Think You Have Swine Flu? What to Do

Most infections are so mild they go undiagnosed, but see a doctor anyway if you have telltale symptoms.

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In recent conversations with friends, all I've been hearing about is swine flu. "I had it. I was sick for three days," one friend told me. Her middle child came down with a mild case as well. Another friend said she had to cancel her business trip to Germany after her daughter tested positive for the virus. She was warned that she could be quarantined in her hotel room if she came down with it while traveling; she spent the week indoors with her kindergartner who had a 48-hour sore throat and fever—but didn't wind up getting ill herself.

After hearing about my friends' experiences, I'm wondering why H1N1 is still big news. (Today, Reuters reports that 11 cases of H1N1 have appeared on a U.S. military base in Afghanistan! The country's only known pig was finally released from quarantine, "two months after he was locked away because of swine flu fears.") As of June 25, the Centers for Disease Control and Prevention estimated that more than 1 million cases of H1N1 have occurred in the United States. "Yet the vast majority of these are mild cases," says infectious disease expert William Schaffner, chair of preventive medicine at Vanderbilt Medical Center in Nashville. "Most people haven't been diagnosed because only the most severely ill are likely to be tested for the virus." In fact, he tells me, this flu virus has so far been only "slightly more severe" than seasonal influenza.

But the worry that the H1N1 virus will mutate into a more severe strain—as did the strain causing the 1918 flu pandemic that killed more than 50 million people worldwide—may be justified. So far, there's no evidence of that happening. "Surveillance coming in from Australia, New Zealand, and Argentina, all in early winter, so far shows that this is the same virus," says Schaffner. That means if the virus strain continues along the same course and doesn't mutate, we don't need to be hypervigilant about flu precautions this winter. Still, he adds, "we're still watching it like a hawk."

Were we foolish to have been so worried in the first place? "No," says Schaffner, "those were the best decisions made at the time, and now that we know what we're dealing with, we can modify what we do." So, yes, it's OK to go about your life as usual even in the face of this flu "pandemic". But you should be aware of the telltale signs of H1N1: fever, cough, sore throat, stomach cramps, diarrhea, fatigue, and muscle aches.

If you're experiencing these symptoms, it's probably a good idea to pay a visit to your doctor. (Folks with asthma, lung disease, heart disease, or diabetes should make a point to get their symptoms checked out because they're more at risk from a flu infection.) A rapid swab flu test will tell you if you're infected with a type A flu virus, the category that includes H1N1. At the moment, Schaffner says, more than 90 percent of the type A flu infections in the United States are H1N1. If you test positive for the flu, taking an antiviral drug like Tamiflu can help reduce the symptoms and duration of the infection, especially if you start the medication within the first 48 hours after the onset of symptoms.

Although you could remain contagious for up to a week after your symptoms resolve, Schaffner says there's no reason to quarantine yourself beyond a day or two after your fever breaks. "I would say treat it as you would a regular flu infection," he advises. You can also rest assured that, once infected, you're protected from H1N1 this winter, he says, even if it mutates into a more severe form.

Does this mean we should be sending our kids to swine flu parties to catch the bug now? "Absolutely not," Schaffner stresses. "You can never predict what a virus is going to do. It would be heart-rending if you sent your child to this party, and 72 hours later your child is hospitalized in the ICU." What's more, there most likely will be an H1N1 vaccine that's widely available this winter to go along with the regular flu shot, so you don't need to get sick now to protect yourself later.

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