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

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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.

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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.

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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

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