Case Study

Case Study

Patient History

Before Sept. 20, Isabella was a T-ball-playing tomboy with no health problems, friends and family members say. But that night, she awoke crying in pain and burning up with a fever that spiked at 105 degrees. “She was so hot, she wanted me to take her shirt off,” Kristina Ragan recalled. The next day, doctors tested the child for H1N1 influenza and started her on a course of Tamiflu, the antiviral drug. But the medicine made Isabella sick to her stomach, and not even Popsicles could soothe her. Two days later, she was no better, so Ragan took the girl back to the doctor.

Isabella was referred to the small local hospital, where doctors quickly realized the girl was in trouble. She was breathing rapidly and her oxygen levels were dangerously low. Soon, Isabella was on her way to Huntsville Hospital, an hour away in Alabama, where a pediatric intensive care unit was available. When she arrived, she was a very sick little girl, Kristina Ragan recalled. “The doctor explained it would get a lot worse before it got better,” she said.

Diagnosis

Swine flu is presumptively diagnosed clinically by the patient's history of association with people known to have the disease and their symptoms.

Usually, a quick test (for example, nasopharyngeal swab sample) is done to see if the patient is infected with influenza A or B virus. Most of the tests can distinguish between A and B types. The test can be negative (no flu infection) or positive for type A and B. If the test is positive for type B, the flu is not likely to be swine flu (H1N1).

If it is positive for type A, the person could have a conventional flu strain or swine flu (H1N1). However, the accuracy of these tests has been challenged, ...