Trying to put the flu back into perspective

I made a comment on Twitter tonight that was directed at a fellow mom blogger that I follow who is dealing with flu in her family:

I received the following response from FluWatcher2009, a Twitter account that I believe is (at times) spreading misinformation and possibly increasing the already rapidly growing panic that has been manufactured by the media over the past several months:

As soon as I saw the "99%" statistic, I knew I had to look into it. But first, to answer the question this person asked, no, we don't know with 100% certainty that we don't have H1N1 - we weren't tested as only hospitals are doing the H1N1 tests. Neither my husband nor myself have been ill enough to warrant hospitalization. While I suppose it is possible that we've had H1N1 over the last few days, it's unlikely because of the symptoms that we've had and how quickly (or rather how *not* quickly) they came up. Anytime you see the symptoms of H1N1, it indicates that it develops quickly, in 3-6 hours. Our flu developed over several days. We've both seen different doctors and both specifically said they don't think it's H1N1. With the current state of things, I doubt very much that they would make that claim if they weren't pretty darn sure.

That actually wasn't the worst part of this person's post, though. The worst part was the statement that "99% of all current influenza being the H1N1 virus", which is a gross misrepresentation of the Center for Disease Control's (CDC) data in their flu report, which states:

"Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses."

I had to do some further research to get a better understanding of what this means and I found a really wonderful article about the different types of influenza on MedicineNet.com that was perfect to help me decipher what the CDC meant, and coincidentally a very pro-flu-vaccine article. I am not a proponent of the flu vaccine for myself or my family, but if you are this article gives a very good and thorough explanation of influenza and vaccines - it was very informative.

The CDC's statistic is quite shocking when you read it at first: "Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses." It sounds like EVERYONE with the flu has H1N1 until you break down what they are saying.

First, this percentage includes only "subtyped influenza A" viruses. So, in this statement there's no mention of or comparison to influenza B or C - the other two types of influenza. Influenza B is not discussed at any great length in the article like influenza A. Influenza C is not tracked or even a concern because it doesn't cause major illness or epidemics. However, the CDC breaks down the influenza A subtypes and influenza B in their table below the statistical statements.

Based on my obviously limited understanding of the types of influenza and the tracking methods being used, those cases that are tested (I assume most often upon hospitalization), that are found to be a subtype of influenza A end up being H1N1 over 99% of the time. Where I think this figure is misleading is that it doesn't include cases that were unable to establish a subtype and it leaves out those cases where subtyping wasn't performed, yet a diagnosis of influenza A was made. I did my own math (not my best subject) and I found that if you add in all of the influenza A categories, only 67% of reported cases were confirmed to be H1N1 - hopefully my math wasn't off. If subtyping was done on all, that number would probably be higher, but would it be "over 99%"?

I think most people jump to the conclusion that if you have the flu these days, you have swine flu. Perhaps it's a safe conclusion - you'll likely take a step or two back from someone who has the flu, which is good. But, as I like to do, I have to question the absolute assertion that most instances of the flu are H1N1. I have no doubt that a lot of what is going around is H1N1. However, you can't rule out other strains of flu being active as well - it's the season for the flu. Most people who get the flu don't go to the hospital and get tested. Many don't even go to the doctor unless they're having trouble of some kind. Therefore, reporting on these other strains may not be happening - just as mild cases of H1N1 may not show up in the statistics.

It doesn't matter whether you're pro-vaccine or anti-vaccine - I think it's important to keep the numbers in proper perspective. So much of what's being reported these days is put out there without proper context or background and it ends up sensationalizing a situation that is already causing unnecessary panic. I'm definitely not immune to it. I have had an overwhelming "ticking time bomb" feeling ever since Matt started getting sick and then I did, too. To help combat my personal panic, I went to the Public Health Agency of Canada's (PHAC) FluWatch site to see what's really going on. Because my biggest concern is my son, it helps me to read that since April 26th across Canada, there have been 605 hospitalizations of children under 16 for influenza, 95.2% of which were H1N1. Additionally, 4 deaths of children under 16 from H1N1 have been reported in that time. Though every hospitalization is extremely scary and every death is such a tragedy, it's reassuring to know that the number is so low.

I guess the perspective I needed was that Brandon - and, really, all of us - has a much greater chance of something totally random happening to him than getting seriously ill or worse from the swine flu.

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