ATLANTA -- So many messages have emerged about swine flu -- it's
bad, it's not that bad, it's like the common flu, it's not like the
common flu -- that many people are confused about when to seek care
or head to an emergency room, doctors say.
When swine flu emerged as a new virus in April, U.S. health
officials communicated their alarm about the disease that appeared
to be causing severe illness and numerous deaths in Mexico. Schools
were shut down and disinfected when a single student was diagnosed
with the new flu, which is a mixture of swine, avian and human flu
viruses.
But as more information emerged, health officials at the Centers
for Disease Control and Prevention softened their alarm and
reversed their early advice: Not everyone with a flu needed to be
tested for swine flu, and schools should remain open when possible.
Basically, they likened the virus to the seasonal flu.
More recently, however, the message turned again as it became
clear that this new virus should not always be treated as the
regular flu. Swine flu, or H1N1, was more apt to strike children
and young adults than the seasonal flu, and even people with no
pre-existing health conditions could quickly sink into illness
requiring hospitalization.
The changing messages have left many confused about whether to
seek treatment if they or their child are sick, and even health
care providers themselves have been challenged to keep up with the
emerging research on the best treatment.
"Whenever you change the message, it will create confusion,"
said Dr. David Propp, a staff physician at the Emory Clinic in
Atlanta.
Propp said the clinic has received many calls from people
showing symptoms of swine flu but who are unsure whether they
should come in for an office visit, go to an emergency room or just
curl up with some tea and rest for a few days.
He pointed out that in most cases the swine flu affects a person
much the same as the seasonal flu, but there are people who will be
hit harder and possibly face a health crisis.
Propp has a general rule: When in doubt about what to do, call
your doctor.
Often when people call a doctor's office, they speak to a
receptionist or scheduler, but doctors recommend that when you need
some medical evaluation over the phone, you ask for a nurse or
doctor.
"You don't have to be seriously ill to call a doctor," said
Dr. Beth Bell, associate director for science at the CDC's National
Center for Immunization and Respiratory Diseases. "I don't think
it's a good idea to just stay at home and not ask," she said.
While seasonal flu kills about 36,000 people each year in the
U.S. on average, CDC reports the swine flu has killed 1,049 in the
U.S. since April.
People with underlying health conditions -- such as pregnant
woman, diabetics, asthma sufferers and others with weakened immune
systems -- should seriously consider consulting a doctor anytime
they have flu symptoms, health professionals said.
Signs of significant trouble can include severe shortness of
breath, chest pain and skin taking on a bluish tinge, Bell said. In
addition, if a person appears to be getting better and then
suddenly gets worse, he should call a doctor, Bell said.
Particularly, labored breathing and a bluish tint to the skin
require a trip to the emergency room, Propp said, as these could
reflect problems with "vital functions."
Delaying that call to a doctor's office can be costly, health
officials say, because the swine flu can escalate quickly into
pneumonia.
The World Health Organization has urged doctors to treat swine
flu quickly with antiviral drugs.
The antiviral Tamiflu is most effective when taken within 48
hours of the onset of flu symptoms, but can reduce the severity of
the flu if given within 72 hours.
Some people may be confused by the changing messages, but CDC
officials say they felt obligated to release information as it
emerged.
"I think it's important for the CDC to be viewed as credible
and transparent. If what we know changes, we need to reflect
that," said Dr. Anne Schuchat, the CDC director of immunization
and respiratory disease.
Some confusion may be occurring due to faulty test results for
swine flu, CDC officials said.
"We are concerned that patients may not be getting diagnosed
and treated because some of the tests may be giving incorrect
results," said Dr. Dan Jernigan, deputy director of the CDC's
influenza division.
Jernigan said, "Clinicians should treat patients who have the
significant symptoms of flu regardless of the results of the simple
flu tests."
Michelle Freeman, a mother in Newnan, Ga., suspects a faulty
test delayed care for her daughter.
About two weeks ago, her 14-year-old daughter, Ashley, showed
flulike symptoms and was running a 102.5-degree fever. But a
doctor's test came up negative for the flu, she said.
Her daughter's condition has turned into pneumonia.
Freeman suspects she did have swine flu and might have recovered
sooner if she had received Tamiflu earlier.
"It's very confusing," Freeman said. "Did she have swine
flu?"
Craig Schneider writes for The Atlanta Journal-Constitution.
E-mail: cschneider@ajc.com.
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