It's official, we survived H1N1

shawmutt

Squirrel Murderer
shawmutt
Joined
Jan 17, 2009
Messages
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For some reason they stopped tested folks for H1N1 in our area (my mother-in-law is a nurse in the area and she said because of cost considerations)--but they continued testing anyone under one. My daughter, 10 months old, was really sick and we had to take her to the hospital. They did the testing, and she had it, which means that's what our whole family was sick with.

It's a really frightening thought. Our company is finally shipping out the first doses of the H1N1 vaccine. I'm probably still going to get my shot (or mist)--but damn--the what if's are bugging the crap out of me. What if this strain was just a little more deadly? Would any of my family have died?

I know my company and many others are working on a way to produce vaccine without using eggs. It's just damn scary to think that, in 2009, something as small as an influenza virus could run rampant throughout our population before we could lift a finger to prevent it. The anti-vax wonks, coupled with the rugged individualism of most US citizens, could really put a hurting on our country. It certainly is food for thought.
 
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I guess that puts you in the enviable position of being essentially a spectator as the main event unfolds then. I'm a bit curious, though, as to why you feel it necessary to get vaccinated against a bug you're sure you've already had and recovered from. There's not going to be anywhere near enough of the vaccine to go around, you know; especially not right at first.
 
Where I am they do not even test you for H1N1 unless you are hospitalised and likely on a respirator. I was misdiagnosed twice (first time for bronchitis, second time for pneumonia) before having my half-dead body brought into hospital where it was confirmed H1N1.

In my humble opinion it isn't a conspiracy that they are not testing the population, we just have an overflow of people with coughs and colds who immediately think the worst (our ER's get flooded badly). It does, however, undermine the statistics of how many people are actually infected, regardless of the severity of symptoms.
 
Dymanic said:
I'm a bit curious, though, as to why you feel it necessary to get vaccinated against a bug you're sure you've already had and recovered from. There's not going to be anywhere near enough of the vaccine to go around, you know; especially not right at first.
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I don't want anyone to be able to say that I don't get myself and my family vaccinated.

PowderNine said:
In my humble opinion it isn't a conspiracy that they are not testing the population, we just have an overflow of people with coughs and colds who immediately think the worst (our ER's get flooded badly).
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Well, my mother-in-law claims the tests cost $800, and doctors aren't willing to spend that much money for H1N1. I don't know enough about their policies to really comment.
 
That's because the vaccine is not yet available. When my friends and family ask me if I've been vaccinated I want to be able to tell them yes.
 
Well, especially since they don't ever add "since you already go the flu" to the fact that you "refused the vaccine" if you don't get it.
 
shawmutt said:
Well, my mother-in-law claims the tests cost $800, and doctors aren't willing to spend that much money for H1N1.
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Huh?

This is the basic Influenza A/B test, about $15 a pop, that would at least rule-out whether or not the patient has the flu. Specific H1N1 testing could follow, but likely would be unnecessary. You could just presumptively assume they have H1N1, send the patient home, and tell them to sit tight for a week only to return if they got REALLY sick.

~Dr. Imago
 
Dr. Imago said:
Huh?

This is the basic Influenza A/B test, about $15 a pop, that would at least rule-out whether or not the patient has the flu. Specific H1N1 testing could follow, but likely would be unnecessary. You could just presumptively assume they have H1N1, send the patient home, and tell them to sit tight for a week only to return if they got REALLY sick.

~Dr. Imago
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At some point our area was testing for the subtypes to document novel H1N1 cases, which they stopped, according to my mother-in-law, due to cost considerations.
 
shawmutt said:
At some point our area was testing for the subtypes to document novel H1N1 cases, which they stopped, according to my mother-in-law, due to cost considerations.
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Maybe, but I seriously doubt it was $800. That's about what a regular brain MRI costs.

I will find out what it costs and, more importantly, what the patient is billed at our hospital and get back to you.

:)

~Dr. Imago
 
The reasons they aren't testing for H1N1 specifically anymore are

1) When they were testing, basically everything was coming back positive, so if you have infuenza A, you most likely have H1N1, and
2) It really doesn't matter whether you specifically have it or not. Unless it is serious enough for hospitalization, the treatment is the same (go home, rest, and don't infect anyone until you get over it)
 
shawmutt said:
For some reason they stopped tested folks for H1N1 in our area (my mother-in-law is a nurse in the area and she said because of cost considerations)--but they continued testing anyone under one.
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The CDC issued a statement on this point a month or so ago. At some point, there was no longer a need to track individual cases but rather to track it the way they do the normal seasonal flu.

This is from their Q & A page:

CDC said:
Is reporting hospitalizations and deaths associated with flu new?
Routine seasonal surveillance does not count individual flu cases, hospitalizations or deaths (except for pediatric influenza deaths) but instead monitors activity levels and trends and virus characteristics through a nationwide surveillance system. The reporting of hospitalizations and deaths by state health departments was a new surveillance system that was initiated at the beginning of the 2009 H1N1 outbreak.

This season, CDC and states will continue surveillance for flu-related hospitalizations and deaths, but the system has been modified to combine all influenza and pneumonia-associated hospitalizations and deaths and not just those due to 2009 H1N1. This is a new system in place effective August 30, 2009, that will be used to monitor trends in hospitalizations and deaths. CDC believes this system will provide a fuller picture of the burden of serious flu illness and deaths during this pandemic. This number will be cross-checked periodically against modeling studies to assess its validity.
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I haven't heard that they were still tracking individual cases in infants, but I suspect that might be more to study its virulence in that age group than to track the epidemic. (Or it may have been something done locally just to improve treatment for that age group.)
 
shawmutt said:
but damn--the what if's are bugging the crap out of me. What if this strain was just a little more deadly? Would any of my family have died?
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I'm more concerned about the possibility of a widespread epidemic, even if the sickness isn't especially virulent. The effect on our struggling economy of 30 to 50% of the population coming down sick for 10 days or so could be significant.

ETA: And that's aside from concerns related to an over-burdened healthcare system. (No space left in ICUs, for example.)
 
Skeptical Greg said:
Are ICU's usually employed in the case of flu victims ?
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Depends on how sick the patient is. I haven't personally taken care of any H1N1 patients, but our hospital has had two deaths (so far), including a 19-year-old and an infant. Both were treated in our pediatric ICU, which is a unit in which I do not provide patient care.

~Dr. Imago
 
Reading from my post which was quoted to my response (see above, now gone), the logical answers are between them. My apologies.
 
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Dr. Imago said:
Maybe, but I seriously doubt it was $800. That's about what a regular brain MRI costs.

I will find out what it costs and, more importantly, what the patient is billed at our hospital and get back to you.

:)

~Dr. Imago
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Thanks, when my wife told me I was sure it was b.s., at least the cost of it sounded a bit extreme. It's more likely that they just followed the CDC recommendations.
 
shawmutt said:
That's because the vaccine is not yet available. When my friends and family ask me if I've been vaccinated I want to be able to tell them yes.
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But can't you say that now anyway? You've been vaccinated with a live culture of the H1N1 strain, conferring at least as much immunity as you're ever going to get from the vaccine. I'm not a medical practitioner, so I appeal to any who are reading here to correct me, but if you insist on being vaccinated against a disease you've just recovered from, just so you can say you've been vaccinated, aren't you rather missing the point of vaccination in the first place?

Dave
 
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