Diabetics more prone to Swine Flu infection

By M H Ahssan

A crucial finding by clinicians in Mexico, the country where the deadly H1N1 flu virus originated, could have India worried.

Initial observations made by the World Health Organisation, Centre for Disease Control and Prevention and the Mexican clinicians, who studied the first 40 deaths in Mexico, show that people with underlying conditions like asthma, cardiovascular diseases (CVDs), immunosuppressive illnesses like HIV, diabetes and TB appear to be at greater risk of hospitalisation or death if infected with H1N1.

India, which is yet to report a positive H1N1 infection, and is presently testing the throat sample of a Jet Airways ground staff in Delhi for H1N1 infection, has the dubious distinction of having the largest number of people with such illnesses.

India diagnoses 1.8 million new cases of TB every year with 370,000 deaths. The country is home to 2.35 million HIV positive people and has 15 million asthmatics. CVDs have become the leading cause of death with heart attacks projected to kill 2 million by 2010.

Even though experts said the finding was preliminary, they agreed that a few trends had begun to emerge. Dr V M Katoch, ICMR’s director general, told TOI, “People with HIV, TB and CVDs are in the high risk group. Uncontrolled outbreak of H1N1 could pose a problem, specially to this community. They have to be better looked after in case of a positive infection.”

Dr Sylvie Briand, project leader of WHO’s global Influenza Programme, said, “We reviewed all the severe cases that Mexico had and were able to differentiate two types of people that are at risk of severe illness. One group had previously healthy people, who got sick and experienced rapid deterioration of their health with most of them having died of acute viral pneumonia. The second group had people with chronic underlying conditions such as diabetes, TB, cardiovascular diseases. In these people, viral pneumonia progressed into acute respiratory distress. So they died mostly of respiratory and major organ failure.”

Dr Briand added, “These findings are interesting because in earlier pandemics too, we have seen two types of complications, one being viral pneumonia caused by the virus and the second one being bacterial pneumonia.”

Experts say viral pneumonia may be a result of the cytokine storm, in which the body’s own immune reaction to a new virus floods the lungs with fluid. It can progress faster and be harder to treat than bacterial pneumonia.

Earlier, scientists had made some other interesting findings about the H1N1 virus. The average age of those who got infected by the flu was around 25 while its incubation period was 1-5 days. Over half of those infected with this virus suffered from increased bouts of diarrhoea besides leading to severe respiratory distress like pneumonia. In India, samples of 36 suspected cases of swine flu have been tested and found negative.

H1N1 flu now in 29 countries
The number of confirmed H1N1 swine flu cases in humans jumped by nearly 1,000 cases in one day, with the deadly virus now found in 29 countries across the globe. On Sunday, the World Health Organisation said the number of confirmed cases of H1N1 — the virus that has brought the world on the brink of a pandemic — was 4,379. It was 3,440 on Saturday. The virus has killed over 50 people till now with Costa Rica reporting its first death. The victim was a 53-year-old man who was suffering from diabetes and had a chronic pulmonary condition. The virus has also infected eight other Costa Ricans.