Can You Get H1N1 More Than Once?

[Dark Horse]

Re: Can You Get H1N1 More Than Once?

Grandson has just been sent home from Richmond Hill, GA, Middle School with his second bout with influenza. When his mother asked how many kids were absent she said that she was not allowed to give out that information.

 

[gsgs]

Re: Can You Get H1N1 More Than Once?

OTOH NYC publishes school attendance quotes
and ACHA college sicknesses data

 

[tesseract]

Re: Can You Get H1N1 More Than Once?

North - My apologies. The article I read about 14% increase in Ontario specifically stated that the lab could only confirm Type A or B - *not* H1N1, and that led me to assume wide spread use of the Rapid Test like here in the states. I concede that makes no sense for that assumption. Here's that article: http://www.thestar.com/newsfeatures/swineflu/article/703646

So what do you think is the sensitivity rate at the provincial labs today? I just started researching it and so far I did find a study a few years back suggesting sensitivity at 33% (in the 30-40% range), but perhaps some things have changed in the last few years to bring that up a bit?

Here's the study I am reading right now....

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0006681

From that study the tests they found being utilized were:

For the 2005/06 season a survey of laboratory techniques in current use indicated that culture accounted for 44% of the diagnostic tests with RT-PCR, rapid antigen tests and direct fluorescent-antibody assay (DFA) accounting for 21%, 19%, and 16% respectively

Of course, that is 3 years ago!

 

[North44]

Re: Can You Get H1N1 More Than Once?

Hi tesseract,
No apology necessary. These are all valid questions.
In Ontario, the provincial government lab does all the testing. Initially, PCR (polymerase chain reaction) screening is done to confirm if positive for Influenza A or B. It appears the sample is cultured, regardless.
I don't have actual numbers for false negative tests, but I don't think it is high. The one sample I sent for testing a few weeks ago came back with a result of negative PCR, followed a week later by a negative culture. I presume they are using PCR to get a quick result, but not trusting it, alone.

 

[North44]

Re: Can You Get H1N1 More Than Once?

As further clarification, if the PCR is positive and they are able to subtype it as H1N1, that's the end of the testing. If PCR is negative, it appears the culture is done. I don't have it in print, but this is what appears to be happening in my practice.

 

[Legadillo]

Re: Can You Get H1N1 More Than Once?

Here are some of the letters I wrote to gov and school officials who continue to ignore my pleas for info and who allow the schools in Richmond Hill, GA to remain open despite more than a 14% absentee rate due to flu-like illness as of Friday:


Subject: Flu Outbreak in Richmond Hill, GA

I hope this email finds you well! I would like to express my concern for the obvious upsurge of flu-like illness in the schools here in Richmond Hill, GA. I am currently aware of 6 families who are experiencing flu at their homes, many of the children of those families attend Carver Elementary and Richmond Hill Middle School. My own children and I are one of those families and this is our second time in a month being infected by the flu virus and testing positive. We are not the only ones, as I am personally aware of several families here in Richmond Hill that have been re-infected, thus putting into question the belief that one is immune to the virus after the first exposure. This is supported by evidence from the local Urgent Care whose doctors and nurses have also seen many people previously ill in the last two months with flu returning again with sick family members.


My greatest concern is my inability to make contact with Mr. McGrath of the Bryan County School System who was aware three weeks ago when I called him about the CDC recommended cut off point of 10% absentee rate and the closure of schools, after the first wave of flu-like illnesses at the schools. Seeing that the absent rates are now well past 10%, according to some of the teachers and other sources, I would like to have some explanation as to why my kids and other children were put at risk at the Richmond Hill Schools during an obvious outbreak. I know several families who have children with underlying health conditions who are severely at risk when exposed to the virus. I am hoping that next week that the schools will not only remain closed here in Richmond Hill but that parents are fully informed on a daily basis of the running absentee rates so that parents can make informed decisions about whether they want to take a risk in sending their children to school during an outbreak.


I have run into some severe information blockades in trying to obtain data about absences at the schools. For instance, I went to the middle school and when I asked about how many kids were out sick they reported that they were "No allowed" to give out such information, which is shocking considering that it is a public school. Moreover, on another occasion, when I asked a school official about absences she looked at me with a worried glance and made a zipper-like motion across her lips as if she were not allowed to talk about how many kids were sick. I found this very peculiar and I am curious as to why this information is not being made public.


I would like to request another community meeting to discuss some of the information gaps in relation to the current outbreak and how this problem can be resolved. Time is, of course, of the essence!

Best Wishes

-------------------------------------------------------------------------------------------------------------------

Sent: Monday, October 05, 2009 8:14 AM


Subject: Increased Illness in Richmond Hill, GA

I would like to express my continued concern about the decisions being made in relation to Richmond Hill Middle School remaining open despite a significant absentee rate due to flu-like symptoms, as of Friday. When I contacted the school to inform them of my son's absence and to obtain school work (he's still exhibiting flu-like symptoms), I was treated rudely and there was a refusal to answer any questions I had in relation to absences. I believe it is important to gain an understanding of how many children are ill with ILI (influenza-like-illness) symptoms so that I can better gauge the situation and make more informed decisions about whether I find it appropriate to send my children to school or not in a potential outbreak. There are other local parents who feel similar.


Again, I find it highly unusual that the school remains open despite our knowledge of the current situation and would like this apparent data blockade and poor decision making (keeping the schools open despite a high illness rate) addressed as soon as possible. Let me be clear that there is no sense of panic on my part but a keen awareness of the current health situation based on my 7-year study on the pandemic. I am one who firmly believes that prevention is the best tool in such situations. Moreover, I believe that a school should follow the guidelines set out by the CDC in such a situation, thus protecting the children at risk and reducing infecton rates.


Best Wishes,


Rachael Bell


--------------------------------------------------------------------------

From: Bell, Rachael
Sent: Monday, October 05, 2009 7:55 AM

Subject: Richmond Hill Flu Cases


I would like to request information about those involved in making decisions for school closures based on illness and surpasing the 10% absentee mark outlined by the CDC. If you could be so kind to provide me with names, numbers and emails of those involved, I would be most appreciative being that the schools here in Richmond Hill refuse to divulge any information, although I know from a state health official that the absences in Richmond Hill Middle School alone exceeded 14%.

I am concerned about the decisions being made at a school level in relation to our children's health and would like to have the matter looked into. Please keep me informed of the situation.

Best Wishes,

Rachael
__________________

 

[Missouriwatcher]

Re: Can You Get H1N1 More Than Once?

Why not homeschool? Sometimes you need to make sacrifices in order to protect your children. I did this in Missouri several years back when I felt there was a true lack of understanding. A couple of years later, I placed my son back in the system. I do not regret placing my career on hold. He developed into a responsible young man.

 

[tropical]

Re: Can You Get H1N1 More Than Once?

#66

Leg., you will be quoted a "spammer" there ...


Only an heavy mass media publishing bell, could drive some change in the estab public behaviour

 

[Legadillo]

Re: Can You Get H1N1 More Than Once?

#66

Leg., you will be quoted a "spammer" there ...


Only an heavy mass media publishing bell, could drive some change in the estab public behaviour

Whoops! I wasn't aware we were not able to post such things. However, I have contacted the media to make them aware of the problem here in my town. There are many more residents who are doing the same. If a MOD sees it necessary to delete my post, please do!

 

[tropical]

Re: Can You Get H1N1 More Than Once?

Whoops! I wasn't aware we were not able to post such things. However, I have contacted the media to make them aware of the problem here in my town. There are many more residents who are doing the same. If a MOD sees it necessary to delete my post, please do!

No real fears about, no censuring,
as I said: - it was a joke-comment Rachel.

"there" = the official recipient e-mail addresses

Sure you can say something, as a citizen.

As a citizen you can send your question/point of view about pandemic, to the public officials.

But it is dificult that such mails could make them change the route.

After few renewed mails, they could look at it as har., or spam, no matter if the text is true or not.

I think it is named "unsolicited" e-mail, but usualy for marketing/selling purposes only.


With my previous comment I want to point to not be embarased if there will be no positive outcome from such e-mail kind of awareness.

At the same time, when the main mass media (TV) pop up with some tricky stuff about, it drive at least a few days of off. public attention/media releases ...

 

[Legadillo]

Re: Can You Get H1N1 More Than Once?

No real fears about, no censuring,
as I said: - it was a joke-comment Rachel.

"there" = the official recipient e-mail addresses

Sure you can say something, as a citizen.

As a citizen you can send your question/point of view about pandemic, to the public officials.

But it is dificult that such mails could make them change the route.

After few renewed mails, they could look at it as har., or spam, no matter if the text is true or not.

I think it is named "unsolicited" e-mail, but usualy for marketing/selling purposes only.


With my previous comment I want to point to not be embarased if there will be no positive outcome from such e-mail kind of awareness.

At the same time, when the main mass media (TV) pop up with some tricky stuff about, it drive at least a few days of off. public attention/media releases ...

Thanks Trop! You rock!! I guess my sense of humor is negatively affected by the flu---Hopefully I will get it back as I recover--LOL!!

 

[tesseract]

Re: Can You Get H1N1 More Than Once?

Legadillo,

I too am a "letter writer" and in the past when I've wanted to get a response from a particular person or official, I email that official directly, then CC many other officials and the media. To date, this has been 100% effective at getting a response.

For example, I once needed some help on a school policy regarding a child in our neighborhood that was temporarily staying at a neighbors home after Katrina and was being denied registration at the local school. I emailed the Superintendent directly, and CC'd various officials at the State Department of Education as well one reporter from each local television station and one reporter from the newspaper and the mayor. That got some action - fast!!

I have done this 'type' of emailing when trying to get help on consumer issues as well - and again, got a very fast response from my intended target.

When you address one person in particular, and then cc the media and/or that person's peers or 'bosses', it is more effective than just emailing a 'group' of people. People in Groups will think "Someone else will take care of this - I'll ignore it" but one person being targeted will want to CYA very quickly and the media loves a good story! Just wanted to share that! Good work on the letters!!!

 

[Legadillo]

Re: Can You Get H1N1 More Than Once?

Legadillo,

I too am a "letter writer" and in the past when I've wanted to get a response from a particular person or official, I email that official directly, then CC many other officials and the media. To date, this has been 100% effective at getting a response.

For example, I once needed some help on a school policy regarding a child in our neighborhood that was temporarily staying at a neighbors home after Katrina and was being denied registration at the local school. I emailed the Superintendent directly, and CC'd various officials at the State Department of Education as well one reporter from each local television station and one reporter from the newspaper and the mayor. That got some action - fast!!

I have done this 'type' of emailing when trying to get help on consumer issues as well - and again, got a very fast response from my intended target.

When you address one person in particular, and then cc the media and/or that person's peers or 'bosses', it is more effective than just emailing a 'group' of people. People in Groups will think "Someone else will take care of this - I'll ignore it" but one person being targeted will want to CYA very quickly and the media loves a good story! Just wanted to share that! Good work on the letters!!!

Thanks! Yes, I addressed each person individually, as well as en masse! I have since received a response from the Chairman of the school board, the newpaper and others in response to my repeated complaints.

 

[rootcellargal]

Re: Can You Get H1N1 More Than Once?

Awesome letters Legadillo! I hope they change their policy of secrecy and close the schools too! It is incredibly frustrating to read about this occurring all over the country. I sure as h*ll wouldn't be sending my kids to school in these "hot spots" at this time!

 

[Legadillo]

Re: Can You Get H1N1 More Than Once?

Here's one of the newpaper articles in response to my complaints.

Parents voice concerns over H1N1

Jeff Whitten
jwhitten@bryancountynews.net
Posted: Oct. 6, 2009 9:02 p.m.
Updated: Oct. 7, 2009 1 a.m.

Some parents want the school board to close Richmond Hill Middle School for at least a week as a result of the H1N1 virus.

One of those parents, Rachael Bell, has contacted a number of state and local officials and the media. Bell is critical of the way local school administrators have responded to the H1N1 virus.

"The question is, why is Richmond Hill Middle School still open and why are we continuing to subject our kids, especially those with compromised immune systems, to such significant risks," she said. "There simply comes a point when where one has to ask oneself what’s more important, missing a couple days of work and the financial ramifications or our kids’ health? I think a lot of sick kids’ parents are asking themselves that very question and I believe they make that choice for their kids."

Bell told officials in a blanket email she and her children were among a number of people in Richmond Hill who have gotten the flu twice.
And she isn’t the only one voicing concern.

Another parent claimed to have heard there were absentee rates at RHMS as high as 39 percent. On line at bryancountynews.net, a frequent blogger posted Tuesday that 20 percent of the student population was out with the flu.


-Read more in the Bryan County News
http://www.bryancountynews.net/news/article/4627/

 

[North44]

Re: Can You Get H1N1 More Than Once?

How does she know they had H1N1 twice? I'm not saying she is wrong, I just have not seen any evidence that this happens. Traditionally, one develops immunity through initial infection or immunization and this confers protection against that particular flu virus. Recurrences are usually the result of antigenic drift. I am interested to know if anyone has documented reinfection with H1N1?

 

[tesseract]

Re: Can You Get H1N1 More Than Once?

How does she know they had H1N1 twice? I'm not saying she is wrong, I just have not seen any evidence that this happens. Traditionally, one develops immunity through initial infection or immunization and this confers protection against that particular flu virus. Recurrences are usually the result of antigenic drift. I am interested to know if anyone has documented reinfection with H1N1?

On page 1, in post #20, Legadillo states:

Well, my duaghter and I returned from the doctor and for the second time I was diagnosed with Influenza A-H1N1 in a month.

My initial assumption was that meant she tested positive twice...but not sure if that is absolutely true or not.

My thoughts on that were:


A) She had 2009 H1N1 aka "Swine Flu" AND seasonal H1N1 (even though surveillance doesn't show seasonal in any great numbers right now) in the same month....

or

B) Swine Flu has mutated just enough to cause reinfection - i.e., not the exact same strain she had previously, but also not the seasonal H1N1

or

C) She was still shedding from the first round and that caused the positive test both times, but her symptoms right now are actually a manifestation from some other bug

I think the simplest explanation might be C, however, she is not the only one reporting this type of reinfection so.....'tis a mystery for now - and how likely is that scenario for both her and her daughter? Also if she did both test positive I guess we need to also evaluate the possibility that the test caused a false positive. Again, though -if she and her daughter were BOTH sick twice, that still seems odd, doesn't it?

 

[North44]

Re: Can You Get H1N1 More Than Once?

We are so caught up with influenza, we forget that the great majority of respiratory and gastrointestinal infections are caused by other viruses. It is true that H1N1 is taking over seasonal flu in the realm of influenza infection, but there are hundreds of other viruses that cause infection that may be mistaken for influenza. As a physician, I commonly make the mistake of telling patients they have the "flu" - meaning a group of symptoms related to a flu-like illness. I don't mean a specific Influenza infection. I wonder how many other physicians do this.

 

[Legadillo]

Re: Can You Get H1N1 More Than Once?

Hello! Just to answer some of the questions.

My daughter and I were both diagnosed with H1N1, as were several other families in our community. Most of us initially got sick in late August (around the 24th) when we were first diagnosed. The second time we were diagnosed was last week (Sept 30).

Some explanations are that one bout was seasonal flu and the other H1N1, which I previously posted, viral overload due to repeated exposure (??) to the same virus. Who knows! I also find it strange, as do the health care workers in our community and the families who continue to get sick over again.

What's most important to me at this point is asking ourselves the question:

Can we get it a second time after initial exposure or getting the vaccine and what are the ramifications of this?

What I see is that those getting it a second time are less likely to get Tamiflu again, go to the doctor again, they return to work or school faster (before recovery) and miss work/school a lot more due to continued symptoms. Overall, the problem is that most getting ANY flu a second time in a short period are more likely to shrug it off and keep on truckin' thus putting themselves and others at risk.

TESSERACT, I was just curious to know if it is actually possible to shed for more than a month. I didn't think so.

 

[tesseract]

Re: Can You Get H1N1 More Than Once?

Hello! Just to answer some of the questions.
TESSERACT, I was just curious to know if it is actually possible to shed for more than a month. I didn't think so.

I didn't think so either, but was just trying to put out all the possible explanations

Just so I understand - when you say "diagnosed" are you saying you were swabbed twice and the results were positive twice for Type A? Just want to make sure I understand!

If not, it is possible that, as North pointed out, you have simply been exposed to some other viral bugs circulating.