I have been sitting in my office this morning with the television on, watching the coverage of the swine flu outbreak.  I am always impress at how much panic an infections disease can generate.  Personally, if the swine flu does become pandemic, I hope I am one of the first to come down with the disease.  Why?  With a disease as virulent as the flu, the odds are very good that I will develop the disease eventually and if that happens, I want to get it before the medical system is overloaded and drugs like Tamiflu run out. Beside, I am a healthy 38 year old and the risk of serious complications, let alone death, are small.  This way, I would get the best care, medications, will get it over with quickly, and be healthy (and immune to the disease) when the disease hits it’s peak so I can help care for others.  So you won’t find me walking around with a mask on – which really doesn’t provide much protection anyway.

What does swine flu have to do with gout?

Not much really, however some medications used to treat gout can suppress the immune system which can make you more susceptible to disease including the flu and can make the flu worse if you should get it.  If you are unlucky enough to develop the flu just as you are being treated with corticosteroids or colchicine for a gout attack, it could make it much worse - particularly if you are elderly.  Note that NSAIDs and medications to lower uric acid levels do not suppress the immune system.

Of course, if you manage gout properly by lowering uric acid levels, there is no need to ever treat a gout attack because you will not get them.

Update: NYC Assistant Principal in Critical Condition

In New York City an Assistant Principal has come down with the N1H1 flu and is now in critical condition.  It has been reported in the media that the only preexisting health condition he had was gout.  As a result I have seen a lot of interest in any possible connection between gout and swine flu.  It has been reported in the media that this Assistant Principal is suffering from kidney failure.  As I have written previously (see,Is Gout Dangerous) that gout is strongly associated with kidney failure.  If fact, nearly all people suffering from gout have significant kidney damage at the time of death.

So, did gout combine with swine flu contribute to this man’s kidney failure?  That remains to be seen, but I would not be surprised if this turns out to be the case.  The flu could have found a comfortable home in the already damaged kidneys.  As the disease spreads, we will see if more people suffering from gout develop serious kidney complications.

Update 2: NYC Assistant Principal Passes Away

Unfortunately, NYC Assistant Principal Matthew Wiener passed away Sunday, May 17th.  Our sympathies go out to his family.

As for the connection between gout and swine flu…  Its unlikely that gout played a role, but it is possible.  I hope that the CDC takes a close look to see if there was a connection.  If they can find a connection, then I hope that they will at least advise the public of the risk and advise the medical community to treat those that have gout and develop swine flu more aggressively.