Archive for the ‘H1N1’ Category

Rapid Influenza Tests Often Fail to Detect H1N1

Wednesday, December 9th, 2009

Doctors’ offices and hospitals are using “rapid influenza diagnostic tests” to identify the presence of the H1N1 flu in patients; however, these tests actually do a poor job of sniffing out H1N1 because the rapid test does not detect H1N1, only influenza A. A confirmatory test must be done to identify H1N1 – a strain of influenza A.

Scientists confirmed this theory recently in a report published in The Journal of the American Medical Association, which found that one-third of California patients hospitalized with H1N1 flu were given a rapid test that came back negative. A different test that uses more sophisticated technology confirmed they had H1N1.

The discrepancy is caused by the high specificity (80-90 percent) and the low sensitivity (10-70 percent) of the rapid test for influenza A. The test often does not identify influenza A, especially in adults, who don’t shed as much virus as children. Therefore, correctly identifying those with influenza A, which could be either H1N1 or seasonal flu, is the real issue with the rapid tests. Since about 90 percent of circulating influenza A is H1N1, doctors can be fairly sure that anyone with flu-like symptoms who is also positive for influenza A – either on the rapid or more advanced tests – has H1N1 flu. But, there is still a 10 percent chance that it is seasonal flu.

Regardless, many are not taking the chance that their illness could be something other H1N1. Dartmouth pediatrician Hank Bernstein, who’s on the American Academy of Pediatrics’ infectious diseases committee, said in a recent USA Today article, if symptoms look like the flu, “it’s H1N1 until proven otherwise, almost.”

Stephen Baum, an infectious-disease physician at New York’s Albert Einstein College of Medicine, in the same USA Today story, says: “If you test positive, you got it. If it’s negative, you may still got it.”

Therefore, it is important to understand the symptoms of flu versus a common cold. Those symptoms, not the test results, should be the trigger to take relevant action – either treatment or protecting others from exposure. Further, a negative test shouldn’t make one complacent in taking steps to prevent spreading the flu. Learn what you can do to keep your family healthy this winter by visiting the “Prevention and Treatment” section on the Centers for Disease Control and Prevention H1N1 website.

(Jerod M. Loeb, PhD, is Executive Vice President, Division of Quality Measurement and Research, The Joint Commission, and a member of the Water Quality & Health Council).

Second Wave of H1N1 Peaks

Monday, December 7th, 2009

The Centers for Disease Control (CDC) says the level of H1N1 activity across the United States has dropped for the fourth straight week, indicating that the second wave of H1N1 in the United States has peaked.

In its weekly update on flu activity, the CDC reported that:

  • The number of states experiencing widespread flu cases during the week that ended Nov. 21 had fallen to 32, down from 43 states the week before and a high of 48 states in late October.
  • Influenza-like illnesses accounted for 4.3 percent of all visits to doctor’s offices during the week, down from nearly double that proportion in October.

Yet, officials warned that the number of people getting infected with the H1N1 virus remains high, and cases could surge again. Therefore, federal health officials are trying to avoid creating the impression that the outbreak is over.

“We’re far from being out of the woods,” said Thomas Skinner, spokesman for the CDC. “There’s still a lot of flu out there. And we wouldn’t be surprised to see another uptick in activity as we approach the end of December and beginning of January, when kids come back from Christmas break.”

Other experts argue that if there is another surge, it will be relatively mild because most people will have either been exposed to the virus or will have received the H1N1 vaccine.

Thus, federal officials urge people to continue seeking the H1N1 vaccine, despite the current drop in H1N1 influenza cases. According to a Dec. 1 article in the Washington Post, more than 60 million doses of vaccine have become available and officials are predicting millions more will be shipped to states in the coming weeks.

In the meantime, people should protect themselves by:

  • Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. If you don’t have a tissue, cough or sneeze into your elbow or shoulder; not into your hands.
  • Disinfecting surfaces by wiping them down with a disinfectant according to the directions on the product label.
  • Washing your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoiding touching your eyes, nose or mouth. Germs spread this way.
  • If you are sick with flu-like illness (fever with sore throat and/or cough), CDC recommends staying home for at least 24 hours after your fever is gone except to get medical care or for other necessities.

For more on stopping the spread of H1N1, please visit or the CDC’s H1N1 information page.

(Ralph Morris, M.D., M.P.H., is a preventive health and public health physician, and a member of the Water Quality and Health Council)

The Water Quality and Health Council Calls for Greater Surface Disinfection to Combat Bad Hygiene During this Flu Season

Friday, October 9th, 2009

Do you cough without covering your mouth while standing in the lunch line? Or sneeze loudly into the air when squeezed onto the morning bus? Nearly all Americans (96 percent) have seen you do things like this – and a shocking three quarters (77 percent) say they are guilty themselves. Even with heightened concerns during this year’s flu season, Americans admit that sleeves are a fine substitute for tissues; one in four wipes their nose on them. One in ten is even more gross; skipping sleeves altogether in favor of hands to wipe their nose and then… extending for a handshake or reaching for a door handle.

A recent survey by the Water Quality and Health Council shows that despite constant warnings from health officials and a recent study showing a 31 percent chance of infection through hand contact with contaminated surfaces, few Americans frequently clean the public surfaces they use. At the same time, not many have faith that others are cleaning them either. Regardless of this, just one in ten is inclined to do the job themselves.

Knowing that flu viruses can live on inanimate surfaces for hours or even days should motivate people to take personal responsibility to protect themselves; disinfecting surfaces when feasible, using disinfecting wipes or chlorine bleach – especially at home and at work – as well as washing hands and practicing good personal hygiene habits. Contacting school administrators, office managers and even health club managers will help you understand their cleaning and disinfecting protocol and how you can better safeguard against the flu.

To help people prevent the spread of H1N1, The Centers for Disease Control and Prevention (CDC) recommends keeping surfaces clean by wiping them down with a disinfectant according to the directions on the product label. Also, in addition to cleaning surfaces, the CDC advises a number of helpful tips. For more information on how to prevent the spread of H1N1 through surface disinfection, please visit

USA Today – Fight swine flu with good hygiene

Friday, September 18th, 2009

A recent USA Today article on H1N1, or swine flu, highlights once again that the best way to prevent such diseases is through the practice of good, basic hygiene.

That is especially true in the case of schools where large numbers of children are in close contact. When exposed, those children become a reservoir for spreading the infection at home and in other settings. When I read that many schools now wipe down desks regularly, I wondered why they hadn’t been doing this already. This would prevent not only the flu, but also the spread of other viruses and germs.

As a public health professional, I know that cleaning and disinfection are always a part of a smart prevention strategy. In schools, disinfection is critically important for areas where students come into contact with contaminated surfaces, including bathroom fixtures, doorknobs, handrails, athletic equipment and desktops. Diseases can be readily transmitted via all these surfaces. The use of an effective cleaning agent followed by a proven disinfectant such as chlorine bleach after cleaning can effectively help prevent the spread of disease.

Add good hand washing with the appropriate use of hand sanitizers, and you have the recipe for healthy students and a healthy school.

Back to School Special: Pick up Your Free Germs Here

Friday, September 18th, 2009

As parents send young children back to school and pack their older ones off to college, the government’s warning of up to 90 thousand U.S. deaths this season from H1N1 flu has given many of us pause. Germs and people go together; turning classrooms, dorm rooms, and cafeterias into giant-sized Petri dishes for the virus’s spread. H1N1 flu viruses– like noroviruses which cause vomiting and diarrhea – are able to maintain the infection cycle by spreading through the interaction of people who cough and sneeze, transmitting the virus by droplets in the air or their contaminated hands.

Parents are justified in their concerns. Numerous suspected cases of H1N1 have been reported at schools and as of mid-August, the Centers for Disease Control and Prevention (CDC) had reported 8,843 hospitalizations and 556 deaths in the U.S. Children and young adults are getting sick from H1N1 flu more than older people. In fact, a look at the spread of Norovirus in 2005 provides further evidence of schools as ground zero for contamination. According to a New York study, the Department of Education was one of the primary agencies to alert the health department that people were getting sick.

What is the best line of defense against H1N1 virus and other germs? Hygiene. The word comes from the French word for healthy or healthful and the Latin word for living and is defined by conditions and practices (such as cleanliness) which are conducive to maintaining our health. To stop the spread of dangerous viruses, everyone has a role in maintaining good hygiene; from parents arming their students with hand sanitizers, to school administrators ensuring that surfaces are properly cleaned. Even for students maintaining their first apartment or dorm, hygiene should be top of mind.

Hygiene is more than just cleaning. Disinfecting to kill disease-causing germs provides an additional safeguard. Viruses can survive for hours or even days on doorknobs, countertops, handrails, bathroom fixtures, desktops, athletic equipment, and other high-touch areas. In fact, a recent model simulating virus spread found that without adequate surface disinfection, even the benefits of good hand washing practices were nullified, and there was a continued risk of disease.

So as our children start classes, we should remember that good hygiene includes disinfecting high-touch surfaces in living areas; whether it be a fourth grader’s desktop, or a freshman’s first kitchen counter. Parents, students and school administrators must implement good disinfection practices for all common areas so we can continue to learn and educate.