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Misinformation Linked to Explosion of Swine Flu in US Schools
Recombinomics Commentary 22:42
August 26, 2009

A high number of students at Sylacauga city schools are reporting being sick, but it appears to be a stomach virus doing most of the damage right now instead of the H1N1 strain of influenza that has worried health officials around the world.

Lisa McGrady, the school system's registered nurse, said students are fighting off strep throat, the flu and a stomach virus which are all making the rounds right now.

McGrady said her main complaint has been the stomach virus with students complaining of headaches and being nauseated but without any signs of fever.

The above comments describe a rapidly spreading pandemic H1N1 outbreak in Alabama (see map), but similar statements have been made by others regarding other swine flu outbreaks.  10-20% of the schools population is ill, and only a portion of the illnesses is attributed to swine flu.  However, swine flu causes sore throats, has a gastrointestinal component, and over 50% of infections have no fever.  Consequently, the above comments suggest there is little swine flu, even though step throat and upset stomachs generally do not affect 10-20% of the student population in August.

In addition to the above outbreak, there are similar outbreaks throughout Alabama, as well as other states in the south (see map) where the school season started several weeks ago.  These other outbreaks include students that are influenza A positive and have flu-like symptoms.  However, even in those outbreaks officials are stating that swine flu hasn't been confirmed, even though there is little seasonal flu in August, and over 99% of influenza A positive infections are swine H1N1.

Thus, although it is clear that swine flu is spreading rapidly, the general public is confused by false statements by officials, testing limited to influenza A determinations, or the lack of any testing.

However, at this time of the year, it is clear that swine flu is accounting for the vast majority of absenteeism, and the infections include college as well as younger students.  The older students are told to remain in their rooms and avoid health care centers because those facilities are being overwhelmed, and therefore cannot treat the more serious cases.

Because of the lack of testing, it remains unclear how many students are infected with Tamiflu resistant H1N1.  Many schools are now recommending prophylactic Relenza, suggesting that Tamiflu resistance is more widespread than reported.  Indeed the resistance may be contributing to the rapid spread and may be causing more significant problems in cases at risk patients.

The confusion caused by media broadcasts of misinformation should be addressed now, when diagnosis of swine flu can be accurately made in the absence of lab confirmation, and students lacking fever can be isolated.

Similarly, more information on the anti-viral sensitivity of the rapidly spreading H1N1 would be useful.

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