Swine Flu 4.992: The Winter of our Discontent



Yes, the picture that is worth 1000 words: H1N1 mortality in children has overtaken seasonal flu mortality.  Considering how prevalent this infection has been (we were busier during late spring than during any seasonal epidemic I can recall), swine flu is clearly more contagious than seasonal, but not necessarily more virulent — an individual’s risk of contracting it is high; once contracted, the risk of complications is in the same ballpark as for regular flu, except for highest-risk groups such as pregnant women.  Our original impression of this as mild flu is based on our model of care — rapid access to care, rapid diagnosis, prompt treatment.  Children treated 24 hours after onset of fever in our office have been recovering literally overnight! 

 We have also dispensed close to 1000 doses of H1N1 vaccines (injectable and nasal), and are running out.  As always, shortages create demand, and people who were declining the vaccine a month ago are clamoring for it now.  As of last night, we were out of injectable, and down to 30 doses of nasal.  Additional doses are expected from the Department of Health, which so far has done an amazing job handling this epidemic. 

Safety of the vaccine has been reviewed elsewhere; we have seen no serious reactions to any of these vaccines.  The number of people who turn up sick after immunization with “normal” illnesses is no higher than the number of unimmunized people who get sick just from being around other sick people.  There have been too few (a couple a day) positive flu tests to say anything about how effective the vaccine is; that is the subject for another post.