Wednesday, April 29, 2009

Okay, insulin dependent diabetics, we're cool re Swine Flu

graphic lifted from my favorite Twitter page right now @the_swine_flu
Update: May 18, 2009

Okay, strike all of that. I'm watching AC360 and Dr. Gupta is on. It seems that ALL of the cases of death in the USA have victims with underlying chronic conditions. So, um, nevermind.

Update: April 30 @ 11:37pm

Interesting. has a piece about the first known victim of the H1N1 virus. Although, some are saying those with compromised immune systems might get through this, the first victim had diabetes. Now since the first victim had diabetes, are blunt Amy and Dr. Gupta correct about fragile immune systems being less at risk or are our fragile immune systems poised to have the same strong reactions to this virus?

Now the writer doesn't say what type of diabetes she had. Honestly, I doubt the person who wrote this has enough knowledge to know that probably matters. I say that because I don't know how many times I say "I'm diabetic" and the person I'm speaking to doesn't know the difference between insulin dependent and non-insulin dependent diabetes. I don't expect your average person to know, but I'd like people writing articles on this to have a bit of a clue.

So I'm putting it out there. First, my condolences to her family, but variant of diabetes did this she have? That might matter (and might make me take this post down...and I've never done that before.) Swine Flu's First Fatality: A Chronicle of Deaths Foretold
BBC: Mexico shuts down to control flu

Okay, the strike through code completely corrupts the rest of the page, so another way to keep this up as an act of contrition for posting something inaccurate is to just change the color. It's in white. If you want to read it, highlight it. But it's factually inaccurate.
She totally put it in a blunt way in how she said it, but she said it and that got me on the research path to verify it.
The absolute last thing you want to do is strengthen your immune system. Does no one know anything about immunology on here before they start spouting? The 1918 flu (the closest thing we have to the current virus) induced a cytokine storm in mouse models. ie it is the immune response to the virus that will kill you, NOT THE VIRUS. This means that young healthy, fully immunocompetent people are the people who will experience the cytokine storm to it's full extent, and ultimately die. Younger people without a fully challenged immune system, people who are immunosupressed (yes, diabetics etc) are much more likely to survive. Not many older individuals will even show symptoms. This is going to be a young and healthy persons problem. Read up on things before you get the immunosupressed community having MI's please.
Originally posted as a comment by Amy Firth on Mashable - The Social Media Guide using Disqus.

I verified it here. Dr. Sanjay Gupta from CNN basically says the same thing:
CNN: Sanjay, one question that we haven't gotten to ... most of the people who died from swine flu in Mexico were in the prime of their lives really, and this usually hits infants or the elderly. What does that say to you as a doctor?

Gupta: This is interesting. And the same thing happened in sort of a nonintuitive way when we were talking about SARS and when we were talking about avian flu.

Think about it like this: Typically, you think of someone who has a weakened immune system, who's going to be most adversely affected by an infection. Their immune system simply can't fight it.

But in these cases, it's the immune system itself that reacts robustly, and it's the immune system in that reaction to the virus that is causing death in these patients. So the virus starts that cascade, but all that fluid builds up in the lungs, and all those inflammatory cells throughout the body -- that's what's causing the problem. We saw the same thing with SARS and with avian flu as well.

Which is why exactly as you said ... [people in their] 20s and 30s and 40s, this hospital behind me, they say that's been the bulk of their patients with regard to swine flu.
She's right. I'm no longer paranoid and will be handing out N95 masks at my local airport.

Thanks blunt Amy and Dr. Gupta ;)

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