Was it just me, or are we all jumping to conclusions with swine flu?

Every few days, someone I know tells me that they – or their child – has come down with swine flu. It sounds plausible – the Centers for Disease Control and Prevention warns that the H1N1 virus is spreading rapidly throughout the United States. California is one of 41 states reporting “widespread influenza activity.”

So over the weekend, when my preschool-age daughter suddenly came down with a high fever, my husband and I naturally thought swine flu.

She didn’t have the aches and pains one normally associates with the flu. But she had a moderate case of chills, followed by a sore throat and one episode of vomiting. That added up to four of the nine symptoms listed on the CDC’s H1N1 website.

The World Health Organization said back in July that there was no longer any need to confirm each case of probable swine flu through laboratory testing. Labs were overwhelmed with samples, making comprehensive testing impractical, the WHO said. Besides, at that time, more than 95% of all tested flu specimens were indeed cases of H1N1.

But when our pediatrician offered to test our daughter, I was more than happy to oblige. If I could confirm she had H1N1, she could safely skip her two doses of swine flu vaccine. (I’m not afraid of the vaccine, but I’m totally sympathetic to her dread of shots.)

After a short history and physical exam, the pediatrician concluded it was unlikely my daughter had swine flu. A couple of hours later, the laboratory at Childrens Hospital Los Angeles confirmed it. “Influenza test was negative,” he reported in an e-mail.

Now I’m reconsidering all those casual reports of swine flu. How did so many of my friends and colleagues know that they were dealing with H1N1? The truth is, most of them probably didn’t. The CDC’s answer to the question “How do I know if I have the flu?” is so broad that almost any cold would qualify.

At a previous checkup, our pediatrician said he feared doctors were overcalling cases of swine flu and handing out Tamiflu to patients who didn’t really need it. That would be bad on several counts – exacerbating antiviral shortages and speeding the development of drug-resistant strains chief among them.

It might also give people a false sense of security about skipping the vaccine. Plenty of people are already wary of the vaccine, and for the most part, these fears aren’t scientifically sound. As the Vermont Department of Health puts it in this excellent primer on H1N1 vaccine safety, “Vaccination is the best way to prevent influenza infection and its complications.” Let’s not forget that one of those “complications” is death.

-- Karen Kaplan

Photo: Perhaps more cases of suspected swine flu should be confirmed in the laboratory. Credit: Matt York / AP

Comments

[Hank]

It's just you...

[Joan Bien]

Thanks for the excellent link on H1N1 info. Very helpful when others start posing questions that DO have answers.

[justme67]

Many lab tests are false negatives. Since H1N1 is the predominate flu right now - the CDC says 99% of what is spreading is H1N1 and is what's making the sickest land in ICU. Most people are pretty sure that's what they have. I hope the little one gets better soon! Keep a close eye on her for complications, often they seem to get better but as the flu/cold/respiratory virus moves into the lungs and for many deep in the lungs, that's when trouble starts. If she shares a room with a sibling, have the kids sleep head to foot so there is less chance of coughs spreading. Toss the toothbrushes and get another again when she's well, toothbrushes are breeding grounds for viruses and bacteria. Same goes for mascara for women. Don't share make-up, which is a tough thing to ask as many kids and girls especially do this, and it's Halloween season.

[Paula]

I am concerned as it sounds as if your daughter received one of the "rapid" tests, on which a negative reading has basically no accuracy. The clinical judgment call sounds more signicant, yet still seems worth being ready to push for another appointment if she gets, as I hope does not, even a bit sicker. Let's hope she is soon well, though. And that everyone who needs the vaccine is able to get it.

[rikkitikkitavi]

If what your daughter got was the rapid test - as seems likely given the "couple of hours" turnaround time you mention for getting the results - that tells us very little about whether she in fact had influenza. A recent CDC guidance points out that the rapid test is notoriously unreliable: "the sensitivity of RIDTs [Rapid Influenza Diagnotic Tests] for detecting novel influenza A (H1N1) virus infections ranged from 10-70%. Therefore, a negative RIDT result does not rule out novel influenza A (H1N1) virus infection." You can read the CDC's interim guidance on this here: http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm.

The CDC has found the rapid tests to be so unreliable that in their latest guidance for clinicians they recommend that, for patients at high risk of influenza complications, "treatment [with antivirals] should not await laboratory confirmation because laboratory-based testing could delay treatment and because a negative rapid test does not rule out influenza" (http://www.cdc.gov/h1n1flu/recommendations.htm).

[Gary]

This piece has been featured at TheWeek.com - We really enjoyed your take on this controversial subject.

[Courtney]

I don't believe in vaccinations for the flu. It is all too simple. Wash your hands the proper way, don't let people cough/sneeze on you, and carry a small bottle of hand sanitizer. I haven't had the flu since I was 12 years old and I'm 22 now. That's 10 years I haven't been sick, and I've worked, been around sick people and taken care of my sick husband (army) many times. The american people GREATLY under estimate proper hygiene.

[Anita]

Karen Kaplan writes "As the Vermont Department of Health puts it in this excellent primer on H1N1 vaccine safety, “Vaccination is the best way to prevent influenza infection and its complications.” Let’s not forget that one of those “complications” is death.

However, as Yobie Benjamin says in today's issue of the San Francisco Chronicle: "The government has a poor track record with swine flu vaccinations, given that 4,000 people were paralyzed or died due to the 1976 vaccine". Yet only one person died of H1N1 at this time!!!

36,000 Americans die each year from seasonal flu, but you don't hear the media hawking this news every year. How many people have died from the Swine Flu so far? There aren't even reliable statistics. Divided into 12 months, that's 3,600 people a month. Do you really believe that these many people have died from the H1N1 since April 2009

The vaccine hasn't even been tested as required by Federal Law. Big Pharma now has immunity from any complications resulting from the vaccine. They don't even think it's safe. How could they know, as it hasn't even been tested for the required amount of time, which is 12 to 18 months.

How about along with cleanliness, that we all just take some Vitamin D3 daily?
You won't hear that from the media or these "experts".

Read, research, and educate yourself about vaccines. Think for yourselves. Of course all these "important knowledgeable doctors and scientists" who promote the vaccine are the very same people who are being compensated to keep the vaccine industry alive. Don't forget that at least 50% of doctors said that neither they nor their families will be getting the vaccine.

But do what you want. There will be less doses available for me and like-minded people.