Technology saves swine flu victim
RETIRED teacher Nirmala Harrilall, one of the few South Africans to have contracted swine flu in recent years, is on the road to recovery, thanks in part to new technology being used for the first time at Mount Edgecombe Hospital.
But the Everest Heights, Verulam grandmother is still baffled by how she became infected with the deadly virus, known as H1N1 influenza.
Harrilall, 65, was admitted to the hospital in July with flulike symptoms, and was put in an induced coma after a few days when her condition deteriorated and she developed severe pneumonia and respiratory failure. She was hooked up to a mechanical ventilator.
Professor Umesh Lalloo, a chest specialist and academic at the Durban University of Technology (DUT), viewed her symptoms and diagnosed her with the H1N1 virus.
Harrilall further developed acute respiratory distress syndrome (ARDS) and became non responsive to oxygen. This led to cardiovascular collapse. She went into shock and required extremely high doses of drugs to maintain her blood pressure.
The situation was dire and death was imminent and Lalloo, chest specialist Dr Anish Ambaran, and cardiac and thoracic surgeon, Professor Lucas Mohlala, were called upon to assist.
“Swine flu attacks the lungs. The lining of the lungs become inflamed and oxygen is not circulating properly.
“We took a brave step and introduced a new method to provide oxygen to the blood, because the membranes of the lungs were so badly damaged that oxygen could just not cross into the bloodstream,” Lalloo said.
“We needed to ensure oxygen got to the red blood cells while we waited for the lungs to heal. If oxygen was not delivered to the organs, progressively all the organs would have failed,” he said.
“The technology employed is called extra-corporeal membrane oxygenation (ECMO). It is like kidney dialysis. The blood is drawn from the circulation, via a large catheter, and oxygen is added by diffusion outside the body and then pumped back into the circulation.
“The machine used is very much the same as (what) heart surgeons use during open heart surgery, but now applied for weeks rather than the few hours for open heart surgery.”
Recovering at her home, Harrilall, who was initially not told she had swine flu, said she was given a new lease on life.
“I don’t know how I contracted the virus. When I woke up from my coma I was shocked to find out what had happened. All along I though I had symptoms of the common flu.”
Her husband, Ramesh Harrilall, who was also admitted on the same day with bronchitis and pneumonia but recovered, said he was in total shock.
“We just prayed for her to be healed and we are grateful to the staff at the hospital for their assistance. They went beyond the call of duty.”
Lalloo said the first swine flu outbreak was in 2009 and described the virus as being seasonal, occurring especially during winter.
“The flu is your common cold, headache and sore throat which goes away after an injection or vaccine. Swine flu, on the other hand, continues and worsens over time, leading to pneumonia and severe respiratory failure.”
The spokesman for the national Department of Health, Joe Maila, said the last reported cases of the H1N1 virus in South Africa was about two years ago.
“Since the outbreak we have not received any reports from hospitals about patients contracting the virus,” he said.
“This case (Harrilall) is the first one I have heard of.”