentina: unusual serious cases in young people
Map of confirmed and fatal in Buenos Aires
http://flutracker.rhizalabs.com/flu...-34.67839374011646&lon=-58.6669921875&zoom=10
Map of confirmed and fatal in Buenos Aires
http://flutracker.rhizalabs.com/flu...-34.67839374011646&lon=-58.6669921875&zoom=10
Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Re: Argentina: unusual serious cases in young people
edited
Confirmed cases in Europe coming back from Argentina:
http://www.flutrackers.com/forum/search.php?searchid=1548296
Serbia, Italy, France, Portugal, Germany, Denmark, Belgium
edited
Confirmed cases in Europe coming back from Argentina:
http://www.flutrackers.com/forum/search.php?searchid=1548296
Serbia, Italy, France, Portugal, Germany, Denmark, Belgium
JimO
Well-known member
Re: Argentina: unusual serious cases in young people
That map shows higher numbers in a lot of places, such as South America than what we've seen reported. The legend indicates 480 fatalities worldwide. Do you have the underlying data?
kiwibird
Editor, Senior Moderator
Re: Argentina: unusual serious cases in young people
Each report will have a url attached pointing to the news report relating to it. It will also have been cross referenced with local government media reports. You should be able to trace it back from the map. :magnify:
Each report will have a url attached pointing to the news report relating to it. It will also have been cross referenced with local government media reports. You should be able to trace it back from the map. :magnify:
AlaskaDenise
In Memoriam
Re: Argentina: unusual serious cases in young people
It will be informative to compare data from autopsies from other rapid deaths.
.
It will be informative to compare data from autopsies from other rapid deaths.
.
Re: Argentina: unusual serious cases in young people
Two things about Argentina of interest in relation to the above discussion.
1. There are more doctors per population than most any other country save Cuba. And though the infrastructure is not the best access is free to all.
2. Though by law one needs a perscription for antivirals, they can be obtained at the "friendly local pharmacy" without one. However, elderberry, hypericum and other herbal and folk remedies are common knowledge.
Argentines may be better prepared to face this wave than most North Americans.
Two things about Argentina of interest in relation to the above discussion.
1. There are more doctors per population than most any other country save Cuba. And though the infrastructure is not the best access is free to all.
2. Though by law one needs a perscription for antivirals, they can be obtained at the "friendly local pharmacy" without one. However, elderberry, hypericum and other herbal and folk remedies are common knowledge.
Argentines may be better prepared to face this wave than most North Americans.
Treyfish
Moderator
Re: Argentina: unusual serious cases in young people
HEALTH IN THE DISTRICT Bonaerense
Concern about the cases that show renal complications
In some health centers are at 50% of those considered serious by Influenza A.
.::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::
Concern about the cases that show renal complications
Recommend Article
Print
Say in the FORUM
Notes PROVINCIAL
The usual expansion, during the winters of respiratory disease, often no bigger impact on the services of Nephrology hospitals. At least until now, when some experts were concerned that kidney patients who develop severe influenza A are associated with dialysis services affected by renal failure are difficult to forecast.
This states, for example, from the service of Nephrology Hospital Posadas current referral center hospitals in the Province in regard to the new disease-where they were 8 serious cases of influenza A that were treated affected by renal insufficiency.
"It is very interesting, because there seems to be a complication associated, but rather a form of the virus. In a significant number of serious cases of influenza A (confirmed or suspected) to reach the hospital this impact is kidney, although this is just starting and need to study it more carefully, "said William German, chief of the Nephrology referred to hospital.
According to German, this disorder was also observed in Mexico, in severe patients and that they shared some common features, such as being included in an age range between 17 and 40 years, have no pre-existing disease at the time of contracting the virus and therefore did not belong to the so-called risk groups.
Features
As in Mexico, where renal complications observed are characterized by bilateral pneumonia begin with a box accompanied by a short shock of evolution characterized by the presence of elements such as fever and fatigue.
People are affected by a major interned difficulty breathing and require the use of respirators. Shortly afterwards and in the context of a systemic inflammatory response, stop urinating and derivatives dialysis.
"In general, the prognosis for these patients is poor and in cases such as those described the steps are very fast and can not be avoided once unleashed, seem to be part of the behavior of the virus in some cases, although it must investigate infecot?logos , "German said.
The specialist noted that it had launched a round of consultations to other health centers and three other cases were identified who required dialysis at the hospital in Mar del Plata.
For his part, Amadeo Esposto platense infectologists found that "while there have been serious cases that required dialysis, this is not the most expected. Should be considered the topic to see if this is triggered directly by the virus or some other factor. "
In this sense, the specialist said that "at a recent meeting of specialists it was decided to make a thorough evaluation of the clinical records of patients who have not evolved well off the disease to know the exact causes."
"However, in most cases it remains the most serious pulmonary and difficulties faced by hospitals to deal with a high demand respirator," said Esposto.:tiphat:http://www.diariodemocracia.com/diario/articulo.php?idNoticia=15301
HEALTH IN THE DISTRICT Bonaerense
Concern about the cases that show renal complications
In some health centers are at 50% of those considered serious by Influenza A.
.::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::
Concern about the cases that show renal complications
Recommend Article
Say in the FORUM
Notes PROVINCIAL
The usual expansion, during the winters of respiratory disease, often no bigger impact on the services of Nephrology hospitals. At least until now, when some experts were concerned that kidney patients who develop severe influenza A are associated with dialysis services affected by renal failure are difficult to forecast.
This states, for example, from the service of Nephrology Hospital Posadas current referral center hospitals in the Province in regard to the new disease-where they were 8 serious cases of influenza A that were treated affected by renal insufficiency.
"It is very interesting, because there seems to be a complication associated, but rather a form of the virus. In a significant number of serious cases of influenza A (confirmed or suspected) to reach the hospital this impact is kidney, although this is just starting and need to study it more carefully, "said William German, chief of the Nephrology referred to hospital.
According to German, this disorder was also observed in Mexico, in severe patients and that they shared some common features, such as being included in an age range between 17 and 40 years, have no pre-existing disease at the time of contracting the virus and therefore did not belong to the so-called risk groups.
Features
As in Mexico, where renal complications observed are characterized by bilateral pneumonia begin with a box accompanied by a short shock of evolution characterized by the presence of elements such as fever and fatigue.
People are affected by a major interned difficulty breathing and require the use of respirators. Shortly afterwards and in the context of a systemic inflammatory response, stop urinating and derivatives dialysis.
"In general, the prognosis for these patients is poor and in cases such as those described the steps are very fast and can not be avoided once unleashed, seem to be part of the behavior of the virus in some cases, although it must investigate infecot?logos , "German said.
The specialist noted that it had launched a round of consultations to other health centers and three other cases were identified who required dialysis at the hospital in Mar del Plata.
For his part, Amadeo Esposto platense infectologists found that "while there have been serious cases that required dialysis, this is not the most expected. Should be considered the topic to see if this is triggered directly by the virus or some other factor. "
In this sense, the specialist said that "at a recent meeting of specialists it was decided to make a thorough evaluation of the clinical records of patients who have not evolved well off the disease to know the exact causes."
"However, in most cases it remains the most serious pulmonary and difficulties faced by hospitals to deal with a high demand respirator," said Esposto.:tiphat:http://www.diariodemocracia.com/diario/articulo.php?idNoticia=15301
Re: Argentina: unusual serious cases in young people
Buenos Aires with suspect cases
http://flutracker.rhizalabs.com/flu...=-34.80027235055681&lon=-58.6669921875&zoom=8
Buenos Aires with suspect cases
http://flutracker.rhizalabs.com/flu...=-34.80027235055681&lon=-58.6669921875&zoom=8
AlaskaDenise
In Memoriam
Re: Argentina: unusual serious cases in young people
Commentary
Soaring Death Rate in Buenos AiresRaises Pandemic Concerns
Recombinomics Commentary 18:03
June 27, 2009
"We're seeing the placement of young patients, between 15 and 50 years with pneumonia, some rapidly evolving towards a gravity which for many is unusual, in which the lung is' fire 'in a matter of hours," said Dr. Jorge San Juan, head of the Department of Intensive Care Hospital Muñiz.
This has led to patients with these characteristics begin to be treated in an increasingly aggressive. THE NATION As reported yesterday, doctors from the Ministry of Health received the directive to take, from now on, all cases of influenza and potential influenza A (H1N1), with the recommendation to perform chest radiographs for patients with symptoms of fever and fatigue and internal quickly to all suffering from pneumonia.
"The bodies were viscera, meninges and brain swollen, a little common factor in death from influenza. Additionally, the lungs were in bad shape, with some spots we could not identify. The studies sent pathology, "said the coroner who asked not to publicize his name until the health authorities take note of it found.
The above translation describes patients in and around Buenos Aires (see updated map). In the past few days 26 confirmed fatalities have been reported as well as 15 additional probable fatalities. H1N1 infections of swine on a nearby farm (see map) has also been described in an OIE report.
The targeted population, as well as the description of the rapid deterioration sounds remarkable like reports on the 1918 pandemic.
Sequence data on these patients and swine would be useful. It is the beginning of flu season in Argentina, and the potential for the evolution of a more virulent Pandemic H1N1 looms large.
.
Commentary
Soaring Death Rate in Buenos AiresRaises Pandemic Concerns
Recombinomics Commentary 18:03
June 27, 2009
"We're seeing the placement of young patients, between 15 and 50 years with pneumonia, some rapidly evolving towards a gravity which for many is unusual, in which the lung is' fire 'in a matter of hours," said Dr. Jorge San Juan, head of the Department of Intensive Care Hospital Muñiz.
This has led to patients with these characteristics begin to be treated in an increasingly aggressive. THE NATION As reported yesterday, doctors from the Ministry of Health received the directive to take, from now on, all cases of influenza and potential influenza A (H1N1), with the recommendation to perform chest radiographs for patients with symptoms of fever and fatigue and internal quickly to all suffering from pneumonia.
"The bodies were viscera, meninges and brain swollen, a little common factor in death from influenza. Additionally, the lungs were in bad shape, with some spots we could not identify. The studies sent pathology, "said the coroner who asked not to publicize his name until the health authorities take note of it found.
The above translation describes patients in and around Buenos Aires (see updated map). In the past few days 26 confirmed fatalities have been reported as well as 15 additional probable fatalities. H1N1 infections of swine on a nearby farm (see map) has also been described in an OIE report.
The targeted population, as well as the description of the rapid deterioration sounds remarkable like reports on the 1918 pandemic.
Sequence data on these patients and swine would be useful. It is the beginning of flu season in Argentina, and the potential for the evolution of a more virulent Pandemic H1N1 looms large.
.
colormyquilt
Senior Moderator
Re: Argentina: unusual serious cases in young people
Will it vary, in terms of hours/ days, the amount of time it takes to have internal organs effected in this way? Are we seeing cases where individuals are seeking treatment late? Or has the virus changed? I am thinking of the six year old female child in Canada who died last week- 24 hours post symptoms. Those providing statements from Argentina are saying this is a different presentation that what they are accustomed to seeing- seasonal flu or otherwise. It is difficult putting this together- because there are also "those many other purported high number of cases that experience mild symptoms or are asymptomatic." How is this virus working that it can kill the six year old child in 24 hours/ have First Nation on ventilators/ and yet CFR in New York City is substantially small given the 500,000 cases NYC is reported as now having or had.
It is truly amazing. I am re-reading John Barry's book. So much has changed since 1918, medically. Yet, not so with a novel virus.
How horribly frustrating and exhausting those working the front lines. They are to be commended, their families are to be commended.
Will it vary, in terms of hours/ days, the amount of time it takes to have internal organs effected in this way? Are we seeing cases where individuals are seeking treatment late? Or has the virus changed? I am thinking of the six year old female child in Canada who died last week- 24 hours post symptoms. Those providing statements from Argentina are saying this is a different presentation that what they are accustomed to seeing- seasonal flu or otherwise. It is difficult putting this together- because there are also "those many other purported high number of cases that experience mild symptoms or are asymptomatic." How is this virus working that it can kill the six year old child in 24 hours/ have First Nation on ventilators/ and yet CFR in New York City is substantially small given the 500,000 cases NYC is reported as now having or had.
It is truly amazing. I am re-reading John Barry's book. So much has changed since 1918, medically. Yet, not so with a novel virus.
How horribly frustrating and exhausting those working the front lines. They are to be commended, their families are to be commended.
Giuseppe
Emeritus
Re: Argentina: unusual serious cases in young people
The kidney failure is a not unexpected complication because the pneumonia-related coagulopathy and increased loss of fluids through capillars.
Intravascular coagulation, thrombosis, hemorrhages, lowered serum proteins, are quite common in severe infections' patients.
Even in the early H5N1 cases, kidney failures were observed.
So, I think physicians should keep in mind that severe influenza (as well as other viral infection) requires a comprehensive management of patients, with all supportive care needed, with particular attention to coagulation, capillary permeability and kidney functionality.
It is a matter of critical care unit, and thus a triage protocols are needed in order to select patients with most urgent need.
I see how more than six years since the H5N1 panzootics crisis started has not served to prepare better for emergencies even in developed nations.
The kidney failure is a not unexpected complication because the pneumonia-related coagulopathy and increased loss of fluids through capillars.
Intravascular coagulation, thrombosis, hemorrhages, lowered serum proteins, are quite common in severe infections' patients.
Even in the early H5N1 cases, kidney failures were observed.
So, I think physicians should keep in mind that severe influenza (as well as other viral infection) requires a comprehensive management of patients, with all supportive care needed, with particular attention to coagulation, capillary permeability and kidney functionality.
It is a matter of critical care unit, and thus a triage protocols are needed in order to select patients with most urgent need.
I see how more than six years since the H5N1 panzootics crisis started has not served to prepare better for emergencies even in developed nations.
Dark Horse
In Memoriam
Re: Argentina: unusual serious cases in young people
What I worry about is that the same disastrous experiences are going on in NYC, Utah, etc., except that we don't get the details because it would "scare us...cause panic."
There was quite a lot of detail about the assistant prinicpal who was one NYC's first deaths. It sounded pretty awful and may be similar to what is being witnessed in Argentina.
What I worry about is that the same disastrous experiences are going on in NYC, Utah, etc., except that we don't get the details because it would "scare us...cause panic."
There was quite a lot of detail about the assistant prinicpal who was one NYC's first deaths. It sounded pretty awful and may be similar to what is being witnessed in Argentina.