Start | O nás | Maxdorf | Spolupráce

Velký lékařský slovník online…

A | B | C | D | E | F | G | H | Ch | I | J | K | L | M | N | O
P | Q | R | S | T | U | V | W | X | Y | Z | 0-9 | #

Medical English / 27. 7. 2009

H1N1: Are you at special risk? Step on a scale and find out / By Tom Secrest

By Tom Secrest

Question: How do you know if you’re too fat?
Answer: You know you’re too fat if whenever you go to the beach, people rush up and start pouring water over you, while others try to drag you back into the ocean.

As if obesity didn’t present enough health issues by itself, there is now another one to worry about.

The first case of H1N1 in the United States was confirmed on April 15, 2009. By July 10th the number of confirmed and probable cases had increased to 37,246. Globally the virus has killed almost 500 people, with 211 of those in the U.S. Also on July 10th directors from all the relevant U.S. health agencies met to strategize for what they expect will be a resurgence of the virus this fall. Current estimates suggest that the resurgence and the availability of the first vaccine will have an uncomfortably close proximity in time, and no one knows for sure which will arrive first, but several things point to the flu. The fall flu season in the U.S. coincides with the beginning of the new school year. Depending on the state, that date can range from August 24 to mid September. The vaccine isn’t scheduled to arrive until the middle of October. If cases begin to appear as predicted, the virus may have at least one month’s head start.

The H1N1 virus is a bit different in that it seems to target younger people, which make schools perfect spreading grounds. However there is another factor that’s going to put both children and their parents at risk. America has been getting fatter and fatter, or to be more politically correct, more and more obese. We often think of young people, even young fat people as being healthy, perhaps not fit, but healthy. The dangers of obesity are generally viewed to come much later in life. However on 11 July, 2009, an advanced report from the CDC hinted that obesity may be emerging as a risk factor for flu complications and death.

The CDC report followed ten H1N1 cases admitted to the University of Michigan Health System hospital intensive care unit between May 26 and June 18, 2009. All 10 cases were severe enough to require the patients to be put on ventilators and six required treatment for acute renal failure. Of the 10 cases, 9 were obese (BMI > 30) and 7 of the 9 were extremely obese (BMI > 40). Of the 10 cases there were 3 deaths. All three deaths involved obese patients and 2 of the 3 were extremely obese. The least obese of the 3 had asthma as an underlying condition and was age 28. The other 2 patients had no underlying medical conditions and were aged 43 and 44. Of the 7 that lived, the report goes to say, none have fully recovered.

The CDC report fell well short of a blanket statement suggesting that obesity is an independent risk factor associated with more severe complications; noting that in previous flu outbreaks, obesity had not be identified as a risk factor. However, in the editorial note the accompanied the report, the CDC observed “the high prevalence of obesity in this case series is striking.”

The same report also suggests that doctors can double the normally prescribed does of Tamiflu (Roche AG) without any additional risks, but stopped short of saying that higher doses should be used in obese patients. Dr. Tim Uyeki, a CDC influenza expert, also noted that, as with H5N1, patients seem to do better when given Tamiflu for periods longer than the recommended five-days.

Current CDC guidance ( is that adults receive 75 mg, twice a day for 5 days, for treatment or 75 mg, once a day, for prophylaxis. Dosing for children less than 40 kg is weight specific. All ten patients in the above mentioned report received both larger doses of Tamiflu and extended dosing as part of their treatment.

It looks like we now have one more reason to start that diet we have been putting off; and with flu season rapidly approaching, now is as good a time as any to start shedding kilos.

Happy dieting.

The full CDC, July 10, 2009 MMWR Dispatch can be found at:


  • to pour water (over) – polévat vodou
  • to confirm – potvrdit
  • to kill – zabíjet
  • to expect – očekávat, předpokládat, domnívat se
  • resurgence – obnova, oživení
  • estimates – odhady
  • availability – dostupnost
  • uncomfortably – nepohodlně
  • proximity – blízkost
  • to coincide – shodovat se (časově)
  • depending on – v závislosti na
  • to spread – rozšiřovat (se)
  • to emerge – objevovat se, vynořovat se
  • to hint  – naznačovat (co)
  • underlying – zásadní, výchozí
  • recovered – obnovený, zotavený
  • to suggest – navrhovat; doporučovat
  • outbreak – propuknutí
  • accompanied – doprovázený
  • striking – pozoruhodný, markantní, překvapivý
  • additional – dodatečný, navíc
  • dosing – dávkování
  • to mention – zmínit, uvést
  • reason – důvod, příčina
  • approaching – blížící, přibližující
  • to shed – shazovat

                                                                                                   About Tom Secrest / Tom Secrest online



Pokud ještě nemáte přístupové údaje, můžete se registrovat.