ms4920 wrote:
You are the only one that has all the answers. My MD is stupid and does not have a degree. He went to USC but he is not a bright man. Not everything is SWINE FLU
The swine flu situation really couldn't be clearer. I have read report after report from school officials in the US citing seasonal flu as a contributor to the absenteeism, when in fact the level of seasonal flu was less than 1 % and going down. They all make the same ridiculous statements about "perfect storms" leading to 20-30% abstenteeism. They acknkoewedge swine flu, but then throw in a couple more, like stomach flu, colds, allergies, or bronchitis, all of which match swine flu symptoms.
I can also speak from personal experience. My high school aged daughter was PCR confirmed, as was I. My middle school aged daughter also was infected but wasn't tested because the diagnosis was obvious and she was prescribed Tamiflu. Same for my wife who was prescribed Tamiflu over the phone. However, we all had different combinations of symptoms which could easily be called any of the above misdaignosis.
The sequence of events assocaited with my daughter in high school was most revealing. Her school already had had two waves. At the start of the school year a VERY high percentage of students had a headache, sore throat, and runny nose but no fever. Consequently they stayed in school and didn't get tested. My daughter plays soccer and the team was so sick that practice has cancelled, which has NEVER happened previously. Most got better and then the second wave struck. This time many also had fever and many also had nausea and vomitting, leading to high absenteeism and visits to Drs. The school then came out with a notice about students testing positive for influenza A (i.e. swine flu). A week later another notice came out saying that H1N1 had been confirmed in all six schools (high school, middle school, and 4 elementary). The announcement was no surprise because absenteeism was in double didgits and one day the school nurse was sending home stidents with fever at a rate of 5 per hour.
Shortly therafter my daughter developed a cough. She went to school but after a few days woke up and said she was too sick to go to school. She slept in for a few hours and when she woke up she had a fever of 101.1. We called the Dr and took her in that afternoon. She told the nurse that in addition to the cough and fever she felt weak and tired, had chills, and had a headache. I thought it was pretty obvious that she had swine flu.
When the Dr came in he said she had a "possible case" of swine flu. I asked why he only thought she was "possible" in view of her symptoms, absenteeism, and confirmed H1N1 at her school. He responded by saying that he had done PCR on 10 patients in a row who had "classical swine flu symptoms" and all tested NEGATIVE indicating they just had URI. I said his office had a swabbing problem, which wasn't well received. He did have the nurse take a swab, but wouldn't prescribe Tamiflu. He did say to call if her symptoms worsened.
The next morning her temp went up to 103.1. She was also light headed and dizzy even though we had started her on Tamiflu as soon as we returned from the Dr a day earlier (using Tamiflu we had ontained previously). We called to update the Dr and state that we were not confortable without Tamiflu treatment, which was then called in by the Dr.
That afternoon I went to my daughter's soccer game while she rested (I keep the book on the team). the other parent who volunteered for that game was an MD and she was coughing. I commented on the cough and asked her what she thought she had. She said she had the same thing her daughter had. I asked if she had done any testing of patients and she said she had positives in her patients and staff. I then asked why she didn't think she had swine flu and she thought symptoms lasted longer than a couple of days. I noted that many are only sick for a few days and said she probably had swine flu. I asked if she was taking anything and she admited that she and her daughter were on tamiflu. I then mentioned the 10 "negatives" on patients with "classical swine flu symptoms" and she immediatley said they weren't swabbing correctly. For a proper nasopharygeal swab, the swab has to go deep and into the cavity at the back of the nose.
After the game I developed a dry cough. I didn't think much of it until the next day, when the cough was deeper and I couldn't stop. I would cough 10 times in a row, stop for a minute, and then start over. After doing this for several hours, I started Tamiflu, even though the cough was my only symptom. That night I developed a low grade fever (below 100), had chills, night sweats, and felt much better in the morning. I still had the low grade fever when I woke up, but it was gone in an hour. My cough improved and I saw the Dr the next day even though I felt much better (I really just wanted to refill by Tamiflu stock). I was also swabbed, but expected to be negative since I had already been on tamiflu for 3 days by the time the swab was taken.
Much to my surprise, my daughter and I both tested positive for H1N1. Prior to developing a fever, she would have been a "bronchitis" patient. For me, other than the cough, all other symptoms were present for less than 8 hours. Outside of the very short time I would have been a bronchitis patient also.
My younger daughter then devloped a cough and fever and missed three days of school. She would have been the one most likely to be diagnosed as swine flu. My wife then developed the cough, sore throat and headache. She never had a fever and was diagnosed as swine flu over the phone, because of the three other cases in the house.
A month later my older daughter and I developed symptoms again, She had a cough, sore throat, and ear ache. I had a cough, horrible headache for two days, fatigue, and chills, but no fever. I was diagnosed as swine flu but not retested - the testing center was overwhelmed and asked MD's NOT to send samples from non-hospitalized patients.
The above detail provides some insight into the variety of symptoms within one household (which probably involved the same virus). The MD who diagnosed my older daughter as "possible swine flu" was heavily influenced by bad test result. The 10 patients had swine flu but were told they were PCR negative and had URI (of unknown etiology).
Bottom line is simple. In areas where swine flu is rampant, there will be MANY different presentations of the same virus. The school outbreaks with double digits absenteeism have widespread H1N1. Some will have no fever and the population will present with a range of symptoms, but the symptoms are NOT due to a perfect storm of converging etiologies, as indicated by school administrators.
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