Wednesday, October 21, 2009

Testing for the flu?

I was glad to read this news story that Mark Shea linked to earlier today. Turns out, the whole swine flu thing may be a bit exaggerated:
(CBS) If you've been diagnosed "probable" or "presumed" 2009 H1N1 or "swine flu" in recent months, you may be surprised to know this: odds are you didn’t have H1N1 flu.

In fact, you probably didn’t have flu at all. That's according to state-by-state test results obtained in a three-month-long CBS News investigation.

The ramifications of this finding are important. According to the Center for Disease Control, CDC, and Britain's National Health Service, once you have H1N1 flu, you're immune from future outbreaks of the same virus. Those who think they've had H1N1 flu -- but haven't -- might mistakenly presume they're immune. As a result, they might skip taking a vaccine that could help them, and expose themselves to others with H1N1 flu under the mistaken belief they won't catch it. Parents might not keep sick children home from school, mistakenly believing they've already had H1N1 flu.

Why the uncertainty about who has and who hasn't had H1N1 flu? [...]

We asked all 50 states for their statistics on state lab-confirmed H1N1 prior to the halt of individual testing and counting in July. The results reveal a pattern that surprised a number of health care professionals we consulted. The vast majority of cases were negative for H1N1 as well as seasonal flu, despite the fact that many states were specifically testing patients deemed to be most likely to have H1N1 flu, based on symptoms and risk factors, such as travel to Mexico.

It’s unknown what patients who tested negative for flu were actually afflicted with since the illness was not otherwise determined. Health experts say it’s assumed the patients had some sort of cold or upper respiratory infection that is just not influenza.
Do read the whole thing to see the CDC's role in this, and the criticism from some health officials about the CDC's decision to stop testing routinely for swine flu back in July.

I've heard about some parents being told their children had swine flu even when the parents were sure they had something entirely different--but no test was done, and no confirmation of the diagnosis was made. Granted, the plural of anecdote isn't data, but it's easy to see how busy doctors presented with many patients with flulike symptoms would be quick to diagnose swine flu and prescribe rest and fluids instead of going through a testing process to prove that the illness was really present.

This, of course, is merely an example of what some people think happens nearly every flu season--all manner of viruses from bad colds to serious respiratory illnesses get classified as flu by some doctors, even if the flu outbreak that year turns out to be mild. Viruses that in spring or summer might be investigated more thoroughly get lumped in as "flu" in the winter, or so some think, leading to overall increases in flu statistics.

Though that might seem farfetched to some, the CBS investigation above shows that it is happening this year, and that patients are being told they have or have had swine flu when that might not be the case at all.

Ultimately it might not matter all that much--except that we've had news story after news story about how bad this outbreak of swine flu might be. If it turns out that most people who think they've had it might not have had it at all, then the story of this virus is clearly quite different from what most of us, up to now, have believed it is.


MommaLlama said...

I had to laugh out loud when I read this because I was just telling Daddio that I really felt like they were blowing this thing way out of proportion! Plus, I had talked with a few moms who were told their kids had H1N1, but no actual test was done...

Anonymous said...

Nonetheless it is the interest of Public Health agencies to ensure less deaths to those in the general public. CDC statistics of those that die should not be be ignored. And, as compared to inadvertent exposure to targeted ricin or anthrax, in the case of H1N1 there is an etiological agent, as well as preventive measure which generally affords seasonal 'protection' which with the intranasal vaccination has been found to provide more efficacious even up to 2 years in pediatric patients. And, the fact is that handling this H1N1 is rather new on the scene. If any error is to made in dealing with H1N1, some might prefer to err on the side of caution. And, apparently, there aren't that many 'in the know' that would say the greater error would be to provide too much acive immunity except for those as indicated in the drug labeling.