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The Latest News About Swine Flu

by Sue Hubbard, M.D.

So… today is officially my day off and out of the office. That is really just a matter of semantics as my home phone, voice mail, e-mail and text is still working and the questions and concerns about swine flu continue to follow me. Even with my OWN children.

If you have been keeping up with the national news, H1N1 (swine flu) is already assaulting college campuses from coast to coast. We should expect this trend to only continue the longer classes are in session. This is probably the first time that the student health center is one of the busiest places during the first few weeks of school.  I have patients, who attend many different colleges, and they are all being exposed to swine flu, and some of them have been presumptively diagnosed with swine flu. If I were a virus I would be on a college campus too! Let’s see, student’s live on top of each other (literally in bunk beds in many dorms), they share everything from sinks to computers, to cups and dishes, desks in large classrooms, work-out areas, they hug and kiss all day long so there is the issue of saliva and. …that’s explicit enough. Obviously, a perfect opportunity for viral spread. With all of the unknowns about swine flu, the one known is that it seems to be easily spread, and if you are within a 6-foot radius of someone who is feverish and coughing and sneezing (definitely within 3 feet) you are being exposed. This will continue to be the case for months to come.

The calls today continue to be: What are the symptoms of swine flu? The symptoms are really no different than other influenza A viruses, fever, sore throat, headache, body aches, cough and fatigue. The swine flu does seem to be associated with more GI symptoms than other influenza viruses, so some people are experiencing some nausea and vomiting but the earlier symptoms prevail. A stuffy nose and scratchy throat is not swine flu. I really think most people will be able to tell the difference, as you have a fever and feel MISERABLE! The symptoms are not like a cold and we all need to remember this as we get further into fall and winter.

Question #2: My child has been diagnosed with swine flu but they did not put him/her on Tamiflu. That is correct, as the CDC recommendations are to not routinely use Tamiflu for otherwise healthy individuals who have presumed swine flu. If you are not extremely ill (I know, you feel terrible), do not require hospitalization, and have no underlying risk factors (pregnancy, very young, chronic disease etc) you do not need to take Tamiflu. Tamiflu is being used sparingly to prevent resistance to one of the only anti-viral drugs we have. Remember, viruses are smart and they might become resistant to antivirals if over used, just like certain antibiotics. We also will run out of Tamiflu very early in the season if it is given to everyone with flu like symptoms, and those that they live with. You are also going to be exposed over and over throughout the season. Tamiflu has also only been shown to be effective if given early in the course of the illness (less than 48 hours after symptoms begin) and only shortens symptoms by about a day. It is not a miracle drug for those people who are otherwise healthy.

Most of the patients with presumed swine flu (we are not routinely testing) that we have seen in our pediatric/adolescent population have only had 2 -4 days of fever, sore throat and body aches and also a cough that lasts for a 7 to 14 more days and fatigue. So… stay HOME, treat your symptoms, minimize your exposure to others and call the doctor for worsening symptoms, respiratory distress, and fever late in the illness. There is a concern for secondary infection in people who have any of those symptoms. Also, make sure not to give children or college kids aspirin during a viral illness, due to the association with Reye’s Syndrome.

Lastly, the seasonal flu vaccine is not going to prevent swine flu. My college son called today to tell me he had “dodged a bullet” and not gotten swine flu even though several of his friends had been diagnosed. He was certain it was because he had already received his flumist vaccine before he left for school. Not even my own child listens to me or reads what I write! After I re-informed him that the seasonal influenza vaccine has no cross protection for swine flu and that there will be a separate vaccine, he replied, “Mom, it is the placebo effect, if I think it prevents swine flu, maybe it will work!” What do I know, keep up the hand washing, cough hygiene, stay home if you are sick and think positive thoughts (after you get your seasonal flu vaccine) it certainly won’t hurt.

That’s your daily dose, we’ll chat again soon.

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