OK, here is what happened today:

3 children tested positive for Flu A.  2 of them had been immunized with Flumist, which up till now only rarely failed (maybe 5 previous positive Flu A’s out of hundreds previously immunized children tested).  The 3rd child was not immunized.  NONE of the 3 had “severe” flu — none had high fever, none looked as miserable as actors in NyQuil advertisements, none had anything resembling complications — in fact, in the middle of the epidemic 2 months ago, I probably would not have tested them because they did not look sick enough to have the “real” (garden variety) flu.  I gave Tamiflu to all three, and will follow them closely.  I do not know for sure that they had “swine” flu, but it is unlikely that “garden variety” flu would produce equally mild disease in immunized and unimmunized individuals.

So what is the most likely explanation?

I think this “new” swine flu is actually quite widespread already; I think the great majority of people who had it, never knew they had it because they did not feel sick enough to go to the doctor, and if they did, they did not look sick enough to be tested for flu.  I do not know what was different about the fatal cases in Mexico (apparently caused by the same virus), but I suspect we will find out soon.

Coming soon: Swine Flu III: The Search for Sanity…