Swine Flu: One New York City Pediatrician's View (cont.)
The rest of the country can learn from New York's experience with the H1N1 virus. Continue to use available and inexpensive preventive measures, such as hand washing, covering your cough, and staying at home if you're sick. Getting the flu stinks. Most have had it and, and most get better. It also has great potential to cause severe illness in high-risk individuals as we have seen year after year, and as I wrote last April.
That is why I still believe that the number one way to prevent influenza is to get vaccinated annually. I do. My children do. My patients do. We are now in the middle of a pandemic influenza outbreak throughout the United States. "Flu season" doesn't start until January or so. So do something about it and get vaccinated.
Time-line of H1N1 swine flu news April 24, 2009
On Friday, April 24, 2009 I received a message from the New York City Department of Health advising me of a conference call to discuss the recent outbreak of swine flu in the United States, and possibly at a school in Queens, New York. That seems like a long time ago.
Since then, there have been an increasing number of suspected and confirmed cases reported in several states including Arizona, California, Indiana, Kansas, Massachusetts, Michigan, Nevada, New York, Ohio, and Texas as well as other countries, including Mexico, Canada, New Zealand, the UK, Israel, and Spain.
Most of the disease outside of Mexico has been described as mild illness with few hospitalizations, though on Wednesday, April 29, 2009 it was reported that a 23 month old child in Texas died from complications of the virus. This is sad, but this is not surprising or unique to swine flu. It is what influenza does. It is why Pediatricians and public health officials press so hard for universal vaccination.
The last Influenza season (2007-2008) alone, almost 100 children died from complications of laboratory confirmed influenza, and according to the U.S. Centers for Disease Control and Prevention (CDC) estimates, on average, influenza is believed to contribute to 226,000 hospitalizations and 36,000 deaths per year in the United States. Annual vaccination continues to remain the best method for preventing influenza and its potentially severe complications. Unfortunately, there is no vaccine to protect humans against swine flu, at least not currently; therefore good infection control practice is recommended to try to prevent the spread of the virus. These are the CDC guidelines; they are not innovative guidelines, and most children are already familiar with them:
If you haven't been fortunate enough to avoid an infection with influenza (swine or other) there are some additional recommendations I can offer you.
Testing for swine flu is not very accurate, which is why the CDC generally refers to the symptoms as influenza-like-illness (ILI). The rapid flu tests which are currently available on the market are believed to identify positive cases less than 70% of the time, which means almost a third of the time a patient who actually has swine flu will not have a positive test. This limits the effectiveness of the test as a diagnostic tool, and in some states and cities, such as New York City, testing is not even being recommended.
Lastly, this situation is evolving, and there are daily updates by local, state, and federal health agencies.
REFERENCE: CDC; "Weekly US Map: Influenza Summary Update."
Last Editorial Review: 10/27/2009