New research has shown that the risk of dying from swine flu type A (H1N1) is greatly increased if blood selenium content is low. On the other hand, the infected survived with a selenium content above the recommended level. The more selenium, the faster you recover, the study showed. It also looked at heavy metals as a possible risk factor. The study began in Mexico during the epidemic in late 2009, when a research group involved 40 patients infected with the H1N1 virus. A control group of 94 subjects were divided into two groups: Control group 1 consisted of 30 patients with pneumonia not of the H1N1 type and control group 2 which consisted of 64 patients with flu-like symptoms, also free of H1N1. Fatal infection It can be a serious matter to be infected with influenza type H1N1 is evidenced by the fact that 10 out of the H1N1-infected patients needed oxygen and medication via intubation (a plastic tube in the trachea). Seven of these patients did not survive. Of the 40 infected patients a total of eight died. They all were obese to some extent, but only three of them were smokers. Heavy metals The participants had among others blood levels of a number of metals measured. Analyses showed that H1N1 patients had significantly higher levels of a number of potentially toxic metals than the control groups, but the researchers did not conclude further from this. Selenium The trace element selenium stands out as probably the most important factor when you have to survive and recover from infection with H1N1, and it is apparently dose-dependent, since the survey showed that the group with flu-like symptoms had a low selenium content, the group with normal pneumonia had a lower content, and the H1N1-infected group had the significant most low content of selenium in the blood. Selenium is part of a series of important enzymes, including glutathione peroxidase. A selenium content in the blood of 12.5 µg/dl (equivalent to 125 µg/L) is considered to be optimal for the activity of glutathione peroxidase and is used as an unofficial marker for optimum selenium content in the body. Despite this, it turns out that those who had higher levels than 12.5 µg/dl recovered more quickly after their illness than the average sick time: 5-7 days instead of the normal 10-12 days for pneumonia and 15-21 days for those who were infected with H1N1. Seven out of the eight who did not survive had selenium levels below this threshold. Four patients with complications involving severe renal failure had the lowest selenium levels. Pregnancy a risk factor Influenza type H1N1 is extra dangerous for pregnant women, as their selenium levels fall steadily during pregnancy. Thus pregnant women are rapidly reaching critically low selenium levels, probably because the foetus takes what it needs. Selenium deficiency promotes viral mutations Back in the year 2000 the researcher Melinda Beck showed that mice lacking selenium, in a very short time were able to transform harmless viruses to dangerous viruses, causing myocarditis, ie. inflammation of the heart. Her study showed that selenium deficiency promotes mutations in the viruses, resulting in them becoming much more dangerous. The researchers recommend selenium supplements Although Mexico City, where the patients came from, is not considered to be a low-selenium area, the researchers mention that in the future supplementation with selenium to patients with pneumonia, and in particular to patients infected with virus type H1N1 should be considered. Refs. Moya M, et al. Potentially-toxic and essential elements profile of AH1N1 patients in Mexico City. Sct Rep. 2013. E-pub ahead of print. Beck MA, et al. Host nutritional status and its effect on a viral pathogen. J Infect Dis.2000;182 Suppl 1:S93-6.