A funeral is being held this week for a vital, vibrant Baptist minister felled by the flu.
Rev. Perry Chernesky, 42, is believed to be the fifth Manitoban with a confirmed case of the H1N1 virus to die. His service is Thursday at 10:30 a.m. at Oakbank Baptist Church.
The swift passing of the much-loved husband and active father has people asking how can the H1N1 flu virus kill someone who is relatively young and healthy?
"Very quickly," said Dr. Anand Kumar at the Health Sciences Centre intensive care unit. "It's not really known how."
A Manitoba child and a Winnipeg man in his 40s who had no known significant underlying health conditions also succumbed to the illness in June.
Kumar can't talk about individual patients but said doctors are trying to unravel the mystery of the H1N1 virus on the fly.
"We're seeing four different syndromes among people who are critically ill," he said. In severe cases, people's lungs can't work and they need to have tubes stuck down their throats connecting them to ventilators, or breathing machines.
In one group, it's the older, debilitated person who may have some degrees of organ failure like renal failure or chronic obstructive pulmonary disease (COPD), which makes it hard to breathe. The flu can tip them over the line and into needing life support. He said there are five or 10 per cent of severe flu cases in this category, and the ones who get better usually are off the breathing machines within a few days.
In the second group are people with asthma or bronchospastic COPD. The flu can give them an "extremely bad asthma flare-up," said Kumar. "They may end up in the ICU requiring ventilation for several weeks."
In the third group are toddlers and preschoolers who get bronchitis or croup and don't require ICU care.
The fourth "signature" type of H1N1 infection results in a "white out" of the lungs as they fill up with fluids, said Kumar.
"They drown in their own fluids." He said 80 per cent of these cases in which people are so "incredibly ill" they are, for the most part, young and healthy. They may have hypertension or be smokers or pregnant, but they're relatively young.
Kumar said there are different theories about how it is they get so sick so fast.
"Some have suggested people have such a robust response to the virus" it results in a cytokine storm of inflammatory hormones, which causes a lot of damage.
"My own feeling is what we're seeing is a virus which normally affects the upper respiratory tract with a running nose and a sore throat, for some reason, gets down into lungs," said Kumar. There, the virus replicates quickly.
"We're trying, with very aggressive research, to figure out some of these things."
In the meantime, preventing the spread of the virus is all people can do.
"The best thing is not to get an infection in the first place," said Dr. John Embil.
Wash your hands, stay home if you're sick and, when the flu shot is ready, make sure you get it, said Embil, the medical director of infection prevention and control unit at HSC.
"The vaccine, every year, is the best possible prediction of what viruses might be in the environment," said Embil. "They'll try and include this specific strain and others that may be circulating in future," said Embil. "It's the best possible prediction-- not a guarantee." There are still immunity benefits from taking it, he said.
But it's no silver bullet because viruses change over time.
"It's Darwin in action -- survival of the fittest," said Embil. "Any germ will try and modify itself to survive in a host."
And the vaccine takes several weeks to work.
Seek help if symptoms serious, experts warn
ANYONE who develops serious flu-like symptoms should seek immediate medical attention, because no one can predict when the H1N1 flu will turn life-threatening in otherwise healthy people, infectious disease experts are warning.
Severe cases are occurring in which the infection starts off like regular seasonal flu, with fever and cough, but then the lungs rapidly become inflamed and stop functioning.
"It looks to most of us like a primary viral pneumonia that deteriorates five or six days into therapy," says Dr. Allison McGeer, director of infection control at Toronto's Mount Sinai Hospital. "It's really severe illness."
"If you're young and healthy, you can recover from that severe lung injury. People do. But it takes a very long time," McGeer said. "Sometimes we're talking about a month, five weeks on a ventilator before you are breathing on your own. Some people can be left with so much residual lung damage, they will have abnormal lungs for their lifetime," she said.
But McGeer said attempting to identify whom this happens to "is the same as trying to pick out people who, faced with Group A (streptococcus), get necrotizing fasciitis -- flesh-eating disease -- when most of the rest of us get nothing, or minor illness," McGeer said. "The parallel is, I think, identical."
http://www.winnipegfreepress.com/br...-quickly-kill-young-and-healthy-50212127.html
Rev. Perry Chernesky, 42, is believed to be the fifth Manitoban with a confirmed case of the H1N1 virus to die. His service is Thursday at 10:30 a.m. at Oakbank Baptist Church.
The swift passing of the much-loved husband and active father has people asking how can the H1N1 flu virus kill someone who is relatively young and healthy?
"Very quickly," said Dr. Anand Kumar at the Health Sciences Centre intensive care unit. "It's not really known how."
A Manitoba child and a Winnipeg man in his 40s who had no known significant underlying health conditions also succumbed to the illness in June.
Kumar can't talk about individual patients but said doctors are trying to unravel the mystery of the H1N1 virus on the fly.
"We're seeing four different syndromes among people who are critically ill," he said. In severe cases, people's lungs can't work and they need to have tubes stuck down their throats connecting them to ventilators, or breathing machines.
In one group, it's the older, debilitated person who may have some degrees of organ failure like renal failure or chronic obstructive pulmonary disease (COPD), which makes it hard to breathe. The flu can tip them over the line and into needing life support. He said there are five or 10 per cent of severe flu cases in this category, and the ones who get better usually are off the breathing machines within a few days.
In the second group are people with asthma or bronchospastic COPD. The flu can give them an "extremely bad asthma flare-up," said Kumar. "They may end up in the ICU requiring ventilation for several weeks."
In the third group are toddlers and preschoolers who get bronchitis or croup and don't require ICU care.
The fourth "signature" type of H1N1 infection results in a "white out" of the lungs as they fill up with fluids, said Kumar.
"They drown in their own fluids." He said 80 per cent of these cases in which people are so "incredibly ill" they are, for the most part, young and healthy. They may have hypertension or be smokers or pregnant, but they're relatively young.
Kumar said there are different theories about how it is they get so sick so fast.
"Some have suggested people have such a robust response to the virus" it results in a cytokine storm of inflammatory hormones, which causes a lot of damage.
"My own feeling is what we're seeing is a virus which normally affects the upper respiratory tract with a running nose and a sore throat, for some reason, gets down into lungs," said Kumar. There, the virus replicates quickly.
"We're trying, with very aggressive research, to figure out some of these things."
In the meantime, preventing the spread of the virus is all people can do.
"The best thing is not to get an infection in the first place," said Dr. John Embil.
Wash your hands, stay home if you're sick and, when the flu shot is ready, make sure you get it, said Embil, the medical director of infection prevention and control unit at HSC.
"The vaccine, every year, is the best possible prediction of what viruses might be in the environment," said Embil. "They'll try and include this specific strain and others that may be circulating in future," said Embil. "It's the best possible prediction-- not a guarantee." There are still immunity benefits from taking it, he said.
But it's no silver bullet because viruses change over time.
"It's Darwin in action -- survival of the fittest," said Embil. "Any germ will try and modify itself to survive in a host."
And the vaccine takes several weeks to work.
Seek help if symptoms serious, experts warn
ANYONE who develops serious flu-like symptoms should seek immediate medical attention, because no one can predict when the H1N1 flu will turn life-threatening in otherwise healthy people, infectious disease experts are warning.
Severe cases are occurring in which the infection starts off like regular seasonal flu, with fever and cough, but then the lungs rapidly become inflamed and stop functioning.
"It looks to most of us like a primary viral pneumonia that deteriorates five or six days into therapy," says Dr. Allison McGeer, director of infection control at Toronto's Mount Sinai Hospital. "It's really severe illness."
"If you're young and healthy, you can recover from that severe lung injury. People do. But it takes a very long time," McGeer said. "Sometimes we're talking about a month, five weeks on a ventilator before you are breathing on your own. Some people can be left with so much residual lung damage, they will have abnormal lungs for their lifetime," she said.
But McGeer said attempting to identify whom this happens to "is the same as trying to pick out people who, faced with Group A (streptococcus), get necrotizing fasciitis -- flesh-eating disease -- when most of the rest of us get nothing, or minor illness," McGeer said. "The parallel is, I think, identical."
http://www.winnipegfreepress.com/br...-quickly-kill-young-and-healthy-50212127.html