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Who's at High Risk From Swine Flu?

New Flu Riskiest for Pregnant Women, Kids Under 5 or With Asthma, Many Others
By
WebMD Health News
Reviewed by Louise Chang, MD

July 21, 2009 -- A pregnant Florida woman who got swine flu, lost her baby, and now fights for her life has drawn media attention to the fact that pandemic flu isn't just "moderately severe" for everybody.

Aubrey Opdyke, who came down with swine flu while pregnant, was placed in a medically induced coma on June 3. Doctors last week tried to deliver her baby prematurely, but the infant did not survive. Opdyke remains in intensive care.

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A similar case is reported from Australia. Early in the pandemic, on May 12, the CDC reported details of three cases of swine flu in pregnant women. One of the women, age 33, died two days after giving birth to a healthy child. The other two women received Tamiflu treatment; they and their babies are doing well.

The word is now out: Pregnant women are at increased risk of complications from pandemic swine flu. But they aren't the only people at higher risk.

Underlying Medical Conditions and Swine Flu

Flu viruses attack the upper and lower airways, making it harder for a person to breathe. That's one of the reasons the flu is such a miserable illness even for people who were healthy when they caught the flu bug.

But anyone with an underlying illness that can make breathing difficult is at much greater risk from the flu. Flu can send someone with a chronic lung condition -- such as asthma or COPD -- to a hospital equipped with mechanical ventilators.

The flu also makes a person's lungs more susceptible to bacterial infection. With seasonal flu, bacterial infections are a leading cause of flu deaths. Those most vulnerable to such flu complications are adults over 65 -- especially those in nursing homes -- and kids under 2.

Just like seasonal flu, pandemic swine flu is hard on elderly people. But so far in the current pandemic, relatively few elderly people are getting the disease. It's mostly striking younger people.

Kids under 5 have been at higher risk of swine flu complications. Those with asthma are, of course, at particularly high risk. So are kids with medical conditions -- such as diabetes -- that put adults at higher risk from flu.

One group of children and teens faces an unusual risk: those under age 19 who must take long-term aspirin therapy. Aspirin is a dangerous drug for people who have the flu, as it raises a person's risk of a dangerous complication called Reye's syndrome.

 

Adults at 'Higher Risk' From Swine Flu

As noted above, pregnancy, lung diseases, and older age put adults at higher risk of swine flu complications.

Those aren't the only underlying medical conditions that make swine flu dangerous. Here's the rest of the list:

  • Cardiovascular conditions (except high blood pressure)
  • Liver problems
  • Kidney problems
  • Blood disorders, including sickle-cell disease
  • Neurologic disorders
  • Neuromuscular disorders
  • Metabolic disorders, including diabetes
  • Immune suppression, including HIV infection and medications that suppress the immune system
  • Residency in a nursing home or other chronic-care facility

A striking number of adults who developed severe swine flu complications have been morbidly obese. However, obesity itself does not seem to be the issue. The vast majority of extremely obese people suffer respiratory problems and/or diabetes, which seem to be the underlying reason for severe flu complications.

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