
How Does the Flu Kill People? - digital55
https://www.scientificamerican.com/article/how-does-the-flu-actually-kill-people/
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toomanybeersies
A few years back I got the flu, I think I was 16 or 17 at the time, I was
healthy and in good shape before I got it.

I was literally bed bound for 3 or 4 days, it was a struggle to make it to the
toilet and back to bed. I was sweating so much that my pillow and sheets were
soaked. I think the worst part was actually the muscle aches, it wasn't
painful but it was constant and unrelenting.

I was quite amazed at how violently it struck me down. There aren't many
common diseases these days that will actually strike someone down in a
developed country.

In retrospect it may have been a good idea to go to the doctor, especially
after reading this article. Instead my parents left me at home to sleep it out
and drink lots of lemon and honey, which is actually a completely ineffective
cure.

~~~
baddox
Same thing happened to me in college when I was 21. Two days nearly completely
bedridden and coughing so hard I thought I was bursting blood vessels.

I did manage to make it down the block to the college clinic, where they
verified that I was their first influenza case of the season, prescribed me
some cough syrup, and told me to take way more ibuprofen than it says on the
bottle.

I was disappointed at the prescription, but after my first dose I was as happy
and energetic as if ever been. Turns out the “cough syrup” was hydrocodone in
corn syrup. Powerful stuff.

~~~
caf
Opiates are cough suppressants.. which is also why in large enough doses,
they're breathing suppressants.

~~~
epmaybe
That's not why they're breathing suppressants...opioids work at a part in our
brainstem that modulates our breathing rate, slowing it down. You still
breath, just less times per minute. That can be really bad for obvious
reasons.

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EngineerBetter
Why do so many US articles sound like a story frim Grandpa Simpson?

"It was a cold Wednesday, with the wind blowing from the north..."

I'm curious if this is commonplace, and if its native audience find it irksome
in the online medium. I can understand this style in print, but very often I
click an HN link, and hit back before finishing the first paragraph as it
becomes clear the article is not written in the pyramid style.

~~~
toomanybeersies
It's the new standard for long form writing. They're trying to craft a story
to keep the reader interested, they're trying to make it more human.

~~~
nitwit005
Which, in turn, has resulted in people learning to automatically skip several
paragraphs of text, much like how people skip the intro portions of YouTube
videos.

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tomohawk
The 1918 Flu Pandemic generally killed the youngest and healthiest. The theory
is that that strain caused a larger immune response than typical flus, making
it much deadlier.

~~~
mindlar
The 1918 flu pandemic also came at the tail end of World War 1, when the
youngest and healthiest were in incredibly close proximity and likely had
compromised immune systems from a few years of warfare.

~~~
walshemj
And people had had less food than normal Germany especially had major food
shortages.

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caf
2017's flu season in the southern hemisphere was pretty bad - it hit teenagers
and young adults more than usual. If the same strains are going to be active
in this year's northern hemisphere season, I'd strongly recommend getting the
vaccine.

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rubicon33
I JUST recovered from the flu (yesterday was my first day without fever). At
it's worst, 102 degrees under a pile of warm blankets, with thermal underwear
and sweatpants on. Was still cold.

I hesitated on taking medication to treat the symptoms because my
understanding is that a fever is your body's way of fighting the virus. I let
it run its course for a few days, before I started taking Ib Profin which was
a SILVER BULLET for breaking the fever. Within 30 minutes of taking it (800) I
was back to normal temp.

I wonder if I had taken Ib Profin from the start, would I have been stifling
my bodies natural ability to defeat the virus? Would I have potentially
increased my risk for developing secondary disorders as a result of the
infection? I can't help but feel like letting your body run it's course (while
being safe) is the best way to go... I am not a doctor, nor a virologist.

~~~
pmarreck
[http://rspb.royalsocietypublishing.org/content/281/1778/2013...](http://rspb.royalsocietypublishing.org/content/281/1778/20132570)

Some evidence seems to indicate you did the right thing. Anecdote: I do the
same thing now (embrace the fever); I let my body overheat; I’m convinced it
shortens the total suffering

~~~
lloydde
Did you mean to link to an articulate that leads with the benefit to the
individual is disputed and then focuses on the benefits to the herd?

~~~
pmarreck
I guess so? I believe the comment I was responding to claimed the
positive/negative effect of antipyretic medications was nebulous; I at least
found something that showed that was not the case

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FreeFull
If the problem is with the immune system reacting too strongly, could
suppressing the immune system potentially help? Of course, you'd probably want
to combine that with antibiotics, to fight any secondary infections that could
develop.

~~~
arkades
Modern biologic immunomodulators have shown no benefit in survival in systemic
inflammatory response syndrome. Steroids have not been assessed in SIRS
specifically, though hey have been in sepsis and septic shock, where high dose
steroids have been harmful and low dose steroids have been beneficial.

It’s tough lobbing immunosuppressants at people with a rampant infection.

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simonswords82
TL;DR:

Based on autopsy studies about one third of people who die from flu-related
causes expire because the virus overwhelms the immune system; another third
die from the immune response to secondary bacterial infections, usually in the
lungs; and the remaining third perish due to the failure of one or more other
organs.

~~~
nkrumm
> and the remaining third perish due to the failure of one or more other
> organs.

One of these organs is the heart-- the seasonal variation in influenza
actually overlaps with an increase in acute myocardial infarction (AMI, or a
'heart attack'). Recent meta analysis has shown an odds ratio of ~2 for AMI in
the setting of influenza.

Mechanistically, there is a suspected link between the virus and inflammatory
changes in the blood vessels supplying the heart that destabilizes existing
atherosclerotic plaques.

More here:
[http://heart.bmj.com/content/101/21/1738](http://heart.bmj.com/content/101/21/1738)
[http://www.sciencedirect.com/science/article/pii/S1473309909...](http://www.sciencedirect.com/science/article/pii/S1473309909702336)

Edit: The article mentions (viral) myocarditis as a sequelao f the flu-- this
can also happen, but is separate from AMI

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gadders
I've often wondered this. Interesting article.

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lkrubner
In 2015 I did my longest fast ever. I went 12 days without food -- just water.
I felt surprisingly normal for the first 7 days. After that I felt weaker and
weaker. The weakness very much reminded me of the experience of having the
flu. By the final day it felt as if I really did have the flu, though those
symptoms would come and go, and disappeared quickly after I finally had some
food.

The conclusion I draw from this is that some of the symptoms that we associate
with viruses actually comes from the under-production of our normal enzymes.
If you go 12 days without food, then your body starts to run out of the
protein needed to make normal, everyday enzymes. And when a virus hijacks the
machinery of your cells, and forces those cells to make virus proteins, the
cells under produce the normal, everyday enzymes that are needed to live. And
the symptoms of both experiences are very similar. So this aspect of a virus
needs more study -- what is the result of not producing normal, everyday
enzymes?

~~~
duozerk
Out of curiosity, beyond the weakness, how painful / unpleasant was the
experience ?

I've read in an account collated from a hunger strike participant that
starving is a bit unpleasant the first few days and then pretty much OK (which
I was pretty skeptical of); albeit apparently the more overweight you are
initially the more unpleasant and painful it is, at first at least. Although
of course 12 days is comparatively short. I'm still curious if you have
anything to comment on this description though ?

I believe the source where I've read this account was here:
[https://books.google.fr/books?id=ipQDHj1aAe4C&pg=PA111&lpg=P...](https://books.google.fr/books?id=ipQDHj1aAe4C&pg=PA111&lpg=PA111)
. It's a fascinating, if a bit morbid, read. The guy stopped eating for 68
days, and ended up weighting 44kg.

~~~
lkrubner
As an example, on the 11th day, I decided to go to the Verizon store and get a
new iPhone, because my old iPhone was having problems. So I walked to the
iPhone store. I felt very weak, and I was sweating. The experience was
surprising because I'd gone for a long walk on the 7th day and I'd felt fine.
But by the 11th day, on a long walk, I felt like I was walking up a steep
hill, even though I was walking on flat terrain. At the Verizon store I
appeared normal and I had a good conversation with the sales clerk. Then I
walked towards home. I felt much weaker on the way home. I stopped to buy
water at a connivence store. The sales clerk asked if I was okay. I explained
that I was sick. She said I looked sick.

I walked a total of 8 kilometers, which isn't much, but it felt like a serious
hike. I felt very sick that night, and I fell asleep early and I slept for 12
hours.

But when I woke up in the morning, I felt good. I had energy and mental focus.
And then that faded away over the course of the day. Which is the other thing
about a long fast -- you still have good stretches, even after 12 days, but
they become increasingly rare.

I think those people who go 2 weeks without food and then claim they feel
great are simply taking for granted the fact that they are resting a great
deal, and they expect you to take it for granted as well. Nobody goes 2 weeks
without food and continues to have the same energy level, sustained over an
entire day, as someone healthy who is eating normally.

~~~
duozerk
Thank you for your response. I imagine in the case of a hunger strike in
prison - which the above testimony was about - the fact that you're basically
not moving all day must help with the weakness (not to mention slow down the
actual starving due to lack of calories burning).

