A Pediatricians Advice About H1N1

This is a direct paste of a letter sent by Dr. Kenneth Polin to my wife, Kerry, along with what I assume are many other parents today. Dr. Polin works out of Town & Country Pediatrics who operate three offices here in Chicagoland. The immunizations being provided by Town & Country Pediatrics are all Thimerosal-free, so are in limited supply and high demand. This is causing the offices to get swamped with calls throughout the day, making it difficult for actual sick children to get appointments to be seen. The offices have informed all parents this morning that they will only accept calls for day-of vaccinations for a single 30 minute period each morning…so a bit of a lottery system if you will. In any case, here is the letter…

Dear Kerry,

There has been a lot of information and misinformation regarding the current influenza as well as relating to the flu in general. We would like to inform and clarify in order to calm fears and help our patients cope with the current situation.

Influenza is an annual event caused by a virus which changes each year. That is why patients need to have a new influenza vaccine annually. The vaccines given in past year do not cover the new strains which appear. Most of the strains we see annually are somewhat related and can cause significant complications in the healthy population as well as in the population with underlying medical issues.

Every year, in the US, approximately 36,000 people die of the flu and related complications. This new flu which has been around since the spring of this year has taken a toll with about 1000 patients dying including 100 children (this is over six months time). The majority of these deaths have occurred in patients with other medical conditions however, this has not been exclusively the case and some healthy patients may have severe complications and even die. It is important to keep things in perspective and if your child gets sick, to be armed with information and not worry needlessly.

The signs and symptoms of the flu (all types) are a quick onset of fever with a dry cough. There are often accompanying body aches and many patients complain of eyeball aches. There may be vomiting also. Not all patients will have all symptoms. If your child has these and has no other medical issues, routine health measures for comfort are all that is needed. If your child is young (under two years old) or has other health issues we should discuss whether we should see your child or manage at home without a visit to our office. Additionally, if your previously well child appears to be compromised in areas of shortness of breath, significant vomiting, acting strangely, or you are just uncomfortable with his/her appearance, call us ASAP. The CDC no longer recommends the use of a flu test as the in-office test is not that reliable and better diagnoses are made using a history and physical diagnostic skills. The use of antiviral medications has also been discouraged in healthy patients in order to avoid development of resistance by the virus to these medications.

The best way to prevent the disease is vaccinating, but there is at the time of this writing only a limited supply as well as a limited resource availability to administer the vaccine. If you want the vaccine, consider all possible sources. Our office supply of seasonal flu vaccine was reduced as the manufacturers were told to shift their production from seasonal to swine flu. All of the swine flu vaccine was sent to the public health sector who in turn have distributed it to multiple sites including, to a limited extent, our office. We will be sending out information about what we have and what we can reasonably be expected to administer via email and on our website.

Keep in mind this is not a panic situation and with your help we can weather this storm together and not fall into the trap of fear that is not warranted.

As it relates to my previous post, The Drama is Deafening, this letter will hopefully show that both extremes are unwarranted right now, perhaps the hysteria about H1N1 even more so.

Be Well!

The drama is deafening!

I am a history buff. Yes, I know…yawn, but alas, I am. So, having the historical education that I have, I should not be surprised by the drama that exists in this country right now (drama has existed throughout history), yet I find myself constantly amazed. I also expect that my posting of this article will cause a fair amount of drama among my limited number of readers, but I am going to post it nonetheless in the hopes that I am being logical, and that the vast majority of people will agree with my points.

On Thursday, we took Hayden into the pediatrician for her 6 month checkup. She is very healthy, growing well…all systems go. While we were there, we continued her parentally modified vaccination schedule with a couple shots (Pentacel and Prevnar). She is still behind in her Prevnar, but she will not get “more behind” going forward. As we did with Xavier during his first two years, we chose not to get Hayden immunized against either seasonal flu or the notorious H1N1 (gosh, it’s like uttering “Voldemort“). Much to Xavier’s chagrin, despite it being Hayden’s checkup, we shanghaied him with an immunization during the visit, as we were afforded the opportunity to get him the thimerasol-free H1N1 nasal mist (he also received the seasonal FluMist 6 weeks earlier). Neither Kerry nor I have ever gotten a flu vaccination.

Kerry has gone on record saying she has never had the flu in her life, and I can tell you that I haven’t had the flu in at least 17 years. Neither of us goes to a workplace, and actually spend most of our time among our own family in our neighborhood. Of course our “neighborhood” consists of something like 1.5 million people, but work with me here. Hayden is still only 6 months old, and in very good health thus far. Hayden (like Xavier before her) does not go to daycare, and is rarely in contact with anything that does not originate in our own house.

Xavier, on the other hand is officially a little boy, and regularly partakes in all the active socializing, and “gross” behaviors that come along with it. As an example, last week he and I walked over to the train station food court so I could try the enticing new “Black Taco” at Taco Bell. As I was waiting to pay, I looked down to spy my beautiful boy licking the front of the service counter! So, figuring that if anyone might bring home H1N1, or the seasonal flu for that matter, Xavier would, we decided to get him immunized for both.

OK, so to the point of the post. Upon returning home, I posted a status update on Facebook asking if our decision to immunize against “swine flu” made me a slave to the media or a responsible parent. I got several answers, and though most agreed we are responsible parents, there was more than one dissension. Being the person I am, and having some time on my hands, I decided to read more about H1N1 than I already had, and am blown away by what I have read.

So, unlike some of my posts, I am not intending to take a particular side of this issue, though it might end up sounding that way. Please remember that my intent here is to call out the unnecessary drama that we continue to create in our lives. Please also remember, we did not get Xavier vaccinated for fear he will die, but more because we would like to avoid him getting the flu because having a sick kid sucks. Additionally, my decision not to get myself vaccinated has nothing to do with fear of the potential side effects of the shot, but rather the laziness with which I take care of myself.

First, I’ll address the drama resulting from the fear of the virus itself. Listen, Influenza is no fun, and is prevalent in our society and the world. It is a nasty virus that attacks the respiratory system, and for most who get it, wastes about a week of their lives with high fever, coughing, and achiness. For too many others, about 3,500 per year in Illinois on average, it unfortunately ends in death resulting from complications associated with this virus, primarily pneumonia. Though a high number, this generally falls well behind heart disease and cancer (#1 and #2), and slightly behind other well-known culprits such as strokes, chronic lung diseases (emphysema/COPD/bronchitis/cystic fibrosis), accidents, diabetes, and Alzheimer’s…in Illinois at least.

H1N1 has been “around” since April 2009, or at least this strain of it. There have been H1N1 outbreaks in the past, the most recent of which was contained to a single military unit at Fort Dix, NJ, and killed only one soldier. So far, in Illinois, H1N1 has resulted in 542 hospitalizations and 22 fatalities. Only 5 of those 22 were children 18 years and younger, and only 1 was under 4 years of age. Even if we acknowledge that the major outbreak might just be gearing up, and we have only really experienced about a month of this nastiness, that trend is suggesting about 265 fatalities in the next 11 months. I understand that I am using grade school math here, and that the actual trends suggest this outbreak will be slightly higher than the 2008-09 seasonal epidemic, but even that suggests that if we take the simple preventative measures that are both being advised and should be common sense, most of us will not perish at the hands of this virus. So, cover your mouth, wash your hands often, and for the love of everything holy, if you are sick, sit your butt down, and don’t go to work, functions, meetings, recitals, or anywhere else where you think your are “needed” for life to move forward until you are over it.

On the flip side, of course, are those afraid or opposed to the immunization. Really, you are scared of the flu shot? What is going to happen? Flu shots do not cause the flu. Side effects of the flu shot are by all reports, rare (though I must admit I can not find any actual reported numbers, just the word “rare”). The worst is an illness called Guillain-Barre Syndrome which is associated with a swine flu vaccine developed and administered in 1976…yes, 33 years ago! Since then, studies have shown that only 1 in 1,000,000 people may be at risk of the illness associated with a flu vaccine. Science has done some remarkable things, and the development of vaccines to prevent illnesses is most certainly one of those things. It is easy to distrust things that we do not personally understand, but why is it so easy to trust those things that are so contradictory to them? I read somewhere that there is going to be an episode of “Sid the Science Kid” created by Jim Henson’s gang airing on Monday and will be about getting your flu shot. The writer was suggesting that the episode was evidence of Big-Pharma backed programming using propaganda to sell more immunizations, as if kids are going to all of a sudden enjoy getting shots.

So, as with so many things in life, I am suggesting that we all relax and attempt to fall somewhere in the middle of the two sides of this drama. This H1N1 is a virus that has, and will continue to cause fatalities among us. More often, it is going to knock people out of commission for several days leading to the usual wintertime decrease in productivity at offices and schools across the country. No doubt, the manufactures of the vaccines will push for more vaccinations as we still live in a capitalist economy designed to allow those corporations to profit from a demand. Take care of yourself, take care of your loved ones. Get the vaccines or don’t, but let’s recognize this for what it is (a respectable viral outbreak), and for what it is not (a conspiracy). So when I stupidly come down with either the seasonal flu or H1N1, the blame will only be mine.

Be Well!