The Doctors Next Door

H1N1 Teen Death--Can You Prevent It in Your Family?

If you're like me you are both saddened and frightened to learn of the death of Naperville teen, Michelle Fahle from H1N1. The natural question that follows such tragedy is "how do I keep that from happening to me and my family?" 

So what do you do?

What should your doctor do in the event you or someone you love develops symptoms of an influenza-like illness  (ILI)?

First let's review the signs of influenza-like illness (ILI):


  • fever                                                          
  • Porky Flu.jpg
    nasal congestion
  • sore throat
  • body aches
  • headache
  • nausea, vomiting
  • diarrhea

These last two are more commonly seen with H1N1 than with regular seasonal flu. Gastro-intestinal symptoms alone however, are not influenza.  If you have the "stomach flu", you don't have influenza at all. You may have different virus but not influenza.

The overwhelming majority of people who develop ILI, will suffer relatively mild illness and recover within about a week. Those with an underlying condition such as asthma, diabetes or heart disease are at greater risk of severe illness. We're told that 19 people have died in Illinois from H1N1 since April. Three have been children. Michelle Fahle brings that number to four.  While we don't know yet if Michelle had an underlying high-risk condition, about 20-30% of all those who have died did not have such a condition.

So how do you know if you need to seek medical attention for yourself or your loved ones? What are the warning signs that the illness is becoming a severe case? I'll go over the answers to these questions but first, I'd like to request a little empathy for your doctor's office.

As you can imagine, doctors offices are anticipating an onslaught of sick patients with this outbreak.  If you call your doctor, you can expect the phone lines to be jammed. Please try to be a patient patient while you wait on hold. However, I would definitely call instead of just going in for an appointment.  In most cases it will be best to keep your germs at home.

To complicate matters, these offices could be poorly staffed due to healthcare workers coming down with H1N1. Healthcare workers are on the list of high-risk people that should get the H1N1 injectable vaccine but it isn't here yet!  Once we do get immunized it will take about 2 weeks for the vaccine to take effect.  We may get the flu before we ever have a chance to be immunized and we may have a real hard time meeting your needs in this time of a pandemic. If a healthcare worker gets ILI, they will need to stay home for 7 days following the onset of symptoms to avoid infecting their co-workers and patients.  These infection control guidelines are different from the guidelines for everyone else which state you should stay home until fever-free for 24 hours.

Once you do get through to speak with a medical professional, the Centers for Disease Control recommends a few screening questions to help the office make a decision about whether you should be seen.  Expect to be asked about the presence of:

  • shortness of breath
  • chest pain
  • dizzyness
  • confusion
  • severe or persistent vomiting
  • flu-like symptoms that got better but then recurred again a few days later

If the answer to these is "no", you may still need to seek medical attention if:

  • You are over age 65 or under age 5
  • You have one of several medical conditions including, chronic lung disease (including asthma), heart problems, kidney or liver disease, sickle cell anemia, diabetes, or a suppressed immune system
  • Your weight puts you in the category of obesity

These are the people who really need anti-viral medicine like Tamiflu.  If you do not fall into these categories, your system is expected to be strong enough to enable your recovery without this medicine.  This is where public health officials and we medical professionals recommend that you sacrifice this option in order to reserve it for those who are at greater risk. The truth is, if we treat everyone, we will run out of the drug and not have it for the tiny one year old with H1N1 or the pregnant mother of two.  If, however, you have ILI and are regularly exposed to a person who falls into a high-risk category, that person may benefit from taking the Tamiflu to prevent the illness.

Finally, a word about infants and young children--they may not get the same symptoms as older children and adults. Best to call your doctor about a fever in a child under the age of two years.  This age group is at higher risk for complications of the flu and may not have a cough or be able to tell you they have a sore throat.

One more thing--get your family immunized! 


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