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Originally posted by larphillips
Wow... and they wonder why we don't trust them anymore.
NEW YORK (CNN) -- An assistant principal who died after being hospitalized with the H1N1 virus did have an underlying condition, the New York City's health commissioner said Monday.
But Dr. Thomas Frieden would not discuss the nature of the condition.
Fears virus and bird flu could mix
2009.05.19 03:26:48 Worldwide
The authorities have confirmed that more than 100 wild birds found dead in the Gengahai region of Qinghai province "died of avian flu", sparking fears that the virus could mix with the A(H1N1) outbreak if it spread. Tests on 121 dead migratory birds in Qinghai on Sunday revealed the carcasses contained the pathogenic bird flu virus, said a statement from the Ministry of Agriculture.
Local authorities have culled nearly 600 poultry in the region, the ministry said. Experts warned of the possibility of the A(H1N1) and H5N1 strains "re-assorting or mutating" in humans or pigs to threaten more lives if the former is allowed to spread. "We cannot ignore the possibility that the strains could re-assort to generate a new type of virus with a high transmission and fatality rate among people," Guan Yi, a professor with the department of microbiology from the University of Hong Kong, said. "Mutation of the bird flu virus with H1N1 would be disastrous," Guan said, adding that checks on the possibility of human-to-human transmission of bird flu was "still necessary in the fight against the H1N1". As of May 6, the total number of laboratory-confirmed cases of H5N1 bird flu in humans worldwide is 423, with a death toll of 258, figures from the World Health Organization showed.
As of May 17, 2009, 553 novel influenza A (H1N1) cases, including 333 confirmed and 220 probable cases, had been reported in 32 of 61 local health jurisdictions in California. Of the 553 patients, 30 have been hospitalized. No fatal cases associated with novel influenza A (H1N1) infection had been reported in California. This report summarizes the 30 hospitalized cases as of May 17, including a detailed description of four cases that illustrate the spectrum of illness severity and underlying risk factors. This preliminary overview indicates that, although the majority of hospitalized persons infected with novel influenza A (H1N1) recovered without complications, certain patients had severe and prolonged disease. All hospitalized patients with novel influenza A (H1N1) infection should be monitored carefully and treated with antiviral therapy, including patients who seek care >48 hours after illness onset (4,5).
The largest number of patients, (15 [50%]) resided in San Diego and Imperial counties. Of the 26 patients for whom information on ethnicity was available, 17 (65%) were Hispanic. Ages of the 30 patients ranged from 27 days to 89 years, with a median age of 27.5 years; 21 (70%) were female. Four (13%) patients had traveled to Mexico in the 7 days before onset of illness. None of the 30 patients reported exposure to swine or a known confirmed case of novel influenza A (H1N1) infection.
The most common admission diagnoses were pneumonia and dehydration. Nineteen patients (64%) had underlying medical conditions; the most common were chronic lung disease (e.g., asthma and chronic obstructive pulmonary disease), conditions associated with immunosuppresion, chronic cardiac disease (e.g., congenital heart disease and coronary artery disease), diabetes, and obesity. The most common symptoms were fever, cough, vomiting, and shortness of breath; diarrhea was uncommon. Of the 25 patients who had chest radiographs, 15 (60%) had abnormalities suggestive of pneumonia, including 10 with multilobar infiltrates and five with unilobar infiltrates. Six patients were admitted to the intensive care unit (ICU), and four required mechanical ventilation. Five patients were pregnant. Two of these developed complications, including spontaneous abortion and premature rupture of the membranes; the fetuses were at 13 and 35 weeks gestation, respectively.
Mr. Wiener, 55, had been “overwhelmed” by the illness, despite beginning a course of treatment with an experimental drug, Ribavirin, after he failed to respond to other antiviral drugs, according to Ole Pedersen, a spokesman for Flushing Hospital Medical Center, where Mr. Wiener had been a patient since Wednesday.
Ribavirin (brand names: Copegus, Rebetol, Ribasphere, Vilona and Virazole) is an anti-viral drug indicated for severe RSV infection (individually), hepatitis C infection (used in conjunction with peginterferon alfa-2b or peginterferon alfa-2a) and other viral infections.
It is active against a number of DNA and RNA viruses. It is a member of the nucleoside antimetabolite drugs that interfere with duplication of viral genetic material. Though not effective against all viruses, ribavirin is remarkable as a small molecule for its wide range of activity, including important activities against influenzas, flaviviruses and agents of many viral hemorrhagic fevers.
Other interactions with nucleoside antivirals for HIV should be considered when HIV/AIDS patients use ribavirin to treat hepatitis C.
Experimental data indicate that ribavirin may have useful activity against many viruses of interest, including avian influenza, hepatitis B, polio, measles, Canine distemper and smallpox. Ribavirin is the only known treatment for a variety of viral hemorrhagic fevers, including Lassa fever, Crimean-Congo hemorrhagic fever, and Hantavirus infection. Ribavirin is active in a hamster model of yellow fever, a finding which is not surprising, given the familial relationship of yellow fever AND HEPATITIS C as flaviviridae.
Finally, ribavirin is known to enhance host T-cell-mediated immunity against viral infection through helping to switch the host T-cell phenotype from type 2 to type 1. This may explain ribavirin's antiviral activity against some viruses such as HEPATITIS C, at doses which do not clearly interfere with replication of the virus when used without INTERFERON.
Ribavirin is not substantially incorporated into DNA, but does have a dose-dependent inhibiting effect on DNA synthesis, as well as having other effects on gene-expression. Possibly for these reasons, significant teratogenic effects have been noted in all non-primate animal species on which ribavirin has been tested. Ribavirin did not produce birth defects in baboons,[bold] but this should not be an indication that it is safe in humans.[/bold]
The interferons are a family of naturally occur-ring proteins with nonspecific regulatory activity. These cytokines are secreted by many mammalian cells and influence cell growth and differentiation, modulate the immune response and inhibit the replication of a number of viruses including hepatitis B and C. Although the antiviral, immunomodulatory and anti-inflammatory properties of interferon-a are thought to contribute towards its beneficial effects in patients with CHR]ONIC hepatitis C, the exact mechanism of action of this cytokine in hepatitis C has yet to be established..  The mechanisms of action of interferon-a have been reviewed in detail elsewhere; [21-23] this section therefore provides a brief overview of its putative antiviral activity in patients with CHRONIC HEPATITIS C. Unlike many anti-HIV drugs, which target the functions of HIV proteins, the antiviral activity of interferon-a is achieved by its ability to alter interactions between the host and virus in a complex man-ner.