Posted on 12/02/2005 2:45:24 PM PST by BenLurkin
CHICAGO (Reuters) - The lungs of avian flu victims are racked by infections, clogged with pus and surrounded by fluid, and the severity of the symptoms can predict whether the patients will survive, researchers said on Friday.
Based on chest X-rays performed on 14 Vietnamese bird flu patients admitted to Ho Chi Minh City Hospital -- nine of whom died -- researchers at the University of Oxford in England found shared abnormalities that were good predictors of whether the disease would be fatal.
The infection from the H5N1 avian flu virus caused multiple lung infections, "which usually represents pus and infection in patients with fever and a cough," radiologist Dr. Nagmi Qureshi said. "We also discovered that the severity of these findings turned out to be a good predictor of patient mortality."
The avian flu virus has infected 133 people in Asia since late 2003 and killed 68 of them. Several countries in the region are regularly reporting more suspected cases in people and outbreaks in poultry.
Scientists fear the avian flu virus H5N1 could kill millions of people if it mutates into a form that passes easily among humans. The regular flu vaccine is useless against avian flu and there is no cure, although drugs can help reduce its severity.
Three of the five surviving patients in the study, which was presented at the annual meeting of the Radiological Society of North America, underwent more detailed computed tomography (CT) exams after they left the hospital.
Those images showed that while their respiratory symptoms had subsided, scar tissue formed in their lungs similar to damage suffered by victims of severe acute respiratory syndrome, or SARS, which broke out in 30 countries in 2003 and infected 8,400 people, killing about 800 of them.
"However, additional abnormalities we discovered in avian flu patients -- including fluid in the space surrounding the lungs, enlarged lymph nodes and cavities forming in the lung tissue -- were absent in patients with SARS," Qureshi said.
I just can't think that pus in the lungs is a good thing. Avian flu makes regular flu look like a case of the sniffles.
I hate to pee on anyone's cornflakes but .... X-Rays don't show symptoms! Symptoms are defined as something that a person reports - fever, cough, shortness of breath, pain whatever.
X-Rays are an imaging modality that show (rather non-specifically) what something looks like (in this case the lungs). This can be *correlated* with symptoms but technically are completely separate from symptoms.
are these primary (flu virus) infections or secondary bacterial infections? Does pus indicate the presence of bacteria?
Mrs VS
are these primary (flu virus) infections or secondary bacterial infections?
Can't tell from the article - and X-rays are not specific enough to say - in general. Really could be either from what I can tell. If memory serves, many of the deaths in 1918 where from secondary bacterial infections to the best of our current info (not totally sure of that point though).
Does pus indicate the presence of bacteria?
It is suggestive of it but no, doesn't prove it. Pus is visible evidence of inflammation which is non-specific.
The basic idea here is that the body has only so many ways to react to noxious stimuli - so there is a whole library of "bad things" out there but only a few books worth of responses to those bad things - hence the need for more specific tests like cultures and serology and the like.
OK, how does this all relate to the "cytokine cascade" they were going on about a week or so back?
Shooting from the hip here - in general cytokine cascade is yet another form of the body responding to inflammation - my guess would be the discussion last week was something along the lines of "cytokine cascade == BAD".
So when the body is injured it knows how to respond in various ways - one is to recruit white blood cells to come clean up the mess or kill the intruders and these white cells are basically what we know as "pus".
Another response is to secrete a bunch of chemicals (and those chemicals can secrete chemicals etc. etc. causing a "cascade"). And these chemicals can do "bad things" like maybe in the lungs cause them to fill up with fluid which means you can't breath.
But the points I'd make here again are
1. You can't see "symptoms" on an X-Ray.
2. The body only has so many ways to respond to injury - hence an inflammatory response can be seen in response to various viral agents, various bacterial agents or various chemical agents and the x-ray and/or clinical picture may look surprisingly alike regardless of what caused it. Of course this is not completely true, but it's true to a greater extent than a lot of people realize.
Thanks.
I got my act together and found the article.
What makes the bird flu so deadly?
http://www.advancesinlifescience.com/features_35.htm
If it's all basically a big time inflammatory reaction, wouldn't an anti-inflammatory like prednisone do the job? What am I missing?
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