White Coat Underground

Flu update—spring edition

We’ve been hearing a lot about the new H1N1 (“swine”) flu which is moving quickly around the globe. It’s reasonably likely to be declared “pandemic” in the next few days. Here on the ground, it’s almost like having a second flu season. Normally by this time of year, seasonal flu is sporadic to absent and at the walk-in clinic we see the usual assortment of colds, strep throats, poison ivy, and ankle sprains. Instead, we’ve had all of that layered on top of a steady trickle of flu.


Each colored line represents flu-like illnesses reported to the CDC. The blue and green lines (last season and the season before) have the usual waxing and waning, so that by week 20 (the end of May), the number of reported cases is clearly headed toward its nadir. Not so with the red line, which represents the current season. It’s starting to head up again. Looking closely at some of the details of actual tested samples shows that many of these illnesses are the usual seasonal flu strains, indicating increased reporting rather than (or in addition to) increased incidence. However, many of the cases (about a third of tested cases) are the novel H1N1 strain. In fact, most of the strains I’ve run tests on are not the seasonal flu, so it will be interesting to see what happens to this graph as the weeks go on.

For whatever reason, influenza rates decrease in the summer months, so new strain or no, we’re likely to see the curve head down eventually, at least in this hemisphere (flu season is “opposite” on the other side of the equator).

Still, we’re keeping quite busy here on the front line of medicine, with waiting rooms full of masked, miserable folks. Usually, there is a sudden onset of high fevers (higher than 102), chills, muscle aches, cough, runny nose, and sometimes vomiting and diarrhea. It’s really not fun. This is not a time to tough it out and go to work despite your flu-like illness. Stay home, drink lots of fluids, and call your doctor.


  1. #1 KH
    June 3, 2009

    Ugh, that graph really brings it home. My partner’s coworker was just diagnosed with (probable) flu yesterday, thanks to his child’s classmate. And I have step 1 in a week.

    Are they still recommending Tamiflu prophylaxis? I’m tempted to get my partner on it just to prevent it spreading to me just in time for the boards.

  2. #2 DebinOz
    June 4, 2009

    Here in Australia, they have made a futile effort to prevent the spread of H1N1 flu by closing schools and quarantining families. My daughter’s public high school was closed for two days this week.

    They have now moved into a phase where only the sick person is quarantined at home, and schools will not close. So far it is mainly young people who are contracting this strain, and so far (I think) only one person has been hospitalised.

    Tamiflu is the ‘treatment’ of choice here.

  3. #3 Dianne
    June 4, 2009

    This is not a time to tough it out and go to work despite your flu-like illness.

    Indeed. I just had the following conversation with a member of the support staff here:
    Me: “How’s it going?”
    Her: “Not so good. I feel achy and had a fever to 102 last night.”
    Me: “Go home and rest. Call your [specialist in the chronic health problem she has] and see if she thinks you’re high enough risk to start tamiflu. As soon as possible.”
    Her: “Ok.”

    Why did a chronically ill person who works in an oncology clinic even consider coming to work when she might have H1N1 flu? Apart from the risk to her health, a lot of our patients are immunosuppressed and do NOT need to be exposed to whatever infection she might have. Our culture values dedication to your job and being tough far too much. A little common sense–and better laws on sick leave–are needed.

  4. #4 Right Wing Man
    June 4, 2009

    I have never had a flu vaccine – ever! I refuse to take them becuase some manufacturers make them from aborted fetal cell lines. Merck and others have completely lost their sense of ethics. Before taking any type of vaccine or pill I make sure I find out all I can about how it was made and who is profiting from it.

    The “swine flu” was just like the bird brain flu a few years ago. The media hyped it, everyone took a flu shot and that was the end of the story. No apocalypse or exploding heads or zomies ever happened. Most of the people who did die of the swine flu (was it a manufactured? – see World net daily) was already ill and weak from other health conditions. CBS and NBC refused to acknowledge this. Thank God for Fox news.

  5. #5 MonkeyPox
    June 4, 2009

    Dude, tell me you’re a parodist, cuz my Poe detector is burnin’ up.

    Flu vaccines are made in chicken eggs, not person eggs. And citing WND is like…well…

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