Rhiza Labs FluTracker Forum

Torrow's MMWR has a report on Tamiflu flu resistant in two cabin mates at a summer camp in North Carolina. Disease onset dates were 4 days apart, indicating one camper infected the other.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5835a1.htm

On July 8, she experienced cough and headache without fever, and on July 9 she experienced chills, worsening headache, and loose stools. Despite these symptoms, her oseltamivir dose was not increased to a therapeutic treatment dose. On July 10, the last day of the first camp session, she traveled away from camp with three family members while ill, returning on July 12, afebrile and with a cough, to attend the second session. On July 12, a rapid influenza detection test was positive for influenza A.

A second previously healthy adolescent girl, who resided in the same cabin as patient A, began oseltamivir chemoprophylaxis at a dose of 75 mg daily on July 7 after exposure to patient C. On July 10, patient B left camp for a home visit during the break between camp sessions. The next day, while at home, she experienced onset of fever (101.9ºF [38.8ºC]), sore throat, and cough. She continued to engage in normal activities while ill, including visiting a shopping mall and movie theater. She returned to camp for the second session on July 12 with fever, headache, cough, malaise, and myalgias. On July 12, a rapid influenza detection test was positive for influenza A.

Well, it's more than a little alarming that her parents would allow her to go to the Mall, the movie theater, and back to camp, even though she had fever, headache, cough, malaise, and myalgias, During a Pandemic when flu-like symptoms have been plastered across the media for the last three months!

And we wonder why it spreads.

There is no wonder. I attended one of my daughter's high school soccer games yesterday. I did the scoring, so I was seated between both benches and the excessive coughing was quite noticeable (the two schools, Fox Chapel and Plum, are NOT close to each other). There was no doubt that MANY of these players had swine flu, but they did not have a fever, so they all assumed they had "what was going around" which produced sore throat, cough, and headache.

Today my daughter came home early. Soccer practice was cancelled because 1/4 of the team was sick (although ALL were in school today). I also talked to the trainer, who was also sick over the weekend, and most of the football team had also been sick. He too was shocked to hear that 50% of swine flu cases had NO FEVER, which was also true for the index case with H274Y at the camp in NC.

I believe the 1/4 of the high school soccer team is represntative of the entire high school population, but no one is staying home, and no one is being tested, and there is no notice at website of either school district.

So far there are notices up fir confirmed/suspect swine flu infections at 4 school districts in the Pittsburgh area. but VERY few students (other than Ringgold middle school) are staying out of school.

This is covered by Richard Knox on NPR.

Dr.Niman~

Out of curiousity, did you by chance have a talk with each schools' coaches on the probability of H1N1 cases?

AAAAAAAAAAAAAArrrrrrrrrrrrrrggggggggggggggghhhhhhhhhhhhhhhh.

Too bad they only tested a few of the campers at that camp. I wonder how far these two disseminated their evolutionarily fit, oseltamivir-resistant pandemic H1N1 strain at the camp or back home.

I started a swine flu thread at a Fox Chapel website

http://www.yourfoxchapel.com/forum/swin ... fox-chapel

and did e-mail the entire team (coaches, parents, and players) with a link to the thread, but nothing will happen until someone is tested.

I also talked to the trainer (for the entire high school), and one of the other parents who was an MD (we were in charge of yellow cards, so sat together for the entire game), and have told parents repeatedly for several weeks that swine flu would explode in the PIttsburgh Area, including Fox Chapel, but no one is going to do anything until someone gets tested (one of the parents did get sick, but was not tested).

The coach did announce at the end of yesterday's game that there would be no practice today because so many players were sick, but there is NO notice up for ANY suspect students at either school, and this has been "going around" since the start of school over a week ago.

~ Clever virus....

it seeds itself far and wide, making some sick, taking some lives, but most folks feel well enough to carry on with normal activity, ensuing widespread infection.

I can't help but wonder, what was the flu season of 1917 like ?

I actually have wondered the same thing about 1916 and 1917. The 1918 virus was EXTENSIVELY recombined, with about have of each gene's polymorphisms tracing to human H1N1 and half to swine H1N1, suggesting the virus went back and forth betwen swine and human multiple times.

The 2009 pandemic strain easily infects and transmits in swine and birds, so its potential for more recombination is very high. Right now there is little resistance, so it spreads in humans like wildfire, and most barely notice.

However, when human immunity develops and the vaccine is distributed, the virus will be able to really show what it can do, and for this virus, small changes can have LARGE effects.