Influenza Cause of Death in Four Colorado Children

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Since mid-January, four Colorado children have died from complications related to the influenza virus. In two of the cases, the children received the recommended vaccinations, and in two cases the children were not vaccinated against the flu.

This makes it the worst influenza season for children in Colorado in five years. In 2003, twelve Colorado children died of complications related to the flu.

Two of the children lived in the Denver area and two of the children resided on the Western Slope. In at least two of the cases, the children had other serious medical conditions that may have affected their resistance to infection.

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The first reported case of influenza in Colorado this season was reported in an adult male in El Paso County, which includes Colorado Springs, on October 21, 2008. Since, cases of the flu had been off to a slow start until mid-January. In last year's influenza season, El Paso County had the highest rate of flu infections in the state - 20 percent higher than the statewide average. The 2007-2008 flu season was the worst in four years, with 152 people becoming sick enough with the virus to be hospitalized and tested. Last year, 40 percent of hospitalized cases in El Paso county were in children age 17 or younger.

Unlike with other illnesses, the symptoms of influenza appear abruptly. H1N1 is the prevailing strain this year and the influenza vaccine is effective against it. Public health officials report that it is not too late to still get an influenza vaccine although the vaccine takes about three weeks to induce maximum immunity.

Typical flu symptoms include fever, headache, body aches and sore throat. Children suspected of having the flu should be taken to their physicians or health clinics for nasal swabs, which are used in the rapid Flu test, used in diagnosis. Children with flu should be kept home with bed rest and adequate fluids for hydration. If fever does not respond to treatment, a physician should be consulted. Most fatal complications of influenza are caused by co-existing bacterial infections, particularly bacterial pneumonia.

Statistics from the 2006-2007 flu season show that fatalities related to the flu in children were of rapid onset. 45% of the children died within 72 hours of their first symptoms and 75% died within a week, while 43% died either at home or in an emergency room. Bacterial infection superimposed on flu was not the only cause of death; children also died from seizures, encephalitis, and shock. But it played an important role: Coinfections were involved in 6%, 15%, and 34% in the three successive seasons ending in 2007, representing a fivefold increase. The increase was primarily due to infection with methicillin resistant Staphylococcus aureus: There were one staph infection in 2004-05, 3 in 2005-06, and 22 in 2006-07, and 64% of the staph infections were drug-resistant.

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A Very Concerning Sub-Microscopic Infectious Agent Influenza is the virus responsible for the disease that has its name. This virus can be deadly, as it did create the last pandemic in the United States less than 100 years ago. When this occurred, the United States experienced about a half a million deaths due to what is now known as the Great Influenza Epidemic. Some of these viruses are more dangerous than others. The Influenza pandemic that occurred before the 1918 Spanish Flu happened about thirty years before this one. Influenza epidemics normally occur about every 9 months or so, it has been reported The disease of Influenza is caused by this virus penetrating a host, which could be a human or an animal. Once infected, the virus replicates within the cell of the host in the cell’s cytoplasm. To survive, the influenza virus targets an enzyme called polymerase that directs the content of this cell to produce proteins the virus needs to survive. Virus is a Latin word, meaning ‘poison’. And the virus is more of a very well organized molecular parasite than an actual life form, such as bacteria. The virus cannot grow or reproduce without a host cell. That means it needs you, the host, to exist and thrive. And the virus has the potential to destroy you in the process in order to exist. With the 1918 pandemic, it is believed that it was called the Spanish Flu because the first human case was identified in Spain. The pandemic ended up killing more than those that died during WWI. Understandably there was panic among people worldwide, as the influenza virus itself was not identified until the year 1933, so the mystery was rather frightening of what was happening at that time. Those who survived have allowed others to obtain antibodies from them to develop other antibodies for future viral outbreaks that may occur with this type of virus. This last influenza pandemic also allowed others to obtain this virus from those who died as a result to create effective treatments and vaccines for viral outbreaks that may happen in the future as well. Over a half a million people in the U.S. died as the result of the Spanish Flu- and those that did die was due often to a bacterial pneumonia that followed the viral invasion and the damage this virus caused. Specifically, the bacteria that killed those due to this flu were called strept. pneumo. On average, it took about 9 days for one to die after being infected. The Spanish Flu caused an unusually severe immune response in the human host which made it very deadly due to overkill of the cells of this host. The influenza virus has this ability on occasion, which makes it very deadly to its host. The influenza viruses are of what are called orthomyxoviruses, which is a group or family of RNA viruses that are categorized into A, B, and C. The Influenza A virus is the one that historically has caused pandemics that have developed- such as the Spanish Flu Pandemic. Other influenza pandemics primarily have occurred in countries in Asia. With influenza, it is understood that the disease influenza is a disease caused by a RNA virus that can now infect and kill both mammals and birds. In fact, at least one particular virus can mutate to where it can be shared between the two life forms and multiply within each one of them with ease. Unlike coryza, influenza expresses symptoms more severely, and usually lasts two weeks until one recovers who has the flu. Influenza, however, poses a danger to some with compromised immune systems, such as the chronically ill, so the risk is greater in such populations, along with women who may be pregnant during the flu season, residents of nursing homes or chronic care facilities. If untreated with such patient populations, influenza can create complications such as bacterial pneumonia or encephalitis. Health care personnel are encouraged to get a flu vaccine. However this vaccine, as will be described in a moment, offers no guarantee that the one immunized by this vaccine will not acquire the flu. 80 percent of flu cases in the U.S. are type A influenza virus. Nearly 40,000 people in the U.S. die each year, and 200,000 are hospitalized in the U.S. due to the influenza virus. Such populations of those recommended to receive the flu vaccination are those believed to need the protection the vaccine may offer the most. This is of concern, as Influenza can progress rapidly into the more serious illness of pneumonia. Symptoms of influenza usually start to express themselves symptomatically about two days or so after being infected with the virus. Over 10 percent of the population is infected with this virus every year- resulting in about 200,000 hospitalizations and nearly 40,000 deaths. This season’s first influenza case was identified in Delaware in November of 2008, and it was a type B influenza strain. The flu vaccination is trivalent- meaning it contains three viral strains of suspected viruses for flu outbreaks during a particular winter season, as determined by the World Health Organization, as well as the Centers for Disease Control, and other organizations. Yet one should keep in mind that these three strains of influenza may not even exist in a particular flu season. The vaccination is a guess, at best, yet is certainly better than the absence of a flu vaccination. Unfortunately, the influenza vaccine administered last flu season was largely ineffective due to unsuspected strains of the virus infecting others, although about 140 million injections of this vaccine were administered, and this proved to be pointless for preventative medicine. After giving the vaccination dose to one, it takes about 10 days for that person to build up the immunity for the disease of influenza. The months of October to December are recommended to receive this vaccine. And the vaccine is about 50 percent effective in offering protection from influenza, according to others, if one calculates the previous flu seasons with flu vaccinations. Vaccines are a catalyst for antibody production in humans, which protect them against the virus, if it happens to present itself within them. Influenza vaccines can be given by injection or nasally. Anti-virals, on the other hand, decrease greatly the ability for viruses to reproduce once established in a human. That seems like it should be a focus during viral seasons instead of any vaccination that exist today regarding the disease of influenza. The flu season that is now occurring was supplied with 150 million vaccines in the United States. However, some studies have shown that this vaccine is rather ineffective based on incidences of the acquisition of the influenza virus by others anyway. The influenza season peaks between the months of January and March. The vaccine for this influenza season is manufactured by 6 different companies. Yet the strains chosen contain what are speculated influenza viruses, so this does not eliminate the chance of a new and dominant influenza viral strain that possibly could cause a pandemic regardless if one is vaccinated for influenza. Also, it takes manufacturers about 6 months to make and formulate the influenza vaccination. There is a vaccine for this illness that is produced every year according to which type of virus types that may be prevalent during a particular flu season. If influenza occurs in a human host, the results may be the patient acquiring pneumonia or meningitis is possible, as well as their ability to transmit such a virus to another. The presence of influenza can be widespread in certain states, yet not others. The vaccination is recommended to be administered to those who are at high risk, such as the chronically ill. Also, it is recommended that those under 18 years of age get the vaccine, as well as those people over the age of 50. Furthermore, those people who regularly take aspirin should receive the vaccine, as the influenza disease can become a catalyst for what is called Reye’s Syndrome. Pregnant women should receive the vaccine as well- as there are many vaccines available to hopefully prevent this potentially dangerous viral disease in this form. However, the Avian influenza presented itself in China in 1997. Called the H5N1 virus subtype, it has the potential to be the next flu pandemic. The virus responsible for the 1918 pandemic was an avian influenza, which was called the H1N1. This virus, unlike the human influenza virus, has a longer incubation period- about 5 days. Also, H5N1 has the ability to mutate more rapidly, as well as replicate at a similar speed. Avian influenza viruses are highly pathogenic. No one fully understands the influenza virus and its rapid ability to mutate. This is because this particularly malicious virus is the result of two separate influenza viruses acquiring the same host at the same time. As a result of mutual sharing of genetic material between the two viruses, novel attributes are allowed to develop and create a H5N1 that obviously prove to be rather deadly. For an influenza pandemic to occur, which means a global disease existence and presence, the virus must emerge from another species to humans without a strong immune system- as well as the ability to make more humans ill than normal due to the constant mutation of the influenza virus. Also, the virus must be highly contagious for a pandemic to occur. This particular virus that has been identified is just that. The H5N1 Avian influenza virus seems to have become progressively more pathogenic in the past decade, according to others. The letters H and N, by the way, stand for the antigens HA and NA-and are the letters of proteins that protrude from the viral shell. It is these proteins that mutate so often with the influenza virus, and which is why we continue to be infected with this virus. With the Avian Influenza existing with the H5N1 strain, millions of birds have been slaughtered due to the danger and unpredictability of this strain. The first recorded incidence of human-to-human transmission of the H5N1 virus was believed to be in Thailand in 2004. There have been outbreaks of Avian flu in about 15 countries in the world so far- with Indonesia being the worst. Migratory birds spread this influenza virus between continents. The pathogenic strength of the H5N1 strain varies due to constant re-assortment or switching of genetic material between the viruses- essentially creating hybrid modifications of what it was before this occurs due to this re-assortment that makes this virus much more virulent. So far, about 400 people worldwide have been infected with this strain- and about half have died from the infection. This is believed to be greater than 50 percent of all those infected with the H5N1 virus. Vaccinations are being developed and reformulated constantly at this time due to the pandemic threat of the H5N1 Influenza virus.