WHO and CDC info. on Swine Flu

[bluedawg12]

This may be of interest to some and the sites are good sources to monitor for up dates.

Also, within the CDC website there is further information about caring for sick/infected people in your home.

Swine influenza

http://www.who.int/mediacentre/news/statements/2009/h1n1_20090425/en/index.html

Swine influenza

Current WHO phase of pandemic alert

International Health Regulations (IHR)

In response to cases of swine influenza A(H1N1), reported in Mexico and the United States of America, the Director-General convened a meeting of the Emergency Committee to assess the situation and advise her on appropriate responses.

The establishment of the Committee, which is composed of international experts in a variety of disciplines, is in compliance with the International Health Regulations (2005).

The first meeting of the Emergency Committee was held on Saturday 25 April 2009.

After reviewing available data on the current situation, Committee members identified a number of gaps in knowledge about the clinical features, epidemiology, and virology of reported cases and the appropriate responses.

The Committee advised that answers to several specific questions were needed to facilitate its work.

The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.

Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations.

Concerning public health measures, in line with the Regulations the Director-General is recommending, on the advice of the Committee, that all countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia.

The Committee further agreed that more information is needed before a decision could be made concerning the appropriateness of the current phase 3.

http://www.cdc.gov/swineflu/investigation.htm

Human Swine Influenza Investigation
April 25, 2009 19:30 EDT

Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S. in San Diego County and Imperial County, California as well as in San Antonio, Texas. Internationally, human cases of swine influenza A (H1N1) virus infection have been identified in Mexico.

U.S. Human Cases of Swine Flu Infection
State # of laboratory
confirmed cases
California 7 cases
Texas 2 cases
Kansas 2 cases
TOTAL COUNT 11 cases
International Human Cases of Swine Flu Infection
See: World Health Organization
As of April 25th, 2009 7:30 p.m. EDT


Investigations are ongoing to determine the source of the infection and whether additional people have been infected with similar swine influenza viruses.

CDC is working very closely with state and local officials in California, Texas, as well as with health officials in Mexico, Canada and the World Health Organization. On April 24th, CDC deployed 7 epidemiologists to San Diego County, California and Imperial County, California and 1 senior medical officer to Texas to provide guidance and technical support for the ongoing epidemiologic field investigations. CDC has also deployed to Mexico 1 medical officer and 1 senior expert who are part of a global team that is responding to the outbreak of respiratory illnesses in Mexico.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. There are many things you can to do preventing getting and spreading influenza:

There are everyday actions people can take to stay healthy.

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
Avoid touching your eyes, nose or mouth. Germs spread that way.
Try to avoid close contact with sick people.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Clinicians
Clinicians should consider the possibility of swine influenza virus infections in patients presenting with febrile respiratory illness who:

Live in San Diego County or Imperial County, California or San Antonio, Texas or
Have traveled to San Diego and/or Imperial County, California or San Antonio, Texas or
Have been in contact with ill persons from these areas in the 7 days prior to their illness onset.
If swine flu is suspected, clinicians should obtain a respiratory swab for swine influenza testing and place it in a refrigerator (not a freezer). Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory.

State Public Health Laboratories
Laboratories should send all unsubtypable influenza A specimens as soon as possible to the Viral Surveillance and Diagnostic Branch of the CDC’s Influenza Division for further diagnostic testing.

[seemslikeadream]

1. thank you

[bluedawg12]

2. Your very welcome. Here is more info. about Mexico's situation.

http://www.webmd.com/cold-and-flu/news/20090424/mexico-swine-flu-epidemic-worries-world
Mexico Swine Flu Epidemic Worries World
Swine Flu Deaths in Healthy Young People Raise Fears of Pandemic
By Daniel J. DeNoon
WebMD Health NewsReviewed by Louise Chang, MDApril 24, 2009 -- Mexico's deadly swine flu outbreak is caused by the same virus identified in the U.S., says CDC Acting Director Richard Besser, MD.

The CDC is analyzing 14 virus samples sent from Mexico. Seven of them, the CDC learned today, are very similar to the unusual swine flu strain isolated from U.S. patients.


"People are concerned about this situation," Besser said at a news conference. "We are worried as well. Our concern has grown since yesterday."

Sixty people in Mexico have died of the flu -- and so far, 16 of the deaths are confirmed cases of swine flu, news sources quote Mexican officials as saying.

World Health Organization spokesman Gregory Hartl told the Canadian news agency CBC that there have been some 800 cases in Mexico City, where schools are closed due to the outbreak.

Alarmingly, the flu outbreak in Mexico is striking healthy young people -- a pattern that would be expected if a flu virus new to humans emerged.

<snip>

A pandemic will be declared only if there is "efficient and sustained human-to-human transmission" of a new flu virus. That clearly has not happened yet.

"Whether or not this strain causes a widespread pandemic will depend on its transmissibility among humans. That has not yet been fully elucidated, but should be shortly," Pascal James Imperato, MD, MPH, professor and dean of public health at SUNY Downstate Medical Center, Brooklyn, N.Y., tells WebMD.

Should there be a pandemic -- something that is far from certain -- the CDC has already begun work on a vaccine. Would it be ready by next flu season?

"It would be an Olympic sprint -- a mammoth feat -- to produce a flu vaccine by October," Schaffner says.

Read more...

[chimpyisstillsatan]

3. Perspective please. How does this compare to the previous outbreaks last year?

http://www.google.org/about/flutrends/how.html

[Joe the Revelator]

4. Well for one, its a rare summer flu with a 7% mortality rate

That, on its surface, is what makes it different then last year.

[bluedawg12]

5. This one is striking healthy young people - usually it's the very young

and very old people who are most susceptible.

I don't remember anything like what's going on in Mexico now, going on last year.

The President of Mexico has canceled all public gatherings for the next ten days, it's being taken pretty seriously down there.

It's spread far, from Mexico, now, to NY.

[Joe the Revelator]

6. Cytokine Storms

Essentially, the stronger your autoimmune system, the more it overreacts, and typically your lungs are overwhelmed by a flood of antibodies.

[bluedawg12]

7. Interesting! Any links to research? n/t

[Joe the Revelator]

8. Some good basic information and links here

http://www.fluwikie.com/index.php?n=Science.PrimerCytokineStorm

[bluedawg12]

10. Thank you-- I will check it out!

[stray cat]

15. review in NEJM or pubmed.org search

http://content.nejm.org/cgi/content/full/352/18/1839

[bluedawg12]

20. Thanks! That explains the inflammatory response from cytokines nicely and good overview of flu.

That would explain the rationale for using cortico steroids in treatment of ARDS.

http://jmm.sgmjournals.org/cgi/content/abstract/56/7/875

IMMEDIATE OPEN ACCESS ARTICLE
J Med Microbiol 56 (2007), 875-883; DOI: 10.1099/jmm.0.47124-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Review

A rationale for using steroids in the treatment of severe cases of H5N1 avian influenza
Marissa J. Carter
Strategic Solutions, Inc., 1143 Salsbury Ave, Cody, WY 82414, USA

Correspondence
Marissa J. Carter

Received 15 December 2006
Accepted 23 March 2007


Acute hypercytokinaemia represents an imbalance of pro-inflammatory and anti-inflammatory cytokines, and is believed to be responsible for the development of acute respiratory distress syndrome and multiple organ failure in severe cases of avian (H5N1) influenza. Although neuraminidase inhibitors are effective in treating avian influenza, especially if given within 48 h of infection, it is harder to prevent the resultant hypercytokinaemia from developing if the patient does not seek timely medical assistance. Steroids have been used for many decades in a wide variety of inflammatory conditions in which hypercytokinaemia plays a role, such as sepsis and viral infections, including severe acquired respiratory syndromes and avian influenza. However, to date, the results have been mixed. Part of the reason for the discrepancies might be the lack of understanding that low doses are required to prevent mortality in cases of adrenal insufficiency. Adrenal insufficiency, as defined in the sepsis/shock literature, is a plasma cortisol rise of at least 9 µg dl–1 following a 250 µg dose of adrenocorticotropin hormone (ACTH), or reaching a plasma cortisol concentration of >25 µg dl–1 following a 1–2 µg dose of ACTH. In addition, in the case of hypercytokinaemia induced by potent viruses, such as H5N1, systemic inflammation-induced, acquired glucocorticoid resistance is likely to be present. Adrenal insufficiency can be overcome, however, with prolonged (7–10 or more days) supraphysiological steroid treatment at a sufficiently high dose to address the excess activation of NF-B, but low enough to avoid immune suppression. This is a much lower dose than has been typically used to treat avian influenza patients. Although steroids cannot be used as a monotherapy in the treatment of avian influenza, there might be a potential role for their use as an adjunct treatment to antiviral therapy if appropriate dosages can be determined. In this paper, likely mechanisms of adrenal insufficiency are discussed, drawing from a broad background of literature sources.
...........

[chimpyisstillsatan]

9. Get some sleep,

It's the best defense outside of quarantine.

We are at the tail end of late Winter, and flu is not uncommon in April.

The swine flu numbers should be taken seriously, as should any zoonotic infection. Swine flus happen, and usually peter out. This one does not yet warrant the reactions I see here and elsewhere.

I'll worry only if transmission of the same virus is demonstrated across a braod geographic area, and the rate of transmission increases to indicate acquisition of increased virulence. Until then, this is an anomaly among flu outbreaks and nothing more.

[bluedawg12]

11. They have done the gene sequencing between the Mexican virus

and those found in the US and they are a match.

The rate of spread seems modest to the north, but wide spread. From Mexico to NY now.

Of course the border States are at greatest risk and Kansas. Poor little, what's the matter with Kansas? heh heh

[Bluebear]

12. and New Zealand now. :(

http://www.timesonline.co.uk/tol/news/uk/health/article6171388.ece

[chimpyisstillsatan]

14. looks like good public health practices implemented, though.

this will be interesting to watch.

[chimpyisstillsatan]

13. Interesting. Can you post a link to that for me?

Flu trivia: Kansas was a key source of 1918 virus. But it was a staging area for WWI theater troops back then.

[bluedawg12]

21. Here is a print media source from San Antonio, Tx.

I originally heard it mentioned by a CDC spokes person on one of the news nets.

That's interesting about Kansas, makes sense about troops staging in WWI.

This spread is interesting because they are still working on linking exposure victims to contact sources, as of this article.

>>>
http://www.mysanantonio.com/news/local_news/San_Antonios_swine_flu_strain_matches_Mexicos.html
S.A. swine flu matches Mexico's

Air Force officials said the two 16-year-old boys were military dependents who attend Steele High School in Cibolo and were treated at a clinic at Randolph AFB for flulike illness they suffered roughly from April 10-14.

Throat cultures from suspected flu cases on military bases around the world are routinely tested by the Defense Department's Global Influenza Surveillance Program at Brooks City-Base, which determined the strain was unusual. The cultures were flown by chartered jet earlier this week to the CDC's laboratory in Atlanta, where it was identified as swine flu.

Neither boy had any travel history to California or Mexico, health officials say. Other family members and friends are being interviewed and tested.

<snip>
Dr. Paul Glezen with the Influenza Research Center at Baylor College of Medicine in Houston said conversations with a colleague in San Luis Potosi, between Monterrey and Mexico City, suggested the outbreak had pushed northward.

Glezen said that although the new strain originated in pigs and has a different genetic structure from seasonal human flu — even though it's from the same A/H1N1 family of flu viruses as a flu strain that circulated this past season — it will require more research to learn how dangerous it is.

“The extent of it will depend on whether a lot of people in our population have some immunity to this virus, or if they have no immunity,” Glezen said. “It can make a lot of difference in what could happen. It would be premature to make any predictions, but it's worrisome — the fact they're seeing disease in young adults, and some of it fatal, in Mexico.”

Besser said the federal lab had only been able to examine a piece of the virus's genetic sequence, but that it matched seven samples of the virus from Mexico. “From everything we know to date, the virus appears to be the same.”

The good news is two common antiviral drugs, Tamiflu and Relenza, seem to reduce the severity of the disease. And Besser said doctors in the San Antonio area should be alert to flu symptoms and consider swine flu. Sanchez said that the regular flu season was almost over for San Antonio this year.

Besser said health officials have so far been able to find no threads linking the eight U.S. cases, but that it was still early in the investigation.

<snip><<<

[Lyric]

22. The 1918 flu was the same way.

This is the theory I heard:

1918 flu came in two waves--the first one was mild, and the very young and elderly were the ones most affected, with healthy young adults the least affected. When the second, MUCH more dangerous wave of flu went around, the only people with any immunity to it were the very young and the very old--those who'd gotten sick during the mild first wave. The young, healthy adults who'd avoided catching it the first time, and who therefore had NO immunity to it, caught it the second time when it had gotten more dangerous and died at MUCH higher rates than children and the elderly.

I'm not really panicked, though, even as a "young, healthy adult." That was 1918--medical science has come a LONG way since then. The most common cause of influenza-related death back then was secondary bacterial pneumonia. They didn't have the antibiotics and other supportive medications, procedures, and supplies to treat it back then. We DO. We aren't going to see another 1918-like pandemic, at least not here in the USA, because we have medicines to treat the pneumonia. Even if it goes full pandemic, we won't have many deaths--just a lot of miserable, sick people, a lot of panic, and a lot of lost productivity as everything shuts down for fear of the flu.

The death toll in other, less-advanced nations is going to be awful if this thing goes pandemic, though. I feel so horrible for the poor of places like Mexico, China, India, the African nations, and the poor South/Central American countries. We need to start making plans NOW to beef up antibiotic production and other supportive medications and supplies to send as aid, in order to fight secondary bacterial pneumonia--the biggest cause of death with influenza of ANY stripe.

If our pharmaceutical companies and our government act NOW, we have a chance to save much of the world--literally. Let's hope they do.

[bluedawg12]

26. Avalux has a great thread on how viruses behave, right here on GD. I agree

that we do have a chance to dump the anti-science right wing rhetoric and the right wings "War on Science" and where as the chimperator didnt wan't to "ask" pharmaceutical companies to make less profitable vaccines, free market you know :eyes: I bet President Obama is taking names and kicking butt when it comes to an issue like this and will urge more R&D and demand preparedness.

You mentioned the 1918 flu.

Well, it seems that 1918 shared something in common with this version of H1N1 flu.

Both create, what some just posted here and helped me understand, a strong host response that actually harms the host.

The virus triggers an over exuberant inflammatory response, the release of chemicals called cytokines, which then damage the lung tissue.

That's what seems to make this flu dangerous like other deadly outbreaks in the past.

Check this out,great discussion on viruses right here on GD!

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5537632&mesg_id=5537632

..........
Here is some info on the 1918 flu that you mentioned.

http://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1

Spanish Flu
Main article: Spanish Flu
The Spanish flu, also known as La Gripe Española, or La Pesadilla, was an unusually severe and deadly strain of avian influenza, a viral infectious disease, that killed some 50 million to 100 million people worldwide over about a year in 1918 and 1919. It is thought to have been one of the most deadly pandemics so far in human history. It was caused by the H1N1 type of influenza virus, which is similar to bird flu of today, mainly H5N1 and H5N2.

The Spanish flu caused an unusual number of deaths because it, like H5N1, caused a cytokine storm in the body. The virus infected lung cells, leading to overstimulation of the immune system via release of cytokine bursts into the lung tissue. This leads to extensive leukocyte migration towards the lungs, causing destruction of lung tissue and secretion of liquid into the lung, and making it difficult for the patient to breathe. Due to the nature of the infection, people with a normal healthy immune system were more susceptible to the disease, such as young adults compared to young children and the elderly.


Russian flu
See Influenza A virus subtype H2N2#Russian flu for the 1889-1890 Russian flu
The more recent Russian flu was a 1977-1978 flu epidemic caused by strain Influenza A/USSR/90/77 (H1N1). It infected mostly children and young adults under 23 because a similar strain was prevalent in 1947-57, causing most adults to have substantial immunity. Some have called it a flu pandemic but because it only affected the young it is not considered a true pandemic. The virus was included in the 1978-1979 influenza vaccine.<5><6><7><8>

[Avalux]

16. Your link tracks regular human influenza (flu).

This particular strain of influenza is H1N1, or swine influenza and it contains components of human and avian influenza. It's a unique strain that has emerged and appears to be easily transmitted from human to human - that's why there's concern.

BTW, H1N1 is the same virus that causes the 1918 flu pandemic.

[chimpyisstillsatan]

19. yes, but it offers perspective on numbers of patients...

and shows the many technologies we have for tracking outbreaks and taking measures ahead of the curve. This flu is still orders of magnitude below a typical winter flu.

H1N1 was indeed the 1918 agent. I was thinking of bird flu (H5N1)as more dangerous, since it's not been encountered widely in the population, meaning less endogenous protection from that strain, as has H1N1, and is therefore more likely to "go viral" on us.

[bluedawg12]

23. Interesting footnote: 10 pandemics of influenza A in the past 300 years.

This was written in 2005, when the boyEmperor anti-science guy was in charge. I expect that this is on President Obama's list of things to do, yesterday! No more moaning about the cost inefficiencies of making preventative vaccines, like "Mr.Unregulated, no leadership, cowboy, FreeMarket watch crises develope and be shocked" former emperor was prone to doing.


http://content.nejm.org/cgi/content/full/352/18/1839

"An influenza pandemic has always been a great global infectious-disease threat. There have been 10 pandemics of influenza A in the past 300 years. A recent analysis showed that the pandemic of 1918 and 1919 killed 50 million to 100 million people,1 and although its severity is often considered anomalous, the pandemic of 1830 through 1832 was similarly severe — it simply occurred when the world's population was smaller. Today, with a world population of 6.5 billion — more than three times that in 1918 — even a relatively "mild" pandemic could kill many millions of people.

<snip>

Is there anything we can do to avoid this course? The answer is a qualified yes that depends on how everyone, from world leaders to local elected officials, decides to respond. We need bold and timely leadership at the highest levels of the governments in the developed world; these governments must recognize the economic, security, and health threats posed by the next influenza pandemic and invest accordingly. The resources needed must be considered in the light of the eventual costs of failing to invest in such an effort. The loss of human life even in a mild pandemic will be devastating, and the cost of a world economy in shambles for several years can only be imagined.
"

[FedUpWithIt All]

17. The fact that these things are all labeled flu is causing a lot of confusion.

There is the seasonal HUMAN flu. It rolls around once a year. While it travels through humans it collects and swaps genes with other viruses and inherits new features. When it comes around the next year it is barely recognizable as last years old flu and usually a whole new vaccine needs to be created.

The type of virus being talked about now is a SWINE flu. It is almost always caught through human contact with an infected animal. As most know by now, This PARTICULAR VIRUS also has a bit of human and avian flu ATTACHED. This is a hybrid of sorts. This flu is being called swine flu because it has a majority swine flu makeup.

This "hybrid flu" typically happens when a single animal contracts multiple flu bugs. Certain species are able to cross infect other species. For example, pigs can infect a human with their species type of flu because we are similar.

If a pig contracts multiple flu strains (in this case human and avian in addition to it's own swine flu) they swap and create a new flu which has features of all of the combined flu bugs.

The flu commonly talked about on the news is the AVIAN flu. These can be nasty viruses. The thing is that they USUALLY require contact with an infected fowl. The reason everyone has heard so much about THIS type of flu is because there is a particularly vicious version of it going around right now overseas. It IS STILL only through bird contact, though. This has limited it's exposure ability. Some worry that it can change to a human to human virus. If that happens it WOULD BE VERY BAD as it is particularly deadly.

What it would take for the avian flu N5H1 to change to a human to human version is simply for an already sick (with a human to human virus) person to have unsafe contact with an infected bird. The two viruses could then swap features (genes). This has not happened.

The swine flu, we are currently speaking of, HAS become human to human. It is moving from person to person quite fast. We are still trying to figure out how dangerous it is (two different countries are showing two different rates of mortality)

One thing that concerns TPTB is that this human to human SWINE, AVIAN, HUMAN virus will continue to collect more features as it passes through each person. Some of the features may be LESS troublesome. Some may be more.

Time will tell and in the meantime, educating ourselves never hurts.

:hi:

[bluedawg12]

24. That was a fantastic and very clear explanation of various strains of flu

and how they change.

Absolutely spot on, educating ourselves is the way to go.

:hi:

[FedUpWithIt All]

28. Hey, thank you.

:hi:

[havocmom]

32. thanks for another helpful, informative post

You are an education for us and much appreciated.

[FedUpWithIt All]

18. Thank you for these links.

:hi:

[tofurkey]

25. These pandemics are inevitable

I recommend checking out Dr. Micheal Greger's works on the direct link between human flu and the domestication of animals/factory farming. His book Bird Flu: A Crisis of Our Own Hatching can be downloaded here for free http://birdflubook.com/g.php?id=5. He also does an amazing live presentation, some of which can be also be viewed at this link.

It's information everyone should familiarize themselves with, as it further drives home the dangers of our animal-based diet to our health.

[bluedawg12]

27. Thanks! I will check it out. The other thing is that when we save the life of the host

the virus is also allowed to live on and adapt.

If we let all of the folks who get adult respiratory distress syndrome die (ARDS) from the H1N1 infection die out, then, the virus would die out "in the wild," probably.

But we don't let infected people die out ( thankfully) and so we can expect new strains to keep re-emerging that have developed an adaptive resistences to the most recent anti-virals or vaccines.

Short of letting people and their parasit die out, if we understand this process, then, it becomes less mysterious why new version of old viruses seem better adapted to the last regimen.

[DainBramaged]

29. TOTAL COUNT 11 cases in the US, hmmmmmmmm

from what so many here were writing, it seemed the cases were in the HUNDREDS and we need to PANIC.

[itsrobert]

30. And everyone has recovered or is recoving in the US

Out of a population of 300,000,000 people.

[DainBramaged]

35. Shhhhhh you aren't supposed to be positive about this

the panic squad will descend on you. :rofl:

[bluedawg12]

37. Why gosh drainbrmage, you're not telling me I can't post info?

[bluedawg12]

31. 100's dead? Really?

I didn't see those on here today.

[DainBramaged]

33. Oh boy got to look the numbers yesterday were 200 dead in Mexico alone per the AP

or so they would lead us to believe. However, if you looked at the WHO numbers, they were not confirmed flu cases. TOO MUCH misinformation going on around here, and too much panic and attempts to create panic over this instead of just waiting to see what pans out.

[bluedawg12]

34. Why are you telling me about what "they" wrote? n/t

[DainBramaged]

36. Know what, never mind, I must be in the wrong thread.

I'll go where people aren't in an uproar over this.

[bluedawg12]

38. Yeah, you got a nice one going on this topic. right here on DU GD!

[readmoreoften]

40. "They" probably put him up to it, bluedawg... /nt

[bluedawg12]

43. "They" are everywhere! OMG!!11!!!11!! It's "they."

:rofl:

[DainBramaged]

41. Cya

"click"

I decided further discusions are unnecessary with you. Over anything.

[bluedawg12]

42. It's been a slice. n/t

[readmoreoften]

39. Oh noes! "They" are now leading us to believe the death toll is at 103.

"They" must have an ulterior motive if "They" are reporting on this as much as "They" report on Brittney Spears and American Idol.

http://news.yahoo.com/s/nm/20090427/ts_nm/us_flu

[bluedawg12]

44. ...

:evilgrin:

[DainBramaged]

45. Yesterday, it was 200, and there are links on DU to the AP story

and what is the true information, and what is bullshit? And how much did any of us discuss the torture report and the release of the upcoming photos? Not at all. This has pushed all other news off the front pages.


Think about it a bit before you succumb to the ooze.

Buh Bye

[bluedawg12]

46. Adios! n/t

[bluedawg12]

47. Understanding "cytokine storm."

The history of this particular swine flu outbreak as it related to Mexico, is that people with a normal healthy immune response died.

That's what made it so unusual.

That got turned into phraseology in the media as having a "strong immune system."

The way I understand it is that the young people who died in Mexico had a normal immune system. That this particular strain of virus then causes a normal immune system to liberate agents called "cytokines."

This illustration from the New England Journal of Medicine shows in a schamtic way where cytokines come from.



They are released normally as part of the immune response. Cytokines come from Macrohpages (clean up cells), T cells and epithelial cells.

If cytokines are released in response to a virus in a way that is imbalanced, the cytokines themselves create inflammation.

Think of a bee sting, the first response is redness, swelling, warmth and itching (and pain), those are inflammatory responses. When the imbalance in an immune response occurs between pro-inflammatory and anti-inflammatory cytokines, then a respiratory condition called ARDS, or adult repsiratory distress syndrome occurs. That is part of the lethality of the cytokine storm, the response in the lungs. One of the treatments for ARDS actually includes steroids, to lower the inflammatory response. That in addition to other life support measures, such as fluid, ventilation, antibiotics for secondary infection and IV fluids.

>>Inflammation
For more details on this topic, see Inflammation.
Inflammation is one of the first responses of the immune system to infection.<19> The symptoms of inflammation are redness and swelling, which are caused by increased blood flow into a tissue. Inflammation is produced by eicosanoids and cytokines, which are released by injured or infected cells. Eicosanoids include prostaglandins that produce fever and the dilation of blood vessels associated with inflammation, and leukotrienes that attract certain white blood cells (leukocytes).<20><21> Common cytokines include interleukins that are responsible for communication between white blood cells; chemokines that promote chemotaxis; and interferons that have anti-viral effects, such as shutting down protein synthesis in the host cell.<22> Growth factors and cytotoxic factors may also be released. These cytokines and other chemicals recruit immune cells to the site of infection and promote healing of any damaged tissue following the removal of pathogens.<< (1)

Cytokine storm:

“Acute hypercytokinaemia represents an imbalance of pro-inflammatory and anti-inflammatory cytokines, and is believed to be responsible for the development of acute respiratory distress syndrome and multiple organ failure in severe cases of avian (H5N1) influenza.”(2)

Although in some of the more potent viruses such as, H5N1 (avian flu) the body may actually become resistant to steroid treatment.

“In the case of hypercytokinaemia induced by potent viruses, such as H5N1, systemic inflammation-induced, acquired glucocorticoid resistance is likely to be present.” (2)

(1)http://en.wikipedia.org/wiki/Immune_system

(2)J Med Microbiol 56 (2007), 875-883; DOI: 10.1099/jmm.0.47124-0
Review
A rationale for using steroids in the treatment of severe cases of H5N1 avian influenza
Marissa J. Carter
Strategic Solutions, Inc., 1143 Salsbury Ave, Cody, WY 82414, USA