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H1N1 (Swine Flu): Marketing Hand Washing to Kids and Low Levels of Immune Globulin May Lead to Severe Disease in Pregnant Women

September 18, 2009

MARKETING HAND WASHING TO KIDS

I suppose it was only a matter of time….The Disney corporation is now marketing Musical Hand Wash Timers featuring characters like the Little Mermaid, and encouraging parents to “take precaution against swine flu” by teaching children to wash their hands correctly. “Studies prove that regular hand-washing dramatically reduces the spread of infection,” says the Disney Web page, which links to the Centers for Disease Control and Prevention’s Web site.

For only $3.99 you can get musical tunes to time your kids hand washing! ;-)

For only $3.99 you can get musical tunes to time your kids hand washing! 😉

Oh my…

http://www.gethealthyhands.com/

LOW LEVELS OF IMMUNE GLOBULIN MAY LEAD TO SEVERE DISEASE

Reporting on new research at the annual meeting of the American Society for Microbiology in San Francisco, Australian researchers may have uncovered a clue as to why some people who catch swine flu suffer life-threatening illness.

And if they are right, there is an existing weapon in the treatment arsenal that could help reduce the pandemic death toll. The group found that pregnant women who became severely ill with the new H1N1 virus had low levels of a particular antibody that is known to fight off viruses and help the body respond to vaccine.

Moderately ill women were much less likely to have significantly suppressed levels of the antibody, the researchers reported. “We all believe we may have stumbled onto something very interesting,” said Dr. Lindsay Grayson, director of infectious disease at Austin Health, a network of three hospitals in Melbourne.

The team made the discovery when Grayson’s colleague, Dr. Claire Gordon, ordered a test that looked at antibody levels – not just by class, but looking at individual subtypes within those classes. The call was made in the case of a very sick patient whose decline was particularly rapid, and the team was debating whether immune globulin – a blood product containing antibodies harvested from donated blood – might help.

The testing showed the patient had low levels of an antibody called IgG2, which Grayson admitted came as a surprise. They started ordering tests on all their swine flu patients in ICU.

The testing showed the patient had low levels of an antibody called IgG2, which surprised researchers. They started ordering tests on all their swine flu patients in ICU.

“What we found was almost everyone, all the patients who needed ICU were IgG2 deficient,” he said. Severe cases had IgG2 levels that were about one-third of those detected in people who were moderately ill. While the work was only done in pregnant women, Grayson and others said it would be useful to look to see if this deficiency might explain why a small subset of swine flu cases become gravely ill while most people only suffer through a bout of the flu.

It’s known that between two and 20 per cent of people have some antibody deficiency, he said, though not all of those people would be IgG2 deficient. Three of four critically ill patients treated with immune globulin survived, defying predictions of those caring for them.

Dr. Donald Low, chief microbiologist at Toronto’s Mount Sinai, said the findings are exciting, if preliminary, and might explain why aboriginals seem to be at greater risk of developing severe disease if they contract swine flu. He suggested the hypothesis should be studied further.

“It would be a fishing expedition, but obviously worthwhile.” “I think the bottom line is that this is obviously something that has to be looked into. And it may have therapeutic implication. … It could be a marker for women at higher risk if they get infected to get more severe disease.”

Grayson admitted they can’t say at this point whether there is a cause-and-effect relationship at work here, meaning low IgG2 levels in the patients predisposed them to suffering from more severe disease once they caught the virus. But he doesn’t believe the reverse is at play, that the infection caused the low IgG2 levels.

“We don’t think that influenza is causing this deficiency. We think that instead the influenza is picking out those people who have the deficiency,” he said. The numbers are admittedly small and will require further study, likely in the Northern Hemisphere. Swine flu rates are dropping in Melbourne, Grayson said. Still, 16 of 19 severely ill patients had very low IgG2 levels, compared to three of 20 with moderate illness.

The team looked at healthy pregnant women and found that about 60 per cent of them were mildly deficient in IgG2 levels, which leads them to believe this may be one of the immune system changes that occurs to allow a pregnant woman to carry a foreign body - a fetus - without rejecting it. But Grayson said the group needs to follow women after they deliver to see if their IgG2 levels rise to normal levels.

The team found that about 60 per cent of healthy pregnant women were mildly deficient in IgG2 levels, which leads them to believe this may be one of the immune system changes that occurs to allow a pregnant woman to carry a foreign body - a fetus - without rejecting it. The group needs to follow women after they deliver to see if their IgG2 levels rise to normal levels.

Grayson said while the group’s work hasn’t proven their hypothesis, Northern Hemisphere doctors caring for the sickest of swine flu patients in the weeks and months to come should consider checking IgG2 levels and using immune globulin, which is often given to people seriously ill with some bacterial infections.
Metro News http://www.metronews.ca/toronto/live/article/311673–low-levels-of-key-antibodies-may-lead-to-severe-disease-study-suggests

PRO> ProMED Digest V2009 #434 www.promedmail.org

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