In our province (in Canada) they won't even do the test for H1N1 as they are saying, if you have the flu, it is H1N1 so why take the time and resources to test? I really am sick of hearing about it in the media, mass immunization programs roll out today and apparently the line ups were massive at 8am, with immunizations beginning at 12pm. I am NOT looking forward to standing in that huge line with my kids, but one is asthmatic and the other very young, so I will.

momm28, I think you did the right thing! I hope everyone is on the mend soon and your customer understands why you couldn't do it.

My 11 yr old niece has H1N1....her doctor swabbed her nose and the "rapid test" done in the office came back positive.

He then sent another sample out and 3 days later that too came back positive.

So some places do have a "rapid test" it's just that some doctors either don't use it or don't have access to it.

Her doctor also told her that tamiflu ONLY works within the first 24-48 hrs of the onset of flu like symptoms. It was too late to give it to Hannah, she had been ill for a few days by then.

We're in southeastern MA, I have a friend in RI whose children were also given the rapid test and it was positive.

Some healthcare professionals don't feel that the rapid test is 100% accurate so they don't always recommend them.

Seems like it depends on what area of the country you're living in as to how they are treating this flu.

All I know is it's pretty scary and I hope they can get this vaccine out to the public before we have a real epidemic on our hands.

Oh....they CLAIM that "Seasonal Flu" has not hit our area yet....how they know that is beyond me. It depends who you listen to and what you read.

This is what I have been telling my patients:

Flu is a viral illness. Antibiotics will not help you unless you also have a bacterial infection such as pneumonia. I am checking chest xrays on patients with a productive cough because we are seeing a fair amount of flu combined with pneumonia.

Tamiflu is only indicated if you have meet the CDC guidelines of being very young, very old, have certain medical conditons, are pregnant or live with someone who meets this criteria. Tamiflu does not cure the flu or make it less infectious. It does help you body fight the virus and typically you get better a day or so sooner than without it.

The rapid influenza A screening test is fairly accurate when positive for flu; meaning if the test is positive most liekly you have Type A flu (H1N1 and seasonal flu are subtypes of Influenza A). However, it is not accurate for ruling out flu; just because the rapid test is negative you may still have flu. The PCR test takes anywhere from 2-7 days and is very accurate. We are not testing patients for flu in my area unless they are admitted to the hospital. There is surveillence testing being done but not in my emergency department.

We are not yet seeing seasonal flu. So far all flu in my area has been H1N1.

Pregnant women are more likely to develop serious complications from H1N1.

It takes about 2 weeks to develop immunity following the vaccine.

Get plenty of rest, fluids, and do not return to school or work until you have been fever free for 24 hours - not on ibuprofen or tylenol.

I have had flu this week and am feeling a bit better today. I got my vaccine on Tuesday and the symptoms started Wednesday. I had a feeling the vaccine would be too late for me. I have been seeing so many kids with flu and knew with that much exposure my chances of getting it before the vaccine stimulated immunity in me were very high. Fortunately, my kids and husband are still well.

DKelly - Here's the deal. Yes, there is a rapid flu test, but it is not H1N1-specific. It will detect flu A or flu B (H1N1 fitting into that), depnding on which rapid test you use, but is only 50-60% sensitive (that's according to large studies, not just some healthcare providers). This means you MIGHT have it, but the test will only pick up 50-60% of the people that have it, leaving the other half as "false negatives".

The second test you mention that your niece had done IS specific to H1N1, and takes several days to do, as you said. However, you're right, seasonal flu has not yet started (this we know based on samples, and historical epidemiology). Therefore, the true flu + people who are showing up right now ARE H1N1, not the seasonal flu.

Which is why many people are choosing not to rapid test. The test only picks up half the people who have it, and even when they do have it, Tamiflu (you're right again) only works when given in the very beginning. So, if your treatment (meaning chiefly supportive treatment: rest, fluids, tylenol or other antipyretics for fever) is going to be the same no matter which virus you are treating, you could argue there's not much of a point to getting tested.

The information is actually consistent among healthcare providers as far as what tests are out there, but not everybody is testing in the same way for the reasons I mentioned here. We have CONSTANT updates within the medical community, at least a couple of times per week, so for the most part, we're on the same page regarding what's out there .... the information doesn't necessarily get translated to the public in a uniform way, though, and frankly, since this is the first time we've had this, we don't know yet how effective the immunization campaign will be.

Hope that spells out some of the nitty-gritty details ...

-Emi.

Thanks sooooooo much to beanbean and the next poster for some good info!
I received this info in an e-mail last week. I cannot say how true it is but it sounds good and can't hurt I'm sure.

Dr. Vinay Goyal is an MBBS,DRM,DNB (Intensivist and Thyroid specialist) having clinical experience of over 20 years. He has worked in institutions like Hinduja Hospital , Bombay Hospital , Saifee Hospital , Tata Memorial etc.. Presently, he is heading our Nuclear Medicine Department and Thyroid clinic at Riddhivinayak Cardiac and Critical Centre, Malad (W). This is what he says:
The only portals of entry are the nostrils and mouth/throat. In a global epidemic of this nature, it's almost impossible to avoid coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is.
While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps, not fully highlighted in most official communications, can be practiced
1. Frequent hand-washing (well highlighted in all official communications).
2. "Hands-off-the-face" approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap)..
3. *Gargle twice a day with warm salt water (use Listerine if you don't trust salt). *H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don't underestimate this simple, inexpensive and powerful preventative method.
4. Similar to 3 above, *clean your nostrils at least once every day with warm salt water. *Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to clean nasal cavities), but *blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.*
5. *Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). *If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.
6. *Drink as much of warm liquids (tea, coffee, etc) as you can. *Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.

The most important points are the first two frequent handwashing and keeping your hands away from your face. Practicing these two actions will help prevent other illnesses such as the common cold as well.

In terms of the salt water gargling, drinking hot liquids, and Vitamin C I am not aware of any studies regarding these. Vitamin C is tough because some people including so very well known scientists and researchers swear by it, but it has never really proven itself out in clinical trials. Like you said though, it can't hurt.

I wash my hands a million times a day but when your grand kids cough right into your face.....ding ding ding........I get pneumonia......
thanks for all the heads up great info beanbean.....i wish I would have bought stock in purel hand sanitizer lol

I wash my hands a million times a day but when your grand kids cough right into your face.....ding ding ding........I get pneumonia......
thanks for all the heads up great info beanbean.....i wish I would have bought stock in purel hand sanitizer lol