Here’s how the flu virus kills some people so quickly

A 10-year-old Connecticut boy died of flu. So did a 21-year-old bodybuilder, and 4-year-old Jonah Reiben of Dayton, Ohio.

These are not the usual sick and elderly people who die from influenza. But every year, flu carries away perfectly healthy young adults and children, and tens of thousands of people over 65.

How does flu kill, and why does it sometimes kill so quickly?

Doctors who study the body’s immune response say there are three main reasons: co-infection with another germ, usually bacteria such as strep; aggravation of existing conditions such as heart disease and asthma; and a so-called cytokine storm, marked by an overwhelming immune system response to infection.

Related: Flu is taking no mercy on vulnerable kids

Sometimes this can happen very fast. During the 1918 “Spanish flu” pandemic that killed up to 50 million people a century ago, many people were reported to have died within hours of showing their first symptoms.

Researchers who have gone back and re-examined tissue samples, and read reports from the time, believe most deaths were caused by co-infection with another germ. But many of the healthy young men and women who died quickly of flu that year more likely succumbed to cytokine storms.

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The Best Drinks to Fight the Flu
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The Best Drinks to Fight the Flu

Water

This shouldn't be a surprise: the ultimate clear liquid, water is the truest drink to keep you hydrated. Don't like the taste? Add a sugar-free flavor packet, like Crystal Light, to your glass to encourage more guzzling.
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Ice Pops and Ice Cubes

How do you think ice cubes became the 25th most searched recipe in America, after all? Ice pops, or ice cubes if your freezer just happens to be void of summer’s best treat, are two of the best defenses against dehydration. WebMD advises to look for ice pops made with 100 percent fruit juices to get a 2-in-1 fight against the flu – hydration, plus vitamins.

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Black Tea

Mother Nature Network notes one Harvard study that shows black tea as the ultimate immunity booster. Drinking five cups of black tea per day for two weeks nearly quadrupled a person’s immunity system – so if tea isn’t a part of your diet already, you germaphobes, you should get on it. Thanks to black tea’s abundance of theanine, flavonoids (antioxidant-like compounds), catechins (compounds that fight free radicals in the body), it’s been proven to fight off the flu.

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Ginger Tea

Ginger may as well be called a superfood, seeing as how much it can keep the flu at bay. Most people reach for a ginger ale when tummy troubles come about, and we can see why – it’s been a part of Chinese herbal medicine for more than 2,000 years to relieve digestion problems and nausea. Plus, ginger can help detox the body by inducing sweating (not the most fun symptom of the flu) to get rid of the body’s toxins. And ginger’s analgesic and anti-inflammatory properties relieve aches and pains that come with the flu. Convinced? Fortunately, ginger tea is simple to make: the University of Maryland Medical Center advises adding 2 tablespoons of ground ginger or ginger root to a cup of boiling water. (We particularly like this honey, lemon, and ginger flu-fighting concoction from Simple Green Smoothies, too.)

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Chicken Broth

Chicken broth may be your best remedy against a cold and the flu. Vitamins and protein? Check. Hydration power? Check. Anti-inflammatory properties? Check. Congestion-fighting properties? Check. The most popular study on chicken broth, from the University of Nebraska, showed that chicken soup helped reduce upper respiratory cold symptoms and helped build up the nose’s protective cilia, hair-like substances in the nose that prevent contagions – like that pesky flu bug – from entering the body. While you may need a few days to feel well enough to eat a hearty chicken soup, the University of Nebraska provides the ultimate chicken noodle soup recipe. A scientifically-backed recipe to feel better? Not even your mom’s homemade soup-made-with-love can top that.

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The human immune system has a load of weapons to throw out against infections, including cytokines produced by a variety of immune system cells.

“Those substances work to stop the virus from spreading,” said Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins University Center for Health Security.

Related: Tsunami of flu activity covers entire continental U.S.

They cause the typical “flu-like symptoms” that bring misery from flu and other infections.

“The muscle aches, the fever — all of that is the result of the immune system responding to the virus,” Adalja said. That’s why so many diseases cause similar symptoms: it’s the body’s response, not the particular invader, that’s to blame.

But different people have differently composed immune systems.

“In certain individuals there can be a very pronounced immune response that can result in a lot of damage to the cells in your body including the cells in the respiratory tract," Adalja said.

When a virus is new, like the 1918 strain of H1N1 and the 2009 H1N1 “swine flu”, it usually kills far more people. One theory is that the immune system can become overwhelmed by the never-before-seen invader and sends so many troops to fight it that perfectly healthy tissue in the lungs and other organs gets killed, too.

People who die from “bird flu” viruses, such as H5N1 or H7N9, also seem to die via an over-the-top immune response.

Related: Here's why you need a flu shot every year

And these newer viruses also tend to kill younger people, perhaps because the older population may have been exposed to a distant relative of the virus in the past. The H1N1 flu virus killed 282 U.S. children in 2009-2010, the Centers for Disease Control and Prevention says. It may have infected 61 million people.

Now it’s just part of the annual flu mix and while it is circulating and killing some people this year, it’s the H3N2 strain that is suspected of causing most problems this time around.

One experiment showed that certain “new” genes in these never-before-seen viruses help them thrive deep in the lungs, which can cause pneumonia and might provoke an overwhelming immune response.

While a few people seem to die within hours or days, flu can cause lingering sickness in others. Then they become susceptible to other infections, such as streptococcal or staphylococcal bacterial infections.

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Flu Proof Your Home
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Flu Proof Your Home

Health officials recommend getting a yearly flu vaccine, and they urge everyone to protect themselves with one time-honored tactic: wash your hands, well and often. That may be the single best way to stop the disease in its tracks.

But in case you find yourself facing an encroaching onslaught of the illness though coworkers or school-age kids, This Old House has a few strategies to make life as hard as possible for the flu -- or any germs, for that matter -- to take root in your house.

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The sink, the telephone, children's toys, and doorknobs are popular landing sites for virus and bacteria. If someone is sick at home, disinfect daily, especially the remote control and the phone. Charles Gerba, microbiologist and author of The Germ Freak's Guide to Outwitting Colds and Flu, says remote controls and countertops can be the germiest locale in the whole house. "What's the first thing you do after you call in sick? Pick up the remote control," he says. "Sixty percent of them contain influenza virus in the home of a sick person."

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According to Gerba, the home office is another place to watch out for germs. "Desktops have 400 times more bacteria than a toilet seat," he says. Gerba says to disinfect your desktop weekly, along with the rest of the house. This could reduce your exposure to colds and flu by as much as 50 percent.

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Your kitchen sponge should be replaced every couple of weeks. If that runs counter to your frugal ways, you can microwave it for one minute or run it in the dishwasher to eliminate germs.

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Beware of dust rags, dishrags, mops and other cleaning tools. Unless sanitized between uses, they only spread around the germs you are trying to kill. "It's a free ride for the virus," says Gerba. Some of the cleanest houses he's tested had the highest germ counts. And get this: a few untidy bachelor pads tested very low for germs, which he attributes to lazy housekeeping. "They don't move anything around, everything is in the sink or the garbage."

But you don't have to descend into bachelor habits to defeat contagion. Gerba advises heavy reliance on paper towels. If you don't want to stockpile disposable towels, wash and dry cleaning tools at high temperatures so your house is clean and germ-free.

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The most benefit you can get from technology comes from air cleaners. Modern filters mostly catch larger particles such as bacteria, pollen, mold spores, but any virus traveling on a larger host can get caught by the filter. "It's not a see all, fix all. It will reduce, but not eliminate exposure," says Burroughs.

There's one caveat, though: The system must be working 24/7 to be effective. "It only works if the fan is blowing," says Burroughs. When properly used, a system like Honeywell's Electronic Air cleaner captures 99 percent of the larger particles, and some of the smaller particles, too. And that's one good way to keep the flu virus from spreading in your home.

More Ways to Flu-Proof Your Home

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These secondary infections can damage organs, cause pneumonia or get into the bloodstream, causing another kind of immune system overreaction called sepsis.

So far this season, flu has killed 20 children. Last season, 110 children died from influenza in the U.S.

The CDC doesn’t precisely count adult flu deaths, in no small part because it just kills so many. Every year, flu kills 12,000 to 56,000 people and sends as many as 700,000 to the hospital.

Related: H1N1 swine flu hit Americas especially hard in 2009

CDC estimates flu deaths by looking at how many more people than usual died of flu and pneumonia, but even those calculations miss people who may have died from flu complications, such as a heart attack set off by a bout of flu.

For patients with asthma or other lung conditions, flu is just one more problem for the lungs to cope with.

“They are already having breathing difficulties. It can put them into a spiral very quickly where their breathing gets compromised,” Adalja said.

Patients with diabetes already have a damaged immune response, so they also are more susceptible to flu.

Related: Death of teen athlete is a reminder that flu can kill anyone

And pregnant women have a double risk. “Pregnant women are in a state of immunosuppression because the immune system is trying not to reject the fetus,” said Adalja. So the virus can get further, faster in their bodies.

Plus their lungs are compressed by the fetus, so they have less breathing capacity. Humans need a certain level of oxygen and if blood oxygen levels fall too far, they enter a state called hypoxia. Hypoxia can cause organ damage within minutes.

That’s why bluish skin or difficulty breathing is an emergency that requires immediate medical care.

The best defense against flu, the CDC, FDA, pediatricians and other health experts agree, is a flu vaccine. Just about everyone over the age of 6 months should get one and it's still not to late to do it.

And flu is spread by droplets that can linger on surfaces such as countertops, which is why hand-washing is so important. It also spreads via sneezing and coughing and, perhaps, may float in the air on tiny droplets emitted by simple breathing

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