WHO: asthma or diabetes patients w/ H1N1 get help fast

November 12, 2009

H1N1 patients with asthma or diabetes should seek immediate help, WHO warns in

swine flu report BLOOMBERG NEWS, November 11th 2009, 12:23 PM

Swine flu sufferers who have asthma, diabetes or other conditions that may

worsen their illness should seek medical care as soon as the infection is

suspected, the World Health Organization said.

Pneumonia and other complications from the pandemic virus may develop within 24

hours, and any patient with difficulty breathing, who is drowsy or dehydrated,

or who has had a fever for more than three days should be seen urgently by a

doctor, according to the Geneva-based WHO. Severely ill patients should be given

Roche Holding AG's Tamiflu straight away and may need a double dose, WHO said

Tuesday in a 15-page report.

The WHO's latest guidance follows a meeting in Washington last month of doctors,

scientists and public health officials to review studies and unpublished data as

colder weather spurs epidemics across the Northern Hemisphere.

" The guidelines are broadly similar to the strategies used in Australia and New

Zealand during our recent outbreak, " said Webb, an intensive-care

specialist at the Royal Perth Hospital, who participated in the meeting. " They

are sensible and pragmatic. They should be widely disseminated and represent a

highly useful starting point for clinicians. "

More than 6,000 people have died after catching the new H1N1 strain since it was

discovered in Mexico in April and spread to 195 countries. While the majority of

those infected develop " mild-to-moderate disease, " the virus is capable of

causing fatal complications, including " rapidly progressive pneumonia especially

in children and young to middle-aged adults, " WHO said.

As most people have little or no immunity to H1N1, the pandemic is striking down

people in a wider age range than seasonal flu, which kills predominantly the

frail elderly, WHO said. It's also capable of infecting the lower respiratory

tract, heightening the risk of lung disease and respiratory failure.

Diagnosing H1N1 may be more difficult in patients with lower respiratory illness

because initial laboratory tests sometimes fail to pick up the infection in

specimens from the nose and throat, according to the report. Samples from the

trachea and bronchi, which are harder to collect, may provide a more accurate

result, it said.

Researchers in Australia and New Zealand are investigating the proportion of

critically ill H1N1 patients whose infection wasn't diagnosed by so-called

polymerase chain reaction tests, Webb said in an e-mail today. A small

proportion of patients in both countries who failed repeated PCR tests were

later found to have been infected with H1N1 based on antibody studies, he said.

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