H1N1 can cause pneumonia, but that's not the only danger: The rare complications doctors have documented

When flu symptoms go beyond pneumonia and start affecting the lungs, heart and brain

A fever, cough and body ache can make H1N1, or influenza A(H1N1), look like an illness that simply needs a few days of rest. Often, that is exactly what happens. But influenza can sometimes take a more serious turn, particularly when the infection reaches the lower respiratory tract. Pneumonia is one of the best-known complications, but it is not the only one doctors watch for.

“H1N1 should not be viewed as just a seasonal flu, particularly when symptoms are persistent or worsening,” said Dr Shubham Agarwal, Consultant Pulmonology and Sleep Medicine, ApolloMedics Hospital, Lucknow.

Yes, H1N1 can cause pneumonia. Here is how

Influenza viruses infect the respiratory tract, including the lungs. In some people, the infection can move deeper into the lungs and cause primary viral pneumonia. The inflammation can damage the tiny air sacs where oxygen passes into the blood, making breathing increasingly difficult.

There is another route too. Influenza can weaken the respiratory system and make it easier for bacteria to cause an infection. This is known as secondary bacterial pneumonia.

Dr Inder Mohan Chugh, Vice Chairman and HOD – Pulmonology, Yatharth Hospital, Model Town, New Delhi, said pneumonia is particularly seen among adults, young children, pregnant women and people with existing illnesses.

Sometimes, the lungs are only the beginning

Severe influenza can trigger a strong inflammatory response. That is one reason the illness can affect parts of the body beyond the lungs.

Dr Vijay Dutta, Director, Internal Medicine & Respiratory Services, ISIC Multispeciality Hospital, said, “In a few situations, the infection can cause serious inflammation in the body and impact organs other than the lungs.”

Among the complications doctors may encounter are myocarditis, or inflammation of the heart muscle, and neurological problems such as confusion, seizures and, rarely, encephalitis, which involves inflammation of the brain.

Government-backed CDC guidance also lists myocarditis, encephalitis, seizures, myositis and multi-organ failure among possible severe complications of influenza.

These complications are uncommon, but their rarity should not be confused with impossibility.

ARDS can make breathing suddenly much harder

One of the most serious lung complications is acute respiratory distress syndrome, or ARDS. It can develop when severe inflammation causes extensive damage in the lungs.

The 2009 H1N1  pandemic provided some of the clearest evidence of how severe influenza can become. A CDC-published analysis of critically ill H1N1 patients documented respiratory failure, ARDS, septic shock and acute kidney injury among severe cases.

This does not mean every person with H1N1 is heading towards ARDS. Most influenza infections do not follow that path. It explains why worsening breathing cannot simply be dismissed as “part of the flu.”

The infection can return after someone seems better

One particularly important clue is a change in the illness pattern.

A person may initially develop fever, cough and body aches, begin improving, and then suddenly develop a fresh fever, worsening cough, chest pain or increasing breathlessness. That can signal a secondary bacterial infection.

“Secondary bacterial infections” are among the complications doctors specifically monitor in severe influenza, according to CDC guidance.

Dr Dutta said this second phase “must not be overlooked and should be assessed medically.”

That distinction matters because a worsening cough after several days does not always mean the flu is simply taking longer to settle.

Who needs to be more careful?

Serious influenza complications can occur in anyone, but the risk is higher in older adults, young children, pregnant women and people with chronic conditions, including asthma, diabetes, heart disease and chronic lung disease.

Dr Chugh said early recognition remains important because timely medical assessment, monitoring and appropriate antiviral treatment when indicated can reduce the risk of severe disease.

Warning signs include difficulty breathing, chest pain, bluish lips, confusion, extreme weakness, dehydration, low oxygen levels or fever that returns after initial improvement.

Dr Dutta put it simply: “Don't panic, but don't shrug off flu symptoms.”

For most people, influenza will pass without these complications. But when the illness changes direction, the body is giving a signal worth taking seriously.

 

Inputs were used to explain how H1N1 can progress from a respiratory infection to pneumonia and, in severe cases, lead to complications such as ARDS, secondary bacterial infections, myocarditis and encephalitis.

 

 

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The impact of zinc deficiency on our immunity

As doctors, scientists and researchers globally are still studying the novel Coronavirus and discovering how the infection works and new ways to treat it, there is an avalanche of information that might be conflicting sometimes. However, doctors world over have to come to the consensus that building a robust immune system will give you a better chance of combating the virus should you contract it. Zinc is one such micronutrient that helps in building immunity and recent studies show that zinc inhibits coronavirus by blocking a key enzyme. Scientific evidence documented in the past few decades shows that consumption of zinc plays a significant role against viral infections including human respiratory infections because of its immuno-nutrient properties. According to a study by the Harvard T.H. Chan School of Public Health- ‘Inadequate zinc intake in India: past, present and future’ inadequate zinc intake has been rising in India for decades, causing tens of millions of people to become newly deficient in it. Zinc deficiency has caused a malnutrition problem worldwide. The study states that the highest rate of inadequate zinc intake was concentrated mainly in the southern and northeastern states of India with rice-dominated diets: Kerala, Tamil Nadu, Andhra Pradesh, Manipur and Meghalaya. Thus, zinc intake for Indians is of paramount importance.

Coronaviruses is the old common cold virus which causes 30-40% of common colds discovered in the Common Cold Unit in 1964 form UK .Zinc has been studied for more than four decades in common cold therapies . The odds of getting a cold with people taking zinc preventatively is one third less . Essentially Zinc’s properties help in reducing the severity and duration of the cold. It is an essential mineral that our body cannot make by itself, hence we need to make sure our diet is zinc-rich along with other nutrients.

Zinc deficiency is one of the most common nutritional deficiencies in the world, yet it is essential for healthy immune function. Zinc is needed for immune cell development and communication and plays an important role in inflammatory response. Zinc supplementation may prove beneficial against coronavirus infection by providing an additional immunity defense. This given point in time, keeping your immunity system strong and making healthy lifestyle choices is the need of the hour.

Also, assessment of nutritional status of COVID19 patients before administration of general treatment is important as immune response is weakened due to inadequate nutrition. We all need to build strong immnunity in corona and covid times like a safety net or “kavach” around us.

Fortifying your immunity system against colds and flu’s is essential now more than ever. A balanced diet and attention to macro and micronutrients is the basis of building a vigorous immune system. Your meal needs to have the right amount of vitamins, minerals and carbohydrates. Zinc also should be consumed judiciously because an overdose of zinc can cause indigestion, headaches and nausea. Zinc not only has immunity-boosting properties but also makes sure your metabolism is strong. Its important to have the right amount of zinc in your body. 

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Certain cancer drugs could be used in the future to treat COPD

New research has shown the potential for clinically available cancer treatments to treat chronic obstructive pulmonary disease (COPD).

Scientists from the University of Sheffield have been investigating the effect of drugs used to treat a variety of cancers on this inflammatory response; the main driver of lung damage in people living with COPD.

COPD slowly develops over many years - often patients are not aware they have it until their 40s or 50s - and for the 1.2 million people in the UK who have been diagnosed, it makes breathing progressively more difficult.

People living with COPD experience a wide range of symptoms that have an increasing impact on their quality of life, including breathlessness, coughing and frequent chest infections.

The damage to the lungs is driven by inflammation caused by immune cells called neutrophils.
A research team at the University's Department of Infection, Immunity and Cardiovascular Disease screened a library of cancer drugs and identified a number of compounds which accelerate the death of the neutrophil cells and promote healing in the lungs.

The research, funded mainly by the Medical Research Council, discovered that specific cancer drugs inhibit a cell signaling process controlling the death-rate of the harmful neutrophils. The team also discovered that editing the genes that encode the cell signaling in the first place, further decreased inflammation.

Dr Lynne Prince, Russell Fellow at the University of Sheffield, said:

COPD is usually treated with steroids and airway muscle relaxants which ease symptoms, but there is currently no effective treatment clinically available to counteract the damage it does to the lungs.

Our research now shows that inhibitors of these cell signaling processes, or ErbB kinases, could have therapeutic potential in neutrophilic inflammatory disease.
The hope of these drugs is that they can clear the damaging cells from the lungs of people living with COPD, preventing any further damage and therefore the progression of the disease for the first time."

Repurposing a clinically available drug has many benefits, said Professor Stephen Renshaw, from the University of Sheffield:

We are in desperate need of a new treatment for COPD, millions of people all over the world live with the disease and it has a massive impact on their quality of life, especially as the disease progresses.
What is exciting about this research is that these drug compounds are available now, which means if our continued research can effectively find a lead compound to benefit people living with COPD, they are ready to use.
As neutrophilic inflammation is also central to the progression of other chronic inflammatory diseases such as rheumatoid arthritis, the research has the potential to impact not only people living with COPD.
Our next step is to find a way to test these drugs in people with COPD to understand how the ErbB kinase signaling process has an effect on lung inflammation and to address any potential side effects."

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source- Uni. of Sheffield