Symptoms and severity

Video xo.ogv

CDC’s CAPT Dr. Joe Bresee describes symptoms.

The symptoms of swine are similar to other in influenzas, and may include a fever, coughing (typically a “dry cough”), headaches, pain in the muscles or joints, sore throat, chills, and runny nose. Diarrhea, vomiting, and neurological problems were also reported in some cases. People at higher risk of serious complications include people age 65 and older, children younger than 5 years old, children with neurodevelopmental conditions, pregnant women, and people of any age with underling medical conditions, such as asthma, diabetes, obesity, heart disease, or a weakened immune system (e.g, taking immunosuppressive medications or infected with HIV). Most hospitalizations in the US were people with such underlying conditions, according to the CDC.

A New England Journal of Medicine article on hospitalized United States H1N1 patients from April to mid-June found that 40% of them had chest X-rays consistent with pneumonia. And if the same pattern holds from the 1957-58 pandemic, then approximately two-thirds of these patients had viral pneumonia and one-third had bacterial pneumonia. However, antiviral medication was received by only 73% of the patients, whereas 97% received antibiotics. It is recommended that such patients receive both.

A study from Australia and New Zealand estimated that the demand for ICU beds due ti viral pneumonia was much higher during the pandemic than in previous influenza seasons. A Canadian study reported that intensive care capacity in Winnipeg, Manitoba was “seriously challenged” at the peak of the outbreak, with full occupancy of all regional ICU beds. The average age of ICU patients was 32, 40, and 44 years in Canada, Australia/New Zealand, and Mexico respectively.

In adults

In adults, shortness of breath, pain in the chest or abdomen, sudden dizziness, or confusion may require emergency care. In both children and adults, persistent voiting or the return of flu-like symptoms that include a fever and cough may require medical attention. And if it follows the same pattern as in children, relapse with high fever may in fact be pneumonia. Dr. Thomas R. Frieden, Director of the CDC, suggests that people with “underlying conditions” who come down with flu symptoms should consult their doctors first before visiting an “emergency room full of sick people,” since it “may actually put them in more danger.” This was especially true of pregnant women.

In Children

As with the seasonal flu, certain symptoms may require emergency medical attention. In children, signs of respiratory distress include blue lips and skin, dehydration, rapid breathing, excessive sleeping. seizures, and significant irritibility including a lack of desire to be held. Although “too aerly” to tell the certain, Dr. Frieden has noted that so far the swine flu “seems to be taking a heavier toll among chronically ill children than the seasonal flu usually does.” “Of the children who have died so far, nearly two-thirds had pre-existing nervous system disorders, such as cerebral palsy, muscular dystrophy, or developmental delays. “Children with nerve and muscle problems may be at especially high risk for complications, ” the CDC report stated. In children without chronic health problems, it is a warning sign if they seem to recover from the flu but then relapse a high fever, Dr. Frieden added. The relapse may be bacterial pneumonia, which must be trated with antibiotics.

Researchers in Australia and New Zealand have reaffirmmed that infants under the age of 1 year have the highest risk of developing severe illness from swine flu.


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