I'm no MD, so this is a layman’s view, consult your doctor for advice. Then again, MDs make plenty of mistakes and/or disagree with each other, so I’ll trust my own instincts.
My daughter tested positive for H1N1 swine flu 4 days ago. High fever (up to 104.3°), but the fever broke after a day or two and fortunately did not stay that high very long (we cooled her with a bath and medication). Recovery is slow but steady. Another daughter (with asthma) is seeing a fever now, so we are vigilant, and she has started Tamiflu. I’m sick too, feeling crappy with a raw set of lungs, but no fever as yet. We are watching for pneumonia, which is one risk several days into infection.
The advice we received from our health care provider is that we can send a child back to school 24 hours after the fever breaks, assuming the child seems ok. Seems like poor advice to me, when a new flu variant is little understood, and could mutate at any time (it has already crossed the species barrier showing that is is highly adaptable). Trust your own good judgment— it’s public policy to avoid inconvenience for the parents of sick children. If you have to, keep your well children home to avoid infection from others during an outbreak.
An understated risk of H1N1 is a “hiccup” a few days later where bacterial or other pneumonia sets in; H1N1 can weaken and inflame the lining of the lungs. Asthmatics are particularly at risk. Pneumonia can turn on you in hours and it ain’t fun. Be vigilant until completely well. I had pneumonia a few years ago, and it took me 3-4 months to recover. Get your pneumococcus vaccine, which protects you against one cause.
So why do I say “what’s the reality”? Because my daughter attended a field trip with 80-90 other students, a Wed - Friday trip. A lot of weak-looking children got off that bus. My daughter became ill on the trip, and the following Monday there were 36 absences out of ~88 student body. That’s about 40%, indicating an especially infectious bug! Mind you, some parents send sick children to school anyway, so the chances of all the Monday attendees being healthy is next to nil, so the actual figures are probably low. One sick child was diagnosed (lab results) with H1N1 that Friday (probably the vector) and this was reported by the school district in an email 3 days later (all the time it takes for full-blown H1N1 to develop). We reported our daughter positive for H1N1 on Tuesday based on a lab test. Since then, an eerie radio silence from the school district, on H1N1 or anything about the huge number of absences. Those 34 student absences remain unexplained.
So I called the woefully understaffed county health department. They were completely unaware of the unusual number of student absences at our school, insisting that they were helpless to do anything but take confirmed lab reports of H1N1 (the idea of proactive tracking/testing apparently escapes them). In my view, any rapid-fire infection with an apparent infection rate of 40% is cause for alarm, and immediate investigation. Isn’t that what a public health department should do? But they were not informed by our school district. Probably the same problem exists in every other school district too, so no surprise there. It’s very, very strange how our district just doesn’t want to talk about it.
In short, there is no tracking system in place to see rapid-fire infectious disease, no “heads up” alerts in one of the most critical places, our schools. At least in my school district and county. Yet schools are a major vector for disease transmission, with germ factories (kids) being in close proximity for 7 hours a day. Pity the teachers.
I pressed the health department to look into the student absences at our school. They took a verbal report from me, and I’m told that a committee might look into it soon. The report for my county (San Mateo, CA) reports that “For week 40 (ending 10/10/09) of the current 2009-10 influenza season, a total of 203 specimens were tested for influenza, of which 30 (15%) were positive.” Read that again: 203 tests for a county with millions of people. My daughter’s grade had 36 absences alone. The amount of testing means that official H1N1 statistics are for your amusement only, just for giggles.
It was like pulling teeth to get our daughter’s doctor to test her for H1N1 (they are clearly overwhelmed), and it took hours of waiting with other sick people, another risk. There are some very ill people out there, entire families that looks miserable, and the numbers show that very little testing occurs. No one can know what is actually happening in reality, except indirectly by those who show up in the hospital, or perhaps the morgue.
We took our second daughter in today, and the doctor tried every possible way to dissuade us from the H1N1 test, but we prevailed. In other words, the county health department will take only confirmed lab tests, but tests are strongly discouraged! Truly a recipe for ignorance, obviously officials don’t know shit about this epidemic because there is no test data other than hospital admissions. There is also no mad cow disease in the USA because the government makes it illegal to test for it (“Creekstone”).
My view: H1N1 is underestimated by a gross factor. When hardly anyone is tested we are all ignorant, and therefore at risk. When people start showing up dead more often, our “leaders” will act to diagnose what went wrong with the system, and then pledge to fix it with some stimulus money after they are re-elected.
Protect yourself — Especially for those with asthma or other health conditions, get the annual flu shot, the H1N1 shot (when available), and avoid public places— Joe Biden was right even though he was pressured to correct himself (it’s a pity he caved in, but Nancy Pelosi is happy to see you take risks). News flash to politicians: H1N1 spreads through the air. You can trust that the government will lie and mislead to the extent needed to avoid public panic, so take care of yourself and your family.