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Flu Secondary Infections (Viral/Bacterial) with the 2018 Influenza
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  1. #1
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    Secondary Infections (Viral/Bacterial) with the 2018 Influenza

    Am reading some news articles about this recent flu epidemic and am noticing that a number of the fatalities are mentioning a rash and/or brain infection. Was scratching my head over that when I read this article, and more importantly, some comments below it.

    I'll post the article, and then snippet the relevant comments down below. Am interested in what you all think about the secondary infection, be it viral or bacterial...

    Fair Use cited.


    http://www.foxnews.com/health/2018/0...-from-flu.html


    Five-year-old boy dies after developing rash, brain infection from flu

    By Jennifer Earl | Fox News


    Eli Snook's parents didn't want to take any risks when their 5-year-old son spiked a high fever and showed other signs of the flu.

    They took him to an urgent care center in Marietta, Ga., where a doctor gave him antibiotics and prescribed him Tamiflu, his parents told WSB-TV.

    After spending about a week resting and taking his medication, Snook appeared to be better and his parents took him back to day care. Three days later, on Jan. 27, they said they were asked to pick him up early because he had a temperature of 101 degrees.

    They brought him back to the walk-in clinic. Doctors ran some more tests and confirmed he tested negative for the flu, but they told his parents they were concerned about a rash they noticed across his body, CBS News reports.

    A mom from Blair, Neb. recently warned in a viral Facebook post that parents should be on the lookout for rashes, specifically hives, which she says her son developed before testing positive for Influenza B.

    "He had no symptoms. No fever, no cough, and no runny nose. He only [had] hives. Please keep watch on your children so if they develop hives...call your pediatrician," said Brodi Willard, a registered nurse.

    While the American Academy of Dermatology says allergic reactions or infections could be a cause of hives, the Centers for Disease Control and Prevention (CDC) does not list hives as a common flu symptom. They do, however, say a fever with a rash is an "emergency warning sign" of a flu-related illness.

    Due to the combination of a fever and rash, doctors transferred Snook to Children's Healthcare of Atlanta, where he later died from a brain infection that had developed while he had the flu.

    Doctors told Snook's parents the flu weakened his immune system and a virus "quickly attacked" his brain.

    "We prayed for a miracle," Snook's father, Aaron, told WSB-TV. "He got an infection in the brain. His brain swelled past the point of no return, and he went brain dead."

    "It was a shock to me. It was shock," Snook's mother, Leota, said.

    Snook's parents said the 5-year-old was going to get a flu shot this year, but doctors said to hold off until he fully recovered from a previous sickness, according to CBS News.

    The CDC said Friday this has been a "high-severity" flu season. There have been 53 pediatric deaths reported so far, according to the CDC's latest data. Georgia has been hit particularly hard this season, with 25 confirmed flu-related deaths this winter, a report from the Georgia Department of Public Health shows.

    But Snook's mom says it's not just the flu that's killing people.

    "It's the after-effects of the flu that's killing these babies," Leota said.

    A family friend started a GoFundMe account in the boy's name, raising $10,350 in just five days. The money went toward Snook's funeral.

    "Thank you to everyone who has donated anything," the friend posted on the GoFundMe page. The funeral was held [Wednesday] morning and it was everything the family could have hoped for."
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  2. #2
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    Here's the really interesting comment from the Fox news article's comment section:

    http://www.foxnews.com/health/2018/0...-from-flu.html

    [SNIP]

    jcv1953

    Influenza encephalitis is rare. The article suggests the child developed post-influenza encephalitis from a different virus which is also very rare. Alternatively, secondary bacterial infections with the flu are quite common

    If it is a different virus, it was probably an Enterovirus, which is a very common family of viruses. Enterovirus species cause everything from common colds to polio (including encephalitis) and a rash is a frequent presenting finding. There are no specific treatments for Enterovirus and in an immunocompromised state can be devastating.

    All speculation of course, just an interesting (though very tragic) case.

    [SNIP]


    jcv's background:

    [SNIP] Having been a practicing physician for 35 years I would say to a certain point you're correct but there's more to it than guessing. [SNIP]
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  3. #3
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    More on the Enterovirus itself:


    http://www.enterovirusfoundation.org/advice.shtml


    Advice for doctors from Dr. John Chia to aid in the diagnosis of both acute and chronic enteroviral infections:

    *Most of the acute enteroviral infections, even in the case of poliovirus infections, are asymptomatic (no sickness.)

    *The diagnosis of acute symptomatic infection is usually suspected and empirically diagnosed based on the physician's assessment of the patient along with outbreaks of other cases in the community, known exposure risks, geographic locations (next to a river and lake) and age groups.

    *Ulcerations of the mouth (stomatitis), especially over the lining of the cheeks, tongue ulcers, blisters of the soft palate or the roof of the mouth (herpangina) are helpful signs of acute enteroviral infection.

    *Pediatricians can often diagnose enteroviral infections in young children since they are trained to recognize these infections.

    *All "flu-like illnesses" are not the same, and can be caused by a number of infectious agents. With effective influenza vaccination, the numbers of influenza cases have decreased dramatically. Most of the respiratory infections in the winter or summer are not due to influenza but other respiratory viruses or mycoplasma.

    *Whereas acute influenza symptoms rarely last more than one week, acute enteroviral infections often last much longer than one or two weeks.

    *Acute enteroviral infection can present with respiratory and/or gastrointestinal symptoms or just flu-like symptoms (fevers, body ache, headache etc.). Few viral infections present with respiratory and GI symptoms. An enteroviral infection should be suspected if the same symptoms recur every month.

    *Diagnostic testing plays a role in enteroviral infections. As newer methods have demonstrated increased sensitivities, determining viral etiologies of aseptic meningitis and neonatal sepsis has resulted in improved patient care.

    *Cell culture (growth of the actual virus), serology (antibody testing of the blood), and polymerase chain reaction (PCR, a special viral gene test) can confirm acute enteroviral infections. Enteroviruses are found in the stool, the pharynx, blood, and the cerebrospinal fluid.

    *In the past, the standard of virus isolation has been cell cultures, but cultures take approximately 3-8 days to grow the enterovirus, and the identification of the particular type of enterovirus is usually not done for a long time afterwards.

    *Virus isolation from blood is not very helpful because the viral levels may be undetectable by the time symptoms have appeared. Pharyngeal viral levels remain present from 2 days to 2 weeks after the infection. Stool isolation of enteroviruses is not specific to acute infections because viral stool shedding persists for as long as 3 months after the infection.

    *Another method, serologic testing, uses two blood samples to identify a rise of antibody levels over a 2- to 4-week period. A single level of enteroviral antibodies can be present in a healthy patient; therefore, monitoring the serology to identify a 4-fold increase in levels is needed. We can only identify 11 of the 70+ Human enteroviruses by this method. Furthermore, waiting for periods of 2-4 weeks for tissue results is not useful in improving patient care.

    *In contrast, the reverse transcriptase PCR testing is designed to detect a common genetic area of most of the enteroviruses. The results could be available in 24 hours, making detection more sensitive (95%), more specific (97%), and more time efficient. FDA has approved this test for diagnosing enterovirus meningitis. For other body fluids (stool, respiratory secretions and blood), the yield is less certain.

    *Measure cardiac and muscle enzymes in a patient with heart and muscle symptoms. Enteroviruses are the usual pathogen of the heart and skeletal muscles. Other viruses can affect the heart.
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  4. #4
    A lot of the flu deaths seem to follow this pattern. They get sick, and then get better. 2-3 days later the get sick again. And are dead in 48 hours.

  5. #5
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    http://www.enterovirusfoundation.org/symptoms.shtml


    Symptoms Commonly Seen for Persistent NonPolio Enteroviral Infections

    Listed here are common symptoms of persistent non-polio enteroviral infection. This list is from observations made by Dr. John Chia in his Infectious Disease Medical Practice in Torrence, CA.

    *Respiratory and/or gastrointestinal symptoms or just flu-like symptoms (fevers, body ache, headache etc.). Few virus infections present with both respiratory and GI symptoms.

    *Upper respiratory tract symptoms such as runny and stuffy nose, sinus congestion and pain, sore throat, ear pain, difficulty in swallowing, loss of smell or taste.

    *Upper and lower gastrointestinal symptoms such as nausea, indigestion, reflux, abdominal bloating, upper and lower abdominal pain, cramps, constipation alternating with diarrhea.

    *Sudden weight loss due to significant stomach problem or decreased caloric intake, or weight gain due to inactivity.

    *Numbness in the limbs, muscle twitching and spasms. Some experience facial tingling and numbness.

    *Many types of headaches.

    *Bone, muscle, and/or joint pain. Foot pain is quite common.

    *Chest pain, palpitations and tightness

    *Cough, shortness of breath, wheezing

    *Low blood pressure

    *Heart arrhythmia (irregular heartbeat) or tachycardia (rapid heartbeat)

    *Intermittent low grade fever, chills and night sweats.

    *Reproductive irregularities and pain.

    *Prostate issues and pelvic pain.

    *Blurred vision.

    *Herpangina (blisters or ulcers over the roof of the mouth). Ulcers may form in the mouth, throat and for females the vaginal/cervix area.

    *Recurring yeast or bacterial infections due to a weak immune system.

    *Adrenal surge or dysfunction. High cortisol levels or low cortisol levels.

    *Psychological problems, anxiety, or depression.

    *Mental fatigue when trying to concentrate on tasks. Cognitive issues are very common as are short-term memory problems.

    *Sleep disturbance.

    *Seizures are rare but do occur.

    *Vitamin and mineral deficiencies. Many become anemic.

    *Swollen Lymph nodes in the neck and in the armpits

    *Rash

    *Organs that can be affected by enteroviruses: heart, pancreas, lungs, liver, spleen, colon, ovaries, testicles, epididymis, thyroid, muscles, skin and the central nervous system.

    *Enteroviral infections can trigger dormant viruses to reactivate, such as HHV6, Epstein Barr Virus, CMV, and chickenpox– all herpes viruses.

    *Children can show symptoms, but parents may not recognize them especially if they are intermittent.

    *Children can have many of the same adult symptoms – a flu-like illness, fever, mouth ulcers, abdominal pain, loss of appetite, a rash, headaches, leg pain and weakness, muscle twitching, reflux, cognitive dysfunction and perhaps heart pain and arrhythmias. A diagnosis of chronic fatigue syndrome/myalgic encephalomyelitis in children is possible after three months of illness.

    *An enteroviral infection should be suspected if the same symptoms recur every month.
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  6. #6
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    Quote Originally Posted by naturallysweet View Post
    A lot of the flu deaths seem to follow this pattern. They get sick, and then get better. 2-3 days later the get sick again. And are dead in 48 hours.
    Naturally,

    Agreed! That's what's got me concerned - we may be in the middle of *two* epidemics, not just one. Influenza is the first, and the Enterovirus exploding into action once the flu settles down a bit.

    Doctors may need to be treating for both, at first office visit, instead of waiting...
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  7. #7
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    Here's a possible supplement that might be helpful in fighting the flu and/or this enterovirus. There's a lot of data here, but it looks like it *might* be helpful in preventing/reducing flu and enterovirus infection.


    Summerthyme and experienced medical herb users - Do you have any experience with EGCg? (Derived from Green Tea.) Thank you! :-)



    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594666/


    Br J Pharmacol. 2013 Mar; 168(5): 1059–1073.
    Published online 2013 Feb 20. doi: 10.1111/bph.12009
    PMCID: PMC3594666

    Anti-infective properties of epigallocatechin-3-gallate (EGCG), a component of green tea

    J Steinmann,1 J Buer,1 T Pietschmann,2 and E Steinmann2


    [SNIP]

    Effect of EGCG on other viruses
    With respect to RNA viruses, EGCG was tested against two other viruses, enterovirus 71 belonging to the family of Picornaviridae and influenza viruses, which are members of the family of Orthomyxoviridae.

    Influenza A and B viruses are a major cause of respiratory disease in humans. In addition, influenza A viruses continuously re-emerge from animal reservoirs into humans causing human pandemics of unpredictable severity every 10–50 years (Garcia-Sastre, 2011). Influenza A viruses are negative sense, single-stranded, segmented RNA viruses with an envelope. There are several subtypes known, labelled according to an H number (for the type of haemagglutinin) and an N number (for the type of neuraminidase). The annual flu (also called ‘seasonal flu’ or ‘human flu’) results in approximately 36 000 deaths and more than 200 000 hospitalizations each year in the USA alone. Vaccines are the most widely used intervention prophylaxis for influenza infection, but their effectiveness depends on the type of influenza virus and they also have the drawback of limited supply (Collin and de Radigues, 2009). Two main classes of antiviral drugs used against influenza viruses are neuraminidase inhibitors or inhibitors of the viral M2 protein, such as amantadine and rimantadine. These drugs can reduce the severity of symptoms and mortality and can also be taken to decrease the risk of infection. However, viral strains have emerged that show drug resistance to both classes of drug. The antiviral activity of EGCG against influenza virus was reported for the first time in 1993. The green tea molecule affected the infectivity of influenza virus in cell culture and it was shown to agglutinate the viruses, preventing the virus from absorbing to MDCK cells (Nakayama et al., 1993). Furthermore, green tea extracts including EGCG exerted an inhibitory effect on the acidification of intracellular compartments such as endosomes and lysosomes, resulting in inhibition of influenza virus growth in tissue culture (Imanishi et al., 2002). These studies were extended by Song et al.; they determined the structure–activity relationship of the different green tea polyphenolic compounds EGCG, ECG and EGC against influenza and found that ECG and EGCG were more effective than EGC and these molecules also exerted an inhibitory effect on the neuraminidase in a biochemical assay (Song et al., 2005). Influenza viral RNA synthesis analysed by RT-PCR was affected only at very high concentrations (Song et al., 2005). Interestingly, based on these in vitro data clinical studies were performed to investigate if green tea catechins can prevent influenza infections in humans. In a small prospective cohort study it was reported that gargling with tea catechins extracts was effective in preventing influenza infection in elderly residents of a nursing home (Yamada et al., 2006). In addition, in another randomized, double-blind, placebo-controlled trial, the consumption of catechins for 5 months had a statistically significant preventive effect on clinically defined influenza infection and was well tolerated (Matsumoto et al., 2012). The results of these trials indicate these catechins have a protective effect against influenza virus; however, large-scale studies are needed to confirm this.

    Enterovirus 71 is a single-stranded RNA virus and one of the causative agents of hand, foot and mouth disease (HFMD). This virus causes various clinical manifestations, including cutaneous, visceral and neurological diseases. Large outbreaks have been reported in Taiwan and Malaysia in the 1990s. Recently, enterovirus 71 repeatedly caused life-threatening outbreaks of HFMD with neurological complications in Asian children. The neurological manifestations progress very quickly and range from aseptic meningitis to acute flaccid paralysis and brainstem encephalitis. EGCG was demonstrated to inhibit enterovirus 71 replication and formation of infectious progeny virus (Ho et al., 2009). There was a positive correlation between the antioxidant effects of catechins (Yang et al., 1994) and their antiviral activity (Ho et al., 2009). These findings suggest that EGCG may suppress viral replication via modulation of the cellular redox milieu.

    [BIG SNIP]
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  8. #8
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    Excellent information! Thank you for posting, Deb!

  9. #9
    My other concern is the very real possibility of viral cardiomyopathy... essentially, weeks or months later, symptoms of heart damage appear, and there isnt much to be done except to manage symptoms, and eventually a heart transplant.

    I predicted this was going to be a problem with 2009's H1N1, and i wasnt at all happy to be proven right, but tgere were multiple articles of young, healthy people in their 20s showin ip with it 3-5 years later.

    Summerthyme

  10. #10
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    Quote Originally Posted by summerthyme View Post
    My other concern is the very real possibility of viral cardiomyopathy... essentially, weeks or months later, symptoms of heart damage appear, and there isnt much to be done except to manage symptoms, and eventually a heart transplant.

    I predicted this was going to be a problem with 2009's H1N1, and i wasnt at all happy to be proven right, but tgere were multiple articles of young, healthy people in their 20s showin ip with it 3-5 years later.

    Summerthyme
    Essentially what happened to me back in the 69 epidemic. Not only did I get the Hong Kong flu but Rheumatic Fever which left me with a heart murmur ( MVP). Took me forever to recover and get back to feeling well. I'm lucky it doesn't leak ( yet)


    All these articles about how bad it is has me doing my own "quarantine". I only leave the house once a week and then I'm very careful of others and use sanitizing wipes on carts and hand sanitizer when I get in my vehicle and I wash my hands as soon as I get home. I'm also using the wipes all over the house on objects hubby touches because he works at the local hospital
    Genevieve THE EVIL ONE is in HAPPY EVIL LAND!!..........shaking my head at adults who act like children

  11. #11
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    Here is some info re: Resveratrol and the Enterovirus. What is especially interesting is that the mention the Resveratrol being broken down in the gut.

    So, am thinking that *drinking* Resveratrol might not be helpful, however, perhaps keeping the substance in the mouth and absorbing directly into the bloodstream that way might be more effective? (This was suggested a LONG time ago at Canada Sue's Avian Flu board. Unfortunately, I no longer have that thread available, so am unable to hat-tip to the idea's progenitor...)


    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333343/


    Resveratrol Inhibits Enterovirus 71 Replication and Pro-Inflammatory Cytokine Secretion in Rhabdosarcoma Cells through Blocking IKKs/NF-κB Signaling Pathway


    Li Zhang,1,‡ Yuanyuan Li,1,‡ Zhiwen Gu,1 Yuyue Wang,1 Mei Shi,1 Yun Ji,1 Jing Sun,1 Xiaopeng Xu,1 Lirong Zhang,1 Jingtin Jiang,2 and Weifeng Shi1,*

    Dominique Delmas, Academic Editor

    [BIG SNIP]

    Discussion:

    Previous studies have reported that resveratrol has antiviral effects on HSV, HIV-1, HBV, Epstein-Barr virus, influenza A virus and HCMV [8, 32–36].

    [SNIP]

    The inhibitory activity of resveratrol on EV71 replication is a dose-dependent mode. When resveratrol (30 μg/ml) and ribavirin (125 μg/ml) were added simultaneously with or after EV71 absorption for 1.5 h, the viral titers in cell supernatant revealed a decreasing trend, suggesting that resveratrol may block EV71 replication in RD cells, but independent of viral attachment and penetration.

    [SNIP]

    Presently, EV71 mouse models have been employed to evaluate the anti-EV71 activities of drugs, including pleconaril, ribavirin and rupintrivir[48–50]. Moreover, these anti-viral interventions display certain protective or therapeutic effects when given either before or after EV71 infection that include the reductions in morbidity, mortality, tissue virusloads and the alleviation of lesions. Although resveratrol has little cytotoxicity and shows the inhibitory effect on EV71 replication in vitro, the efficiency should be further evaluated on animal models in the follow-up study. In addition, resveratrol can be rapidly metabolized to glucuronide or sulfate compounds with low bioavailability on first pass after oral administration, which seems to be difficult in clinical application. Therefore, resveratrol may serve as a lead for chemical modification and a suitably modified analogue as a clinical candidate.

    In summary, EV71 infection can stimulate the phosphorylation of IKKα, IKKβ, IKKγ, IKBα, NF-κB p50 and NF-κB p65, which correspondingly enhances the secretion of IL-6 and TNF-α. Whereas, the activation of the signal pathway and EV71 replication can be blocked by resveratrol, suggesting that it is effective to inhibit EV71 infection through blocking IKKs/NF-κB pathways. The underlying mechanisms is still not clear and needs to be further studied in vitro or in vivo to highlight IKKs/NF-κB pathway as potential broad antiviral molecular targets for the treatment of EV71 infection.

    [SNIP]
    Treat each day as one of limitless potential and promise.

    The challenge in life is for HOPE to overcome that sense of fear. For GOOD to overcome evil.

  12. #12
    Quote Originally Posted by Genevieve View Post
    Essentially what happened to me back in the 69 epidemic. Not only did I get the Hong Kong flu but Rheumatic Fever which left me with a heart murmur ( MVP). Took me forever to recover and get back to feeling well. I'm lucky it doesn't leak ( yet)


    All these articles about how bad it is has me doing my own "quarantine". I only leave the house once a week and then I'm very careful of others and use sanitizing wipes on carts and hand sanitizer when I get in my vehicle and I wash my hands as soon as I get home. I'm also using the wipes all over the house on objects hubby touches because he works at the local hospital
    Since people also catch flu breathing viruses in the practice of neti is very useful, it is easy and comfortable. DH and I do it often, especially if we go out and breathe "other peoples' air". I think neti pots are sold all over, if anyone wants to know how to do neti PM me to make sure I see it. I've written articles about neti and done it for years.

    Even if you don't have a neti pot at the moment you can do these things to help protect against breathing in viruses:

    1. Coat the inside of nostrils liberally with oil or some kind of salve, home made or purchased. This coats the mucus membranes to keep viruses from latching on, insert as deep into the nose as you can.

    2. When you come home, rinse the inside of your nostrils well by "slurfing" in water and blowing it out, one nostril at a time, several times, very helpful although not quite as thorough as neti.
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  13. #13
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  14. #14
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    I wish people in this country would pick up the habit like they have in Japan, where a person with a cold wears a mask to protect others from catching what they have.....and like wise anyone not wanting to catch whatever is going around also will wear a mask to protect themselves and no one thinks anything of it.

    Had my semi-annual appointment this last week at the local VA Clinic....you can bet I wore a N95 mask when I went. As sure as all get out some gal sat down next to me in the waiting room coughing up a lung and not covering her mouth once.

    Have been in a couple of stores over the last week or two: grocery, Home Depot, etc. and such. Several times I just left after I heard someone in the next aisle hacking up a lung.....UGH!!!
    We have done so much, with so little, for so long....We can now do anything, with nothing, forever.

  15. #15
    The rash is also one of the signs of a bad reaction to Tamiflu. I have to wonder what percentage of these cases are Tamiflu reactions that are not being recognized. I'm also beginning to wonder if there is, for some reason, something about this fly that is triggering the increase in negative Tamiflu reactions.
    Please, come say Hi! and share your experience/knowledge. I love to learn.

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