Influenza pandemic (H1N1) 2009 (47): Spain, ICU patients
Date: Mon 14 Sep 2009
Source: Barcelonareporter.com [edited]
<http://www.barcelonareporter.com/index.php?/news/comments/study_involving_21_spanish_hospitals_states_50_of_swine_flu_icu_patients_ha/>
About half of people admitted to ICU [intensive care units] in
hospitals for severe complications of influenza A [i.e. pandemic A
(H1N1) 2009 virus] had no risk factor or disease, according to a study
conducted in 21 Spanish hospitals. The study, presented on the website
of the medical journal Critical Care [see below] is the largest ever
conducted in Europe on influenza cases requiring intensive care. Their
findings contradict one of the messages on influenza A released by the
Ministry of Health and the Department of Health, which have repeatedly
reported that patients with influenza A cases had previous health
problems.
The findings contain important messages for both the general
population and for health authorities and medical intensivists. For
the general population, there is an appeal to healthy people without
risk factors to avoid falling prey to overconfidence in regard to
influenza A. Although the vast majority of those affected will
overcome the flu without complications, a small percentage will have
pneumonia and should be hospitalized.
"The natural symptoms of the disease are usually 3 or 4 days of fever,
generally over 38 C with a steady improvement in the following days.
But a minority of patients, around the 4th or 5th day, get worse,"
reports Jordi Rello, head of the intensive care unit of Tarragona Joan
XXIII Hospital and coordinator of the study. Therefore, if a sufferer
experiences breathing difficulties after contracting the flu, they
should seek medical attention urgently, but the main point of the
study is that no risk factors or diseases have made them particularly
vulnerable.
Looking to health authorities, the study indicates that efforts to
contain influenza A should not be limited to prevent disease and to
address mild cases in primary care but also to meet serious cases in
ICUs. It is estimated that only 0.2 percent of patients suffer serious
complications, according to a calculation based on the experience of
Britain. This means that for every million affected, 2000 suffer
complications, a figure that may overwhelm the capacity of the ICU
departments.
Although the virus primarily affects the lungs, 75 percent of patients
arriving at the ICU in a few days develop multi-organ syndromes. "I
had never seen this type of pneumonia in the 25 years I've been
practising," says Rello.
The study results confirm that obesity and pregnancy are risk factors
for serious complications. The average age of patients in ICU for
influenza A is 40 years, of which about 25 percent die.
Source: Barcelonareporter.com [edited]
<http://www.barcelonareporter.com/index.php?/news/comments/study_involving_21_spanish_hospitals_states_50_of_swine_flu_icu_patients_ha/>
About half of people admitted to ICU [intensive care units] in
hospitals for severe complications of influenza A [i.e. pandemic A
(H1N1) 2009 virus] had no risk factor or disease, according to a study
conducted in 21 Spanish hospitals. The study, presented on the website
of the medical journal Critical Care [see below] is the largest ever
conducted in Europe on influenza cases requiring intensive care. Their
findings contradict one of the messages on influenza A released by the
Ministry of Health and the Department of Health, which have repeatedly
reported that patients with influenza A cases had previous health
problems.
The findings contain important messages for both the general
population and for health authorities and medical intensivists. For
the general population, there is an appeal to healthy people without
risk factors to avoid falling prey to overconfidence in regard to
influenza A. Although the vast majority of those affected will
overcome the flu without complications, a small percentage will have
pneumonia and should be hospitalized.
"The natural symptoms of the disease are usually 3 or 4 days of fever,
generally over 38 C with a steady improvement in the following days.
But a minority of patients, around the 4th or 5th day, get worse,"
reports Jordi Rello, head of the intensive care unit of Tarragona Joan
XXIII Hospital and coordinator of the study. Therefore, if a sufferer
experiences breathing difficulties after contracting the flu, they
should seek medical attention urgently, but the main point of the
study is that no risk factors or diseases have made them particularly
vulnerable.
Looking to health authorities, the study indicates that efforts to
contain influenza A should not be limited to prevent disease and to
address mild cases in primary care but also to meet serious cases in
ICUs. It is estimated that only 0.2 percent of patients suffer serious
complications, according to a calculation based on the experience of
Britain. This means that for every million affected, 2000 suffer
complications, a figure that may overwhelm the capacity of the ICU
departments.
Although the virus primarily affects the lungs, 75 percent of patients
arriving at the ICU in a few days develop multi-organ syndromes. "I
had never seen this type of pneumonia in the 25 years I've been
practising," says Rello.
The study results confirm that obesity and pregnancy are risk factors
for serious complications. The average age of patients in ICU for
influenza A is 40 years, of which about 25 percent die.
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