Saturday, November 7, 2009

The Personal Side of H1N1

I have not written this blog for a few weeks now as I try to cope with my own bout of H1N1.  While the course is said to be brief, the truth is that it is extremely variable.  If it was always mild and brief, which is true for the majority of cases, we would not see any deaths. Tragically we are seeing deaths.  In my case, and in the case of my fifteen year old son who was generous enough to share it with me after he was infected, it was more severe.  My son’s illness went on for about five weeks and had associated with it a pneumonia on chest x-ray.  I am now at the end of my third week and while my fever and chills only lasted a few days, the cough and muscle pains and weakness that I have are persisting and only now gradually decreasing.  It has obviously impacted all aspects of my life, including the writing of this blog.  It is often easy to forget that all illness has impact beyond the illness itself.  A person who is sick, either with H1N1 or with a serious life threatening illness is a person who is living their life, going to work, taking care of the people they love and all that is impacted by the illness. 

Who Gets H1N1?

Supposedly I am in the age group that is less likely to get the infection.  However I am also a great example of the fact that even if you don’t “fit” the profile you can still get the disease.  By this age graph, since I am in the 50 – 64 age group, I should not be at high risk however it is safe to say that my risk was 100%, since I have it. 

H1N1 age graph

How Do I Feel Once I Get It?

The short answer is not very well.  Fever, cough, shortness of breath and muscle pain are typical of the illness.  On a personal basis, I was lucky enough to have all of those and the cough and muscle pain (from my observation of myself and my son) take the longest to clear up.  This chart shows the common symptoms for those people who have been hospitalized for the illness, according to the CDC. 

Symptom

Number (%)

Fever 249 (93%)
Cough 223 (83%)
Shortness of Breath 145 (54%)
Fatigue/Weakness 108 (40%)
Chills 99 (37%)
Myalgias (Muscle Pains) 96 (36%)
Rhinorrhea (Runny Nose) 96 (36%)
Sore Throat 84 (31%)
Headache 83 (31%)
Vomiting 78 (29%)
Wheezing 64 (24%)
Diarrhea 64 (24%)

Looking at the Data

Every week, the CDC sends out an update on the course of H1N1 from around the country.  The most recent from yesterday, describes a picture of increasing hospitalizations, increasing deaths and widespread activity in 48 states.  However even this may be understated.  An article that was published on the Internet by researchers at the CDC and at Harvard looked at the cases of reported H1N1 and then tried to determine through mathematical models, whether that accurately reflected the number of cases that were being seen.  Their answer was stated in the article:

“Through July 2009, a total of 43,677 laboratory-confirmed cases of influenza A pandemic (H1N1) 2009 were reported in the United States, which is likely a substantial underestimate of the true number. Correcting for under-ascertainment using a multiplier model, we estimate that 1.8 million–5.7 million cases occurred, including 9,000–21,000 hospitalizations.” 

Since then, according to the CDC, the number of cases has actually increased with 17,838 hospitalizations and 672 deaths documented that are related to the H1N1 infection thus far.

What About the Vaccine?

All available data shows it works.  Get it if you can!  The problem for most people is that the vaccine is in short supply and it may also be too late for the bulk of the population.  The illness appears to be peaking now rather than later in the season as is typical for the usual seasonal flu.  Thus far, (as of Nov 5), 26 million doses have been shipped while 36 million doses are needed just for the high risk groups (and I don’t fit into that group).  The government has taken the lead in managing supply of the drug.  They have not done a stellar job however it is hard to criticize as I don’t know that it was possible to do a stellar job under these circumstances. 

Bottom Line

Try not to get sick while understanding that a large part is out of your control, unless you can become a true hermit until the epidemic is over.  If you do get sick, don’t be like me and see your doctor early to potentially take an anti-viral agent, such as Tamiflu early.  I toughed it out and should not have.  I will get back to my usually medical article review and commentary as soon as the coughing stops.