Is that Cough Swine Flu? Don't Ask the CDC

Reading about the microbial adventures of Sanjay Gupta and Anderson Cooper in Afghanistan has made me wonder about something rather personal. I'd just had an extremely sore throat with no fever that kept me up all night, day after day. I visited the CDC page for "Interim Guidance on Case Definitions to be Used For Investigations of Novel Influenza A (H1N1) Cases" and found it blank.

The celebrity journalists both fell ill in Afghanistan--CNN's chief medical correspondent came down with a classic array of fever, sinus congestion, nausea, and body aches while the 360 host got a very nasty sore throat. Gupta was treated for swine flu. Cooper wasn't.

Cooper's circumstances raise an important social question, at least for me and for thousands of other Americans: Do we have swine flu?

Incidentally I've done a lot of research on influenza for an online blog enovel I wrote about an H5N1 pandemic that hits New York City. I know the symptoms pretty well: fever, chills, ache, fatigue, vomiting, headache, diarrhea, and upper respiratory tract problems.

Using a neti pot helped, but I couldn't flush my sinuses while sleeping--or working in a busy office. I embraced antibiotics on the theory that I'd developed a secondary bacterial infection.

Then Gupta and Cooper shed light on my plight. Gupta had been sufficiently alarmed by "profound chills and shakes" that he got tested for swine flu and was given IV sustenance by the U.S. military.

Cooper caught what he described to Gupta on 360 as "the worst cough I'd ever had."

In the field, Gupta told Cooper he "probably" didn't have swine flu because he lacked the "very high fever" that typically heralds it. (Cooper was never tested.) On the air weeks later, Gupta told Cooper that he thought there was "a good chance" the host caught swine flu. What about that missing fever?

An important question. Since the novel H1N1 virus known as swine flu broke out of Mexico and into the media late in April, a lot of people have suffered respiratory symptoms without fever. Strep throat has been a common complaint. But few such cases have been dubbed swine flu. Does this leave countless flu victims spewing virions all over the subway, bus, train, home, or office--oblivious to the fact that they may be spreading the dreaded flu?

If so, someone should inform the school administrators who count only cases in which students present fever symptoms when deciding whether or not to close a given school.

Cooper further highlights the problem of presenteeism, a social condition whereby germs are circulated by sick workaholics and employees who can't afford to take a day off because they lack insurance or paid leave. Workers who don't know their cough is contagious can disable a workplace. "I also didn't take any days off," confesses Cooper.

I didn't miss a day either.

On learning from Gupta that he may well have contracted swine flu, Cooper turned rueful. "I love that I just learned that I may have had swine flu--from you, via satellite," he said. Cooper took two rounds of antibiotics for two weeks and still has ear trouble. Gupta assured him the antibiotics "probably" didn't help.

In my case, they seemed to help a lot, so long as the 10-day cycle lasted. Now my throat hurts and I've resumed coughing. The hacks of my co-workers drown mine out. They are sicker than I am.

Off to work!

So what does the CDC say? I called the agency to find out what it says about this coughing business--and why its swine flu symptoms guidelines page is down.

Ahem. Did Cooper and I have the flu, I ask?

"We have heard of cases that did not involve fever, but that is certainly not the norm," A CDC spokesperson replied. He promised to look into why the symptoms guidelines are missing.

Back to you, CNN Survivors.

Comments

[Sephi]

I don't think that the CDC purposely misleads anyone. It's quite complicated and I think that the real solution is to combat H1N1 by greatly expediting the public health agencies operations of the microbiology, virology, and immunology laboratories. Please have a look at STAR-LIMS approach towards combating H1N1: http://www.starlims.com/STARLIMS_H1N1.htm

Maybe there’s nothing you can do to fight your neighborhood’s version of Clark Griswold, but with a little luck, maybe your local health agency is mounting a serious STARLIMS informatics response to your own local H1N1 epidemic.

[disneykristi]

CDC document on their website in the section for employers http://www.flu.gov/professional/business/guidance.pdf (dated 8/19/09):
"Workers who have symptoms of influenza-like illness are recommended to stay home and not come to work until at least 24 hours after their fever has resolved.... CDC recommends this strategy for all levels of severity. Employers should plan now for how they will operate if there is significant absenteeism from sick workers. However, employers should know that some persons with influenza, including those ill with 2009 H1N1, do not have fever. Therefore it will not be possible to exclude everyone who is ill with influenza from the workplace."

And Yes, I am wondering too, if this nagging barking cough that I've had over a month that followed body aches, diarrhea, & swollen glands that lasted a day and sore throat that lasted for a week and a half is "swine" flu. I can't shake this cough and I feel short of breath. I've had severe bronchitis and pneumonia in the past, so I know I wasn't very sick with this, but it won't go away! For the record I went to Dr. on day 4 and they didn't test per CDC guidelines. But as I read about the lung changes that thay see that are occuring with the H1N1, I am wondering every time I start to cough again if this is a problem to worry about...

[Conk]

The CDC, along with most all of the acronym agencies, are a front for Big Pharma. Do the opposite of what they recommend! CDC, FDA, USDA? Funded and run by Pharma and Agri-business. Run Forest Run!

[clevernamehere]

You make it sound like the CDC is purposely misleading you. All you had to do was go to the doctor and ask to be cultured. It would have taken time to get results, but you would know for sure.

For all your complaints, the CDC needs data to create an accurate symptom list. If you thought you might have swine flu, going to the doctor would have both let you know if you had swine flu and helped the CDC improve their symptom list.

The CDC web page for swine flu currently says "It’s important to note that not everyone with flu will have a fever."

[tzip]

I don't know about you but my HMO would not culture my kid for influenza A which is suppose to be 99% Swine Flu at this time. It was too late for her to get tammaflu because I was sure she had a head cold she had no fever and head congestion. Then came down with the sore throat. 170 kids were absent from her 600 kid middle school this week.

Now she has bronchitis, it makes no sense that few know 10-40% of flu patients are not getting a fever

Our MD said that their flu test was only 60% accurate. After thinking about it I realized that can't be. In Psychology 60% on anything is invalid and medicine is a lot more life and death then that. I can assume that the swine flu test itself is more accurate but expensive.
I also said I wanted to know if she had it so she could avoid the vaccine. I was told that she should have it anyway becasue their are several strains. I thought about that some more and realized I could still avoided giving her the vaccine, when it gets here, because she will not get another strain of it once she has had one. She has a good immune system and I'd rather she kept it that way and we avoid vaccines that are totally unnecessary.

The lack of information is killing people at this point and it is not a small matter at all.

[Cindy1274]

"After all the waiting and worrying, the first of the swine flu vaccines will begin arriving in the United States next week."

Again, I ask "Where is the vaccine coming from?" Does anyone know? I cannot get an answer to this.