Wednesday, August 19, 2009

Is my son having 'swine' flu?

' Is my son having 'swine' flu?"
Father of a young IT professional who is admitted under my care was asking. He was admitted for fever and cough.He had just come back from a Metro City where there were many cases of Novel H1N1 Influenza A infections.
How can I answer him?
He is sick for 2 days,but not very sick.None of his colleagues or room mates were sick.There is nothing to suspect a severe infection. But can I be sure it is not H1N1 flu?
No, unless I have got a negative test result.
To do the test for this patient I will have to send him to nearby Govt Hospital.The doctor there had informed me that the result is delayed by at least 5 days. By that time the patient would have recovered fully or may be in a critical condition.
Then what is the use of sending for the test?
What should I tell this worried Parent?
I explained that as of now I do not suspect H1N1 flu. I also told him about the delay in getting the result. I said I am confident that he will recover fast.
I hope the patient recovers fast and my dilemmas in diagnosis will soon be over.

10 comments:

Nita said...

It's always a dilemma for doctors isn't it! With similar symptoms one doesn't know. I think one should ask the patient himself. very often we ourselves know how sick we are and moms can have intuition! however at times it can be paranoia too!

Smitha said...

It is so difficult for the doctors. We lay people, actually forget all these constraints that doctors work with..

I hope that little boy recovers soon.

Arun.N.M. said...

Welcome here Nita, Most doctors try to rely on thier own intuition, I am also like that, The intuition is developed by experience and I am better off now with that than few years ago. Some patients especially older ppl may have a good intuition of the seriousness of their illness. Many others are paranoid.

Arun.N.M. said...

Smitha, thank you for thinking abt doctor.'s dilemma. The young man is fortunately much better today.

Anonymous said...

Dear Dr

Isnt itpossible to start off them on anti viral drugs... would it cause for resistance in the virus while trying to save lives?

rgds
mohan!

Arun.N.M. said...

Mohan. Welcome to this blog. Only Tamiflu is approved for Novel H1N1 virus infection. It is under Govt control so as to prevent indiscriminate use of the drug. Indiscriminate use will result in mutations in the virus producing resistant strains. 95 % of H1N1 flu patients will recover without Tamiflu. So better to use it cautiously. The patient I mentioned in the post is recovering well and will be discharged today

Anonymous said...

Dear Doctor

Thanks for your quick response.

Am day in out seeing deaths of people mostly due to Asthma, Diabities, High BP etc ... HIn1 hits them and they die due to elevated other conditions.

most of the test reports come in after their death... Its quite scary as nobody can do anything and only prey to god...

Personaly i suffer from asthma, BP, Gout and even a common cold is a scary proposition for me. Since Anti virals are ruled out as stated, other than praying their is no hope for me!!

cheers
mohan!

Arun.N.M. said...

Mohan,
Do not be depressed,just be cautious.Use the simple precautions like washing your hands frequently and keeping away from sick people.Even if infected only less than 1% gets really sick and medicines can be given before test reports come if a patient is really sick.
cheer up

Anonymous said...

Good to know that your patient is doing well. Personally I think 'swine flu' has been blown way out of proportion.

I don't even like to call it 'swine flu' myself; according to me it's just another type of Influenza A, but it appears that adding the 'swine' before the 'flu' is turning 'the flu' into what is perceived as something vastly more virulent. You only need to look into a patient's eyes as he/she is asking the question ("Doc, is it/could it be swine flu?") to see the fear that is there.

Neways, I'll be glad when this thing has blown over.

Came over via Nita's blog.

Arun.N.M. said...

mummy jaan,
Media did sensationalise the novel H1N1 flu. I think it is good to have good public awareness but not panic to deal with such pandemic situation.

The Novel H1N1 flu may cause more death in the younger age group than ordinary influenza and that is little bit worrying