Posts Tagged ‘Mexican flu’

Suicide Danger of Tamiflu – Neurologic Damage Danger of Flu Vaccine

May 9, 2009

1-5-15 UPDATE The flu strain this year is primarily H3N2 (the same strain as in the 1968 “Hong-Kong flu”). Therefore if you were sick in 1968 then you may have immunity. This is a fairly strong strain that caused a lot of illness and much death in 1968.  It is not as worrisome as the H1N1 strain was, but you should consider obtaining the vaccine if less 2 yr old, greater than 65 and especially if you have chronic illness. There is a variant this year, H3N2v, but it is ONLY contracted from contact with infected pigs, so if you work with pigs or go to events where there are pigs you should be very careful to wash our hands. It is not contracted from other persons, just from pigs.  It has a high rate of serious illness and death and is not covered by the flu vaccine, so hygiene is very important.  As always, constantly wash your hands after contact with the public, before you eat, and after using the toilet. Wash all fruits and vegetables thoroughly. Good hygiene is the best way to prevent getting the flu.  The flu is NOT a cold or rhinitis.  You get high fever, body aches, and respiratory symptoms.  I had the flu in 1968 and the best way to describe it was that I felt like I was hit by a truck – aching all over with high fever (103degrees).  If you have a runny nose and temperature of 100 degrees you likely have a cold and not the flu.

10-20-09 UPDATE AND CAUTION! – Studies of the pesent H1N1 pandemic have revealed that there are great risks for women who are  pregnant of severe complications, primarily superinfections with bacteria because the pregnancy weakens the immune system. The death rate appears to be unusually high in this group. If pregnant, especially if you also have chronic illness, you should talk to your physician and consider obtaining the flu vaccine as the H1N1 flu is now “widespread” and your risks are high. 

 Those who are very ill or have severe lung or heart conditions, especially if they are born after 1950 should also talk to their physicians about possibly obtaining the vaccine. Anyone in these categories, who become ill with influenza should consider using anti-viral drugs early despite the risks, the first day of fever over 103 degrees. Just make sure they are supervised closely should psychiatric symptoms develop. There are serious risks in these groups from both the influenza and from the medication. However, you must weigh the risks and the risk of death if you are pregnant or have certain chronic illnesses may be great.  

Be very careful that if you develop signs of bacterial infection you get very prompt treatment. Read the following that explains signs of complications.

I am concerned that the attack rate (cases per 100,000) is fairly high very early in this flu season , particularly for the young (Age 0-24 = 23-27/100,000, Age 25-49 = 7/100,000, Age 50-64 = 4/100,000, and Age >65 = 1/100,000).  This may seem small, but this along with 87 pediatric deaths already is unusual (normally 50-100 pediatric deaths in an entire flu season).  2/3 of the children’s deaths are in children with chronic illness and 1/3 are in healthy children.  I believe the risk/benefit ratio for people under age 24 who are chronically ill or pregnant is now near the point a vaccine administration and certainly VERY EARLY use of anti-virals if a chronically ill persons becomes sick with influenza are warranted.  

Young adults have a particular aversion to going to the doctor early. If they have signs of complications it is medically extremely important that they seek help quickly – hours may make a difference. THIS IS THE MOST IMPORTANT MESSAGE RIGHT NOW TO GET TO THE  PUBLIC!

It is exceedingly important not to use anti-virals willy nilly. If healthy they should not be used as this will encourage development of resistence to the drug.  If the virus becomes widely resistant, then it will be VERY DIFFICULT to treat those few who become critically ill.  We have to approach the next six months of this flu season in a very smart way. Panic, excess use of anti-virals, will only make things worse. The most important thing is good public health measures (washing hands, etc) and quick and early identification of individual cases of complications or severe illness so treatment can be started early.

Educate yourself!  Educate your friends and neighbors!  The situation is concerning, but can be handled if we make wise choices!  Whatever threats (viral, bacterial, environmental, political) we face as a common humanity, we should face with knowledge, faith, and common purpose. We need to care about others as much as we care about ourselves.  Don’t let your chronically ill or pregnant neighbor or friend be ignored if they get ill. Help them judge if they need to see their doctor quickly.  

UPDATE – 11-7-09  New studies suggest that influenza vaccines may not give long term protection to related strains like a natural infection would provide.

The present A/H1N1 flu (Swine flu or Mexican flu) has panicked too many people. Government has given confusing and incomplete information to the people. It is turning out that the H1N1 flu this year is exceedingly mild. However, overtreatment has grave dangers. Everyone should consider the following before medicating themselves with anti-virals such as Tamiflu ( oseltamivir ) or Relenza.

If drugs are overused the virus will quickly become resistent to it. IF the virus becomes more virulent, as an influenza virus did in 1918, which can occur with the influenza virus and cause a rapid onset deadly illness in persons with NO IMMUNITY, overuse of anti-virals for mildly ill individuals on a large scale may push the virus to evolve so that is becomes RESISTANT to the anti-viral drugs. In any flu season many older persons have a degree of partial resistance due to their previous exposure to many influenza strains. Most people born before 1957 seem to be resistant to this year’s H1N1 strain, and many people born between 1957 and 2001 also seem to have some resistance. The people who are in danger in ANY flu season are those with chronic illness, severe congenital illnesses, or cancer that weakens them.

Everyone should seriously think about simply taking a few days of rest in bed, drinking plenty of fluids, and waiting it out if you catch the flu this year (fever >102 degrees for 3-5 days, intense muscle aches, headache, cough, 25 % have vomiting and/or diarrhea). Influenza is not just a cold. If you have a runny nose and low grade fever you are unlikely to have influenza.

As with any infectious disease, if you become sick, watch for symptoms of worsening. This may mean you are developing complications such as a bacterial infection like pneumonia. What is worsening? Well – If your fever lasts more than five days. If your cough is productive and you are spitting out yellow or green mucus instead of clear or white mucus. If you are becoming weaker instead of stronger after 4-5 days. If you are becoming increasingly confused, increasingly dizzy when standing, increasing vomiting or diarrhea after the first day or two.  These are signs that something is wrong – likely a complication – and you should contact your doctor IMMEDIATELY.

Oseltamavir (Tamiflu) or zanamavir (Relenza) are sometimes recommended for prophylaxis, for early treatment, or for treatment only of the sickest. There is nothing wrong with not taking medication if you are healthy and waiting it out. The good part is you are building immunity so that the next time you are exposed in your life to a similar strain you will be at least  partially immune.  The effect of anti-viral drugs is said to be to shorten duration of illness by 0.5 to 1.5 days, and it is hoped that it might prevent more serious complications. You still will be sick for 3-4 days and infectious to others. Persons are infectious for a day or two BEFORE they become ill and for a total of about seven days to fourteen days in serious cases – usually infectiousness decreases when the fever breaks.

In Japan, two teen suicides and 64 psychological disorders were linked to Tamiflu in 2005. These included panic attacks, delusions, delirium, and convulsions in otherwise normal persons. The FDA added a warning to the label (PsychCentral.com, Nov 17, 2006). This potential does not appear to be widely known among U.S. physicians, who may think that psychological reactions are restricted to amantadine, or that they are more likely to be a manifestation of the influenza itself.

Vitamin D deficiency may play a crucial role in susceptibility to influenza. In an April 2005 epidemic in a hospital for the criminally insane, patients on a ward where they were receiving a supplement of 2,000 units of vitamin D daily were spared (Medical News Today 9/15/06). A decreased incidence of colds and influenza was an incidental finding in a study of vitamin D supplementation and postmenopausal bone loss, one of many benefits reviewed by Joel M. Kauffman in the forthcoming summer 2009 issue of the Journal of American Physicians and Surgeons. Toxicity is rare, Kauffman writes. Increased dose recommendations are lagging trial results. Doses of 1,000 IU/d to 2,000 IU/d are now considered routine, and doses up to 50,000 IU/d for rapid repletion are considered safe.

According to a 2006 review, vitamin D suppresses excessive expression of inflammatory cytokines, likely the cause of death in young persons in the 1918 pandemic, as well as increasing the expression of antimicrobial peptides (Cannell JJ et al., Epidemiol Infect 2006).

While a severe influenza pandemic remains a possibility, use of the threat as a pretext for mandatory vaccination and monumental expansion of governmental power is also a danger. Guillain Barre syndrome is a neurological condition where a person becomes temporarily paralyzed and may have to be put on a ventilator. During the last “swine flu” scare in 1979 there were 46 million people who took the hastily made and poorly tested vaccine and 4000 claims against the government for neurological complications – mostly paralysis. Everything, including taking vaccines has its risks.

A very safe and unknown but theoretical treatment for influenza are anti-inflammatory drugs.  Deaths in young, healthy adults in 1918 seem to have been related to intense inflammation.  Steroids are the gold standard of anti-inflammatory drugs but they have so many complications and are so dangerous in many ways that they should only be given in severe cases under medical supervision.

Many diseases caused by intense inflammation such as severe acne, Rosacea, and Bullous Pemphigoid (a blistering disease) have been successfully treated with very old medications including one of the safest combination of medications I know. The vitamin niacinamide in high doses (which is thought to be very safe) [500 mg three times daily – available over the counter through health food stores or on the Internet] even on its own is known to be anti-inflammatory. This is an excellent over the counter treatment for inflammatory acne. DO NOT confuse and use niacin in large doses as it may cause uncomfortable flushing  and warm feeling.  If this is combined with low dose tetracycline (an antibiotic with intense anti-inflammatory properties) the anti-inflammatory affects are increased. Please discuss with your doctor the dangers of excess antibiotic use before using this treatment.  If my family member got the flu, I would take supplemental vit D (this can cause  problems if excess doses are taken so be careful not to overuse it) and niacinamide.

If I got sick with influenza, I might also want to start tetracycline.  I would not take anti-viral if I was a healthy person unless signs of complications. As I have severe intermittent asthma, cardiac, and neurological problems, I would take Tamiflu as soon as my fever hit 103 degrees, even if I did not yet have confirmation it was H1N1. I would ask family and friends to closely supervise me while on Tamiflu due to risks of psychiatric/psychological side effects. I would start antibiotics early. I will not obtain the flu vaccine, because of a personal history of adverse reactions to vaccines and worry about Guillain Barre being an increased risk due to moderate neurological disease.

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Pandemic – OH MY! – A / H1N1 – Other strategies

May 5, 2009

The word “pandemic” raises great fear and trepidation due to the experience of the 1918 “flu pandemic”, “Spanish flu”,  that killed over 40 million people around the world, more than war killed. The average persons equates “pandemic” with a “deadly disease”.  Our government, the CDC, and the WHO have not adequately explained to the public and press that pandemic does NOT EQUAL deadly disease.

The 1918 flu pandemic was caused by the same family of virus A/H1N1 that is spreading around the globe this past month. There are hundreds of members of this family (strains) each which are unique but related. H1N1 was the family for the “seasonal flu” strains that infected people yearly from 1918 to 1957 when a new family emerged as the seasonal flu. Each year the dominant strain rearranged a bit causing a new strain to emerge in the same family of virus.

In 1977 the H1N1 family emerged again, but has not necessarily been the dominant family in the seasonal flu. There have been several families causing the yearly flu strain.  This means that most people born before 1957 have a partial resistance to the A/H1N1 family which might explain why mainly young adults are getting sick with the presently mild A/H1N1 family-new this year strain or “swine” or “Mexican” flu.  

So it is not the fact that it is an H1N1 family virus that scared the public health officials.  It is the fact that this year’s strain was emerging at an unusual time and was coming from the Americas, in addition to the fact that it contained both swine and bird genes, as well as the fact that it was spreading so very quickly from  person to person as well as tending to infect young healthy adults and causing deaths in a few of these people. Therefore it had some similarity to the pattern in the 1918 pandemic. As the scientists and the public health officials DO NOT UNDERSTAND what causes a flu to become really deadly and toxic this made the public health community very nervous.

In the U.S. influenza (the strain going around that year – called ‘seasonal’ flu for the kind of illness not the strain) infects about 30,000,000 people a year (10% of the population) and kills about 30,000 per year on the average. Generally the deaths are among the very old and very young who are already sick or fragile with chronic illness or congenital disease. Of note, the child that recently died in Texas was a chronically ill and fragile child.

Well, how do they pick what strains to make vaccine to every year. A new vaccine is needed every year because last year’s strain does not fully protect against the new strains that emerge each year as the virus has a tendency to rearrange  taking components from other strains each year. The public health authorities and experts meet every year in around February to March and look at the strains that were spread around the previous year and guess at which strains will be around this year. Then they instruct the manufacterers to make a virus to a mix of strains that they think will occur the next fall. The guess is usually pretty good, but 1 out of 3 years they guess wrong and the vaccine is not completely effective. This year they had not expected this new A/H1N1 family – new strain to emerge so it was not included in the list. They are racing to include it or in the alternative if it is too late to include in the “seasonal vaccine’, then to make a vaccine specifically to this new strain. The vaccine should be ready between September and December. The vaccine however is not a cure all and can have complications – dozens of cases of Guillain-Barre syndrom an illness that causes paralysis and puts you on a respirator in intensive care occurred after the last “swine flu” vaccine was distributed.

The 1918 flu was unusual because it emerged in the spring as a very mild illness and then re-emerged in August as an intensely deadly illness. My grandfather during 1918 had this flu but he was in his thirties and recovered. He described people dying suddenly on the street – literally falling on the street with blood foaming out of their mouths. He also described getting on a troop train and young 18 year old soldiers going into massive respiratory failure, foaming blood at the mouth and dying during the few hours it took the train to get to its destination. It was very rapid onset and deadly and death was often due to a rapid onset and toxic viral pneumonia instead of from bacterial complications that often cause deaths in seasonal flu among the fragile. There were so many bodies they were stacked like cord wood in morgues and hospitals and on military bases where up to 80 % of the troops died. Herses in some cities stretched for miles with continuous funerals for weeks. A study revealed that closing schools in 1918 may have slowed the spread of the pandemic. The goal in closing schools is not to prevent people from getting sick but to slow the spread of the disease so that public health officials have time to mobilize, such as to distribute Tamiflu and masks.  It is uncertain if masks are actually useful as most people don’t use them correctly and take them off frequently because they are uncomfortable.

It is my opinion that preventing the spread right now is foolish. I would encourage people to get exposed to this presently mild illness so as to build up herd immunity in the population while the illness is mild. You will also avoid the chance of complications from the vaccine in the fall and from medications. Then if per chance it should evolve and becoming deadly in the fall many people will at least be  partially immune and we can use the medication (Tamiflu and Relenza) for the very ill and use the vaccine that is being developed in a more targeted fashion.  Closing schools, businesses, and public events, when the illness is very mild, to me seems foolish and just deprives the kids of an education.  I would encourage the medically fragile, severe asthmatics, and elderly who are chronically ill to stay home or avoid crowds for at least a few more weeks.

The most important thing to do to protect yourself against catching the influenza virus, not just now, but every year, particularly in the winter, is to WASH YOUR HANDS frequently. Washing/sanitizing schools is a waste of money, except it will remove bacteria that can cause infections. Influenza virus is very fragile and dies after a few hours at most on any surface.  It is useful to sanitize things that people touch frequently like knobs on bathroom sinks and door handles several times a day during the flu season especially.

I do not see the present “pandemic” which just means it has spread across the continents any differently than I see the yearly seasonal strains at the moment. Pandemic does not tell you anything about the seriousness of the strain. It only tells you how widespread it has become. It is an epidemiologic term not a medical term that describes the toxicity or seriousness of the disease.

Excess use of Tamiflu will only cause the flu strain to become resistant sooner. I urge not using it for mild illness in the healthy. Also remember that Tamiflu has complications including delusions. People on it should be around a family member who can help them if they become confused and delusional and should consider not driving unless they know they don’t have this complication.

2009 Mexican Flu – H1N1 Flu – (Swine Flu) – What to do?

April 29, 2009

I prefer to name flu by the city where it started and the year. What animal the strain may have started in can be the same in many years so naming it “swine flu” this year seems odd.

Panic is stupid.  Flu happens every year. A person is infectious beginning a day or two BEFORE they come down with symptoms. That is why it CANNOT be contained. It will run its course. Every year about 40,000 Americans die of influenza (often attacking the very old, sick and very young). Some years 100,000 die in the U.S. and some years the numbers are much smaller.

Its actually good to get influenza now and then because you build up partial resistance to many strains. That is why in the 1918 pandemic the middle aged didn’t die much. The young adults with no immunity died. Influenza (“flu”) will spread very rapidly and tens of millions will get sick. Many will have minimal illness and think they have a bad cold if the fever is less than 101 degrees.

In Mexico City there are probably in reality tens of thousands of cases of people who had mild illness and didn’t realize they have the Mexican flu, so I don’t think the death rate is actually unusually high. Many of these people with mild illness, including people who visited Mexico city and were travelers have already spread the illness around the world before they even had symptoms.

Most will have moderate illness consisting of feeling miserable for a few days with fever greater than 101 degrees (usually around 103) in 3 to 4 spikes per day, headache, severe muscle aches, prominent cough, nausea, diarrhea, minimal runny nose, severe weakness and loss of appetite. (“I feel like I was hit by a truck”) Notice that it is not “just a virus” or a “cold” where you have an intensely stuffy and runny nose, maybe a cough and fever of 100 to 101 degrees with mild muscle aches.

The hallmarks of influenza are the high fever (children may have fevers of 105 as they are often 1-2 degrees higher than adults), the severe muscle aches and the headache along with cold like symptoms and cough.

Make sure to push fluids – a good mixture to keep sipping constantly to prevent dehydration is a cup of juice in a quart of water with 1/2 teaspoon of salt added. The goal should be to drink at least a quart every 4-6 hours (for adults). That is at least a cup every hour. Drink it slowly if you are having vomiting – even a teaspoon every 15 minutes. (This is very similar to the children’s solutions known as “Pedialyte” or “Ricelyte” that you can buy at the store to give a sick child so they don’t become dehydrated. This replaces the salt lost with vomiting or diarrhea. Don’t add too much salt! It also gives a little sugar to keep you going.

If you have symptoms stay in bed and drink lots of fluids. If fever doesn’t go away in 3-5 days CALL your doctor and discuss it with him/her. Don’t automatically go to ER or your doctor’s office – you’ll just spread it. If you must go out wear a mask and wash your hands before leaving to minimize spread. If trouble breathing, uncontrolled vomiting or diarrhea making you too dizzy to stand, go to ER, but call before you go and tell them to be prepared. Ask for a mask as soon as you enter or ask for one to be ready when you arrive by calling them.

Those with chronic illness and the very young must be watched carefully. They MUST obtain medication within 24 hours of becoming sick. Help them call their doctor and go to the pharmacy and pick up the medication for them. This is the time to tell your elderly or disabled/handicapped neighbor, if they need your help you are available.

I expect the usual number of deaths this year so even several hundred doesn’t panic me. 

Wherever you go, keep washing your hands – as soon as you get home, after you go to the bathroom and don’t handle doorknobs or faucet handles with you hands if  possible – push them with your elbow or turn them while holding a towel or Kleenex. Anything you touch can spread the illness. Make sure to wash hands before you eat all the time. Wash hands before and after you go to a different location and after you touch common items like doorknobs before you eat. Don’t rub your nose or eyes with your hands. 

Be courteous and don’t go out if you are sick or if your family is sick – wait at least 3 days to see if you will catch it too – remember you are infectious for 2 days before you have symptoms.

Everything will be fine.  Closing borders NEVER works if the illness has spread already across a border.  It is clear that the illness is already global. Therefore, containment IS NOT POSSIBLE AT THIS POINT.  Containment in the modern era with such an illness (short incubation period of days at most, rapid spread by droplets and touching) IS NOT POSSIBLE. STOP even thinking that borders should be closed.  The only thing that should be curtailed is large gatherings of people and gatherings with close contact.

As to the vaccine – there is none right now. It was a new strain that cropped up in Mexico City this spring and it will take 4-10 months to manufacture this vaccine and distribute it. EVERY year a committee looks at what strains are going around the world. The virus changes every year and every year there are new strains, often related to previous strains but not identical. A decision is made in around March or April as to what strains should be included in that year’s vaccine. The Mexican flu (swine flu) was not included in this year’s recommendation, but that is changing and they may still have time to include it or they may have to make a second vaccine batch this year and give two different vaccines – one to the strains going around and one for the Mexican or swine flu.  When it is available at the earliest in around October or November, the elderly, chronically ill, young, and healthcare workers and emergency workers should get it first, then everyone else can get it if they want. For your information I NEVER TAKE the flu vaccine.  About 1 out of every 3 years the vaccine is ineffective as they guessed what strain they should use for the vaccine and their best informed guess was wrong. The vaccine is NOT PERFECT. Also there is some research data that your risk of Alzheimer’s disease goes up slightly with increased numbers of yearly vaccine shots. There is also a small risk of Guillan Barre Syndrome that may result from the vaccine. Every year a few people get very ill from the vaccine but the numbers are VERY small. Everyone needs to decide their risks and benefits from obtaining vaccines based on their own health history, age, and the health history of their family.

Medication is available for most strains, but YOU MUST start it within the first 24 hours of symptoms. Call your doctor the first day if you become sick.  Tamiflu is not recommended to be used prophylactically. It will likely just make the virus resistent to it if too many people use it daily for weeks or months. Don’t do this unless you are chronically ill and your doctor tells you to do this. There are also several other medications available and your doctor will know which strains are resistent to which drugs and how to use them properly.

Listen to the public health experts and don’t use this publicity about what may end up being a normal flu season to discriminate against other people. Let’s just wait and see if this is a bad season or a mild flu seasson. If it starts to get very bad with a higher number of deaths, then that is when we should close schools and businesses for a week or two if there is an outbreak at such a facility.


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