FED: Australia's first six to fall seriously ill with swine flu

AAP General News (Australia)
08-02-2009
FED: Australia's first six to fall seriously ill with swine flu

By Danny Rose, Medical Writer

SYDNEY, Aug 2 AAP - Swine flu's potency is revealed in a report detailing the first
six Australians who were infected with the virus and then needed emergency hospital care.

The six were admitted to the intensive care wards of three hospitals across northwestern
Melbourne just as the influenza A(H1N1) virus was becoming established in the country.

The list includes an 18-year-old pregnant woman who went into premature labour after
vomiting for four days and then, after successfully giving birth, she required emergency
respiratory treatment.

Also on the list are two men who otherwise had "no identifiable risk factors" - such
as asthma, smoking or obesity - which could explain the severity of their swine flu reaction.

"Here, we present the first six cases of H1N1 influenza ... in which patients required
admission to intensive care in Australia," a group of doctors write in the Medical Journal
of Australia.

"These cases highlight the small but significant risk of life-threatening respiratory
failure associated with H1N1 influenza.

"All patients experienced a rapid (but reversible) decline in respiratory function,
with most requiring complex respiratory support."

The patients are not identified but the report details their symptoms in the days before
admission, and the extensive treatment they required during their hospital stay.

All were treated with Tamiflu, an anti-viral drug which stops the virus from spreading
to new cells in the body, and all but the young mother spent more than 10 days attached
to a mechanical ventilator.

The woman went to hospital after four days of cough, fever and vomiting though she
initially went home after being rehydrated using an intravenous drip.

Doctors had discussed with her the possibility of a swine flu infection.

"She returned several hours later in premature labour," the doctors write.

"Twenty-four hours after delivering a 26-week live infant, she developed hypoxic respiratory
failure ... (and) required a high level of inspired oxygen therapy by face mask."

Tests showed the mother, but not her baby, had the swine flu.

Those also in the list were:

- A 28 year-old woman who was overweight. She arrived at a hospital's emergency department
after five days of a sore throat and lethargy, followed by two days of shortness of breath,
coughing and chest pain.

- A "previously well" 24-year-old man who also had abdominal pain and vomiting, and
who needed ventilation for 15 days.

- Another otherwise healthy man, aged 41, who suffered through a week of coughing and
back pain before going to hospital with a fever.

- A 60-year-old man who went to the hospital suffering from an exacerbation of his
lung disease where it was found he had the swine flu.

- And 26-year-old overweight man with a history of mild asthma who was on the ventilator
for 10 days.

The doctors note the swine flu was a "benign disease" but that it could lead to severe
respiratory complications.

"In our series, prompt diagnosis and intensive therapy was associated with favourable
outcomes," they also write.

AAP dr/it/cdh

KEYWORD: FLU SIX

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