Obesity risk in swine flu confirmed by research

Adviser says vulnerable groups including diabetics and the overweight should be given drugs at the first sign of influenza.

August 26, 2009 / Abu Dhabi / (Rich-Joseph Facun / The National) Renor Riza (CQ), center, a nurse at the Philippine National School, checks the temperature of each student prior to their entrance into the classroom in an effort to try and spot any early stages of swine flu, Wednesday, August 26, 2009 in Abu Dhabi.   *** Local Caption ***  rjf-0826-filipinoschool005.jpg
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Abu Dhabi // French researchers have shown that people who are obese or diabetic are significantly more vulnerable to the swine flu virus than other people. The study by the French Institute for Public Health Surveillance found that either diabetes or obesity was present in more than a quarter of patients with an underlying disease who died of H1N1.

These metabolic syndromes affect a significant portion of the UAE's population. Official figures released earlier this year by the Ministry of Health showed that 68 per cent of people living in the UAE were overweight or obese. The ministry's survey also showed that about 18 per cent of people in the UAE have diabetes, and a further 12 per cent are borderline diabetics. The World Health Organisation (WHO) issued a stark warning on Friday about a second wave of the swine flu pandemic and the dangers posed by chronic diseases such as asthma and diabetes.

Obesity, which is now a global epidemic, was "frequently present in severe and fatal cases", it said. A special adviser for the Eastern Mediterranean office of the WHO said that in the light of continuing research into risk factors, governments needed to change their approach to H1N1. Dr Zuhair Hallaj said countries should implement strict procedures for potential H1N1 cases where there were also notable risk factors. Any patient with a chronic illness who reported influenza-like symptoms should be treated as a severe cases from the onset.

"They should be treated with Tamiflu at the very beginning," he said yesterday. "Usually if they are treated the risk is very low. The problem would be if these people got the flu or something similar thought it was something minor and did not visit a physician. "Of course not all these people would have complications, but a certain percentage certainly would." Dr Hallaj said those without underlying conditions who develop flu-like symptoms should stay at home and rest. They would be risking antibiotic resistance in the future and unnecessary side-effects from medication if they automatically sought treatment and took anti-flu drugs. "We have been getting flu since we were five or six years old and we didn't take Tamiflu every year did we? The best treatment for healthy people is rest," Dr Hallaj said. Because of the climate in the UAE and many other Gulf countries, the region had yet to experience the full force of the first wave of the pandemic, he said.

"I don't expect this to happen until around October and November when people start to socialise a lot more as the weather cools." Individual figures for the number of cases in the UAE have not been released by the Ministry of Health. The obesity study, which was published in the medical journal Eurosurveillance, examined the characteristics of 574 deaths associated with the virus since the start of the global outbreak until the middle of July. It identified pregnancy and obesity as two major risk factors. It added, however, that the question of obesity needed to be analysed further to determine whether it played "a specific role in the pathogenesis of severe influenza H1N1 infection" or contributed to risk in some less direct way.

According to the researchers, the presence or absence of underlying disease was documented for 53 per cent of the cases with individual data. Of the 53 per cent, 90 per cent had an underlying disease. Diabetes and obesity were the most frequently identified underlying conditions, researchers said. The report said: "The pandemic, however, is far from over, and deaths will unfortunately continue to occur."