In the past two weeks, there have been approximately 1,000 flu or pneumonia-related deaths in the US. This is up from 100 deaths weekly on the previous two weeks. This is due to the sharp increase of infected cases from the opening of schools. With that in mind, the extent of the H1N1 virus is vastly overrated and its virulence is definitely underrated. Hospitalized patients have faced a mortality rate approaching 10%, and the overall mortality seems to be hanging around 1%*. If this holds true during the extent of the virus, millions could die in the US alone.

The reason behind this is generally unknown, but there is significant evidence that the flu is mutating. It has shown increasing Tamiflu resistance and a mutation that increases transmissibility in colder temperatures, meaning a higher viral load (and worse outcomes) as the temperature drops in the Northern Hemisphere. There is another unnamed mutation that was reported in two US fatalities, but the sequences have not been released. The virus, contrary to what the CDC has been saying, is highly unstable and capable of mutation. There are several strains circulating around the world right now, and the US seems to be hit particularly hard.

Studies have shown that it is over one hundred times more effective than seasonal flu when in the lungs. Some health officials have referred to it as avian flu on steroids. That said, the flu can survive outside of the lungs, which is why we also see a good amount of mild cases. If it stays in the upper respiratory system, then you're likely to survive.

If it goes into your lungs, however, your odds of dying could be over 8%. Once ARDS (acute respiratory distress syndrome) happens, you have a 50% chance of dying. The reason this happens is because the flu burrows deep into the lungs and destroys the alveoli, which can cause the lungs to fail. The lungs of the deceased have frequently been cited as highly blistered and excessive bleeding or fluid build up in the lungs is often said to be a cause of death. It is not uncommon for people to cough up blood because of the cellular damage caused by the immune response (and the virus itself).

Another cause of death has been multisystem organ failure, which can occur from a lack of oxygen in the blood or from a secondary bacterial infection causing septicemia or similar. Which brings me to another point: H1N1 isn't always listed as the cause of death because it often paves the way for secondary infections. Bacterial pneumonia is a common secondary infection, especially if the patient has been on a ventilator for some time or if they spent time in a hospital. Strep throat and MRSA (staph infection) are other common co-infections and causes of death in people with H1N1. Studies have shown that co-infection with seasonal influenza can significantly increase the mortality rate.

The above, coupled with the fact that rapid tests are sometimes less than 50% sensitive to Influenza A means that a lot of people are misdiagnosed and not treated with Tamiflu on time. It also causes some deaths to go unreported. Strep throat, for example, is not viewed as a dangerous disease but it can be when coupled with H1N1. Be wary and get multiple opinions or tests if you don't recover quickly. A common sign of bacterial co-infection is a brief period of recovery followed by increased illness.

Remember that bacterial co-infection is the most likely way for swine flu to kill you.


image001n - How Does Swine Flu Kill You? Prevention Tips