Swine Flu, Other Viruses and High Anxiety — October 12, 2009
| We’re a month into the school year and it’s the time of year when it seems our kids are spending more days sick than well. Please don’t be fooled into thinking that this winter is so different from previous winters.
Swine Flu does not pose a realistic risk to your family: There will be millions of cases reported and rare fatalities highly publicized. Some of us will get high fevers and have to miss school and work for a few days and 99.9999% of us will remain completely unaffected after the flu season except that those who contract Swine Flu this year will be protected if it gets meaner and more virulent in coming years as expected. Every winter there are dozens and dozens of different viruses. The immune system is built by catching and beating these bugs and acquiring antibodies and “memory cells” for the next time the virus appears. There is no way around this process and no shortcut. Children, in particular, must suffer through a lot of winter illnesses because their immune systems are so inexperienced. Colds and coughs have an acute phase of 2, 3 or 4 days during which children are contagious and may need to stay home from school. Following this contagious period, there can be extra mucus, congestion, cough and malaise for another week or so. By the end of this ten-day period, most children will have been exposed to, and maybe contracted, another 2 or 3 other viruses! It’s really no surprise that your children and many others might seem to be sick for weeks on end. Some children and adults have allergies which compound the congestion and coughing problem. A new study showed that when you examine the blood of children who’ve been sick for a couple weeks or more the majority of these kids show antibodies to 2 or 3 different viruses: In other words, children and adults don’t have ten-day viral illnesses, they have a series of 2 and 3 day bugs which might look daunting but are actually just a part of a normal winter viral season. Why do we get more illnesses in winter? There are more social and school gatherings in confined spaces, the air is drier, more people travel during winter holidays and we eat more junk food during these months. New viruses get more people sick than older ones and this year the Swine Flu H1N1 virus is the newest common infection. The media are taking advantage of this situation and are creating more anxiety about winter illness than at any time in recent memory. Except, maybe, for the SARS scare. Or the Bird Flu scare. Or the West Nile Virus scare. 75-80% of the 76 children had significant or severe underlying medical problems. Any child’s death creates an extremely difficult public discussion but of the 300,000,000 Americans there are 45,000,000 children and teens and there have been 76 deaths of younger people. About 15 of these deaths occurred in seemingly healthy children and teens. Please put all of these numbers in the proper perspective and realize that there are many important lifesaving topics for the media to publicize but none which sell papers and create TV viewership quite as well as this new flu. In July CDC and World Health Organization officials stopped counting the number of cases of Swine Flu and are now relying on a patchwork reporting system which is reporting both “lab confirmed” cases of H1N1 and fatalities from cases which are associated with symptoms of Swine Flu. The science is terrible but the publicity is geared towards increasing fear, selling vaccines and Tamiflu and keeping us all on edge. They are reporting deaths from “secondary” bacterial infections and some unofficial sources are even urging people who might be sick with Swine Flu to immediately see their doctors to get vaccines which might prevent bacterial pneumonia. This, by the way, is a serious misinterpretation of certain vaccines’ purpose and an even more serious misunderstanding of how long it takes a vaccine to work. Vaccines, including the flu shots, should not be given to sick children or adults. In the past 18 months, budget cutbacks have led to the loss of over 15,000 public health department jobs. It might be overly cynical to assume that a full court press about H1N1 could lead to some of these jobs being restored or, at least, might stem the budget cutbacks and preserve further job loss. Every winter I tell the families in my practice that winter viruses–including this new H1N1–are very unlikely to cause serious illness in healthy people but you may choose to do your very best to avoid them before a vacation, an important school event or just because you want this to be a quieter winter for your family. I don’t think that this year’s pair of flu vaccines will create disasters but I also don’t think that they’re a good use of our health care dollars. They are definitely not worth the amount of media and medical attention they’ve received and continue to receive. Swine Flu vaccines are now available and they may be just as safe as the CDC and others say they are but they are not the most important measure for keeping your children free of viral illness. Try to get a good night’s sleep!! Somehow.
Fever is one of the immune system’s best tools for fighting viruses and bacteria and should be left alone whenever possible. Higher fever might need to be decreased for a child’s comfort and, mainly, for assessment. 104 degree children all look like they might have a terrible illness. Using a long bath, natural remedies and even Tylenol or Ibuprofen will give you a “window” to look at a child with a much lower temperature. A cooler child will usually smile more, drink more and look more like herself. You can then see that there might be a pretty big fever but the illness underlying the fever is a small illness. Worry and stress levels can drop. If your child has an illness which is preventing good hydration or if lowering a child’s fever still doesn’t allow you to adequately evaluate the illness, call your doctor. Again, this winter is not different than previous winters. Swine Flu does not pose a realistic risk to your family. Jay Gordon, MD, FAAP |
