- Ivano-Frankivsk Oblast
- All the six dead young people had symptoms of severe
hemorrhagic pneumonia. The disease starts slowly, with temperature rising
to 37.2 - 37.3 degrees, slight cough and pain in joints. Nasal catarrh
developed at the end of the second or third day. Autopsy revealed that
the lungs were soaked with blood, the oblast chief specialist said.
- The above comments are from an early story describing
cases in Ukraine. The clustering of hemorrhagic cases raised concerns.
The concern was increased by anecdotal reports citing a high frequency
of such cases in Lviv. The recent WHO announcement that they were initially
focusing of severe acute respiratory illness in Lviv also increased concerns.
- Hemorrhagic pneumonia was also observed in the 1918 pandemic
and was thought to be linked to cytokine storm. Consequently, those with
robust immune systems (previously health young adults) disproportionately
died, which has also been seen in the current outbreak. However, the cases
in Ukraine appear to be clustered, raising concerns that the virus has
- However, the change may be minor, since the current H1N1
has produced the above symptoms in current cases. More severe cases may
be linked to a higher viral load, which could be linked to minor genetic
changes, or simply due to concentration of virus in schools. In the US
the spread of the virus has been linked to school openings, which lead
to an explosion of cases and subsequent student deaths. However, now there
are increases in fatalities in teachers and administrators, increasing
- In Ukraine, weather changes and heating issues may have
led to a surge in cases, and increased concentrations of virus could have
produced conditions favoring high viral loads and increased cytokine storms.
- Samples have been sent to Mill Hill, and sequence data
should be released shortly. Similarly, investigations on hemorrhagic pneumonia
in lviv should help resolve the mechanism for the high concentration of
such cases in western Ukraine.
- However, H1N1 spread in Kiev has been noted, and other
countries such as Belarus have announced additional H1N1 suspect or confirmed
fatalities. Sequence analysis of these cases and an update on the frequency
of hemorrhagic pneumonia in Ukraine and worldwide would be useful
- Henry L. Niman, Ph.D.
- President, Founder
- Recombinomics, Inc.
- 648 Field Club Road
- Pittsburgh, PA 15238
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