CHICAGO, Dec. 2 /PRNewswire/ -- Ordinary chest x-rays show distinctive
disease patterns of avian flu in humans that are good predictors of patient
survival, according to University of Oxford investigators. Their findings
indicate that patients with more severe x-ray appearances would benefit from
aggressive treatment earlier, giving them a better chance of survival. The
study was presented today at the annual meeting of the Radiological Society of
North America (RSNA).
"On chest x-rays in patients with avian flu, the most common abnormality
we found was multifocal consolidation, which usually represents pus and
infection in patients with fever and a cough," said Nagmi Qureshi, F.R.C.R., a
fellow of thoracic radiology at the University of Oxford in England. "We also
discovered that the severity of these findings turned out to be a good
predictor of patient mortality."
The investigators studied 98 x-rays of 14 patients admitted to Ho Chi Minh
City Hospital in Vietnam after testing positive for avian flu. They assessed
the x-rays for features commonly seen in chest infection and then looked for
associations between x-ray appearances and mortality. Of the 14 patients
studied, nine patients died and five survived.
Three of the five patients who survived underwent computed tomography (CT)
exams after discharge from the hospital. CT images showed that even though the
patients' respiratory symptoms had abated, the abnormal appearance of the
lungs persisted, suggestive of scar tissue formation.
Dr. Qureshi described the findings as similar to what was seen previously
in patients with severe acute respiratory syndrome (SARS). "The appearance of
multiple accumulations of infection in the lung is found in both avian flu and
SARS," Dr. Qureshi said. "However, additional abnormalities we discovered in
avian flu patients -- including fluid in the space surrounding the lungs,
enlarged lymph nodes and cavities forming in the lung tissue -- were absent in
patients with SARS."
The influenza virus that causes avian flu is highly unstable and prone to
mutations. While common in birds, some experts warn that this virus could
mutate and become contagious between humans, leading to a possible pandemic.
Because avian flu in its current form does not typically infect humans, there
is little or no immune protection against it in the human population.
Symptoms of avian flu in humans have ranged from ordinary flu-like
symptoms (fever, cough, sore throat and muscle aches) to eye infections,
pneumonia, severe respiratory diseases (such as acute respiratory distress)
and other severe and life-threatening complications.
Dr. Qureshi's co-authors are Jeremy Farrar, D.Phil., Fergus Gleeson,
F.R.C.R., and Tran Hien.
Dr. Qureshi will present Avian Flu: The Prognostic Implications of the
Radiological Pattern of Disease on Friday, Dec. 2 at 10:30 a.m. CT in Room
E351.
RSNA is an association of more than 38,000 radiologists, radiation
oncologists, medical physicists and related scientists committed to promoting
excellence in radiology through education and by fostering research, with the
ultimate goal of improving patient care. The Society is based in Oak Brook,
Ill.
AT A GLANCE
-- X-rays show distinctive disease patterns of avian flu, including fluid
in the space surrounding the lungs, cavities in the lung tissue and
enlarged lymph nodes.
-- The severity of these patterns is a good predictor of patient
mortality.
-- Identifying avian flu disease patterns will help physicians with more
aggressive treatment planning to improve a patient's chance of
survival.
-- People have little or no immune protection against avian flu.
SOURCE Radiological Society of North America
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