Earlier this week it was reported the the second U.S. death from Swine Flu had occured in a woman with "underlying medical conditions". I must say this got my radar up. I did some research and have found several reports indicating that the "underlying" condition was RA. It does not say she was on a biologic agent but I would presume so. I am on
Enbrel and wondering how nervous I have a right to be. I work in a hospital.
Hi June,
I have been wondering the same thing for a few weeks. I have read everything from "the sky is falling" to "just ignore it and hope it goes away." I have boiled it down to two main camps. 1. The lowered immune system is a GOOD thing because some of the damage done to the body due to swine flu is from a young healthy immune system over-reating to the infection. I found some of this info on a CDC message board. 2. This is the one I am going to follow, if you have a lowered immune system, you and your doc need to be MORE vigilant about signs and symptoms of the flu. Here is a really good article I recently read about it. http://www.mskreport.com/articles.cfm?articleID=3334
Hope that helps.
Brad
Yes, I too find this very worrisome. There is an article from today, http://www.msnbc.msn.com/id/30398682/ that also mentions that the 33 year old woman from Texas had RA. The article goes on to quote an official from the CDC who states that this flu may be transmitted both through respiratory secretions and by the fecal-oral route. Which means that this is a pretty darn contagious flu.
From my reading of the CDC information and other reports, it appears that by having RA were are more susceptible to catching the flu. If we are on immunosuppresants, that increases our risk. If we are under the age of fifty and we do get the flu, perhaps being on immunosuppresants might protect us from going into a "cytokine storm" which is what has caused some of the deaths in apparently healthy young people. But on the other hand, if we are too immunosuppressed, we may not be able to fight it off.
Any flu is potentially serious if you have an underlying health condition. So I think we all need to be vigilent about hand-washing, avoiding crowds in enclosed spaces with others who potentially may be shredding virus. And if you haven't been vaccinated for pneumonia, I would ask my doctor about that, since pneumonia can be a life-threatening complication of any respiratory flu.
Shoot. And we had just gotten through the winter cold and flu season. Hopefullly as warmer weather comes and schools are out for the summer, that will help this strain die out. But as the officials warn, it may come back this winter and could be even more virulent then. On a more optimistic note, perhaps all the press on this flu will help people develop better habits around hand-washing and staying home when sick. We can hope any way.
Hi Josephine,
I'm a 45 year old women who was diagnosed with ra 9 yrs ago. Your photo hit home (your cat, I have 5), I don't know anyone else with ra, have only been taking 2 dmards, and have not had any severe problems, unless you count a very ugly bunion! If you know of any online ra chats, or if you would be interested in emailing, please let me know. Thanks
The woman in Texas who died was also pregnant - which I have read also immunosuppresses you (so your body doesn't reject the pregnancy) (which is why some women with RA improve while they're pregnant, and relapse afterward).
However, I think if the flu comes close and/or I have symptoms, I would try to back off from my TNF blocker (Enbrel injections) until I was over it - if it's only a couple of days, that shouldn't be a horribly big deal. But with another medication with a longer half-life, it might be more difficult to do that, if you weren't scheduled for another IV or whatever.
The other option might be to check with the rheumatologist as soon as you thought you might have the flu or have been seriously exposed - maybe they would give you Tamiflu, especially if you have lung problems (RA gives some people pulmonary fibrosis). It's also the bacterial infections that may follow the flu that could put you at risk. In any event, you can or should have had a pneumovax shot (bacterial pneumonia vaccination - my rheumy insists on it - only has to be given every 5 years).
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Thanks for the article link, Brad - I've been half-expecting something like that, but other people keep saying don't look for trouble (people without RA, that is!) I always look for trouble - I want to spot it before it spots me! (LOL, but true)
Ellen