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Flu vs Rhinovirus at Children´s Hospital
Flu vs Rhinovirus at Children's Hospital
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Ill this fall? Maybe it wasn't swine flu after all

I had swine flu. It is almost a badge of honor, suggesting that the speaker survived the first pandemic of the 21st century and is immune to the next wave.

It also may be wrong.

Tests at Children's Hospital of Philadelphia suggest that large numbers of people who got sick this fall actually fell victim to a sudden, unusually severe - and continuing - outbreak of rhinovirus, better known as a key cause of the common cold.

Experts say it is logistically and financially impossible to test everyone with flulike symptoms. And signs, treatment, and prognoses for a bad cold and a mild flu are virtually identical, so the response hardly differs.

But the finding may send an important message to parents who (despite doctors' recommendations) are questioning the need to immunize their children against swine flu because they seemed to have already had the disease, said Susan Coffin, director of infection prevention and control at Children's Hospital.

"Maybe their child is still susceptible to H1N1 and should still get the vaccine," Coffin said.

For years, rhinoviruses have been the Rodney Dangerfields of microbes. Even major institutions have found plenty of reasons not to pay them much mind. They are exceedingly common, they cause mere colds, they come in hundreds of hard-to-identify strains that make testing a challenge, and there is no effective treatment anyway.

Neither the federal government nor the states track rhinoviruses in the way they do "surveillance" for influenza, based on samplings of doctor diagnoses, emergency-room visits, and lab reports. Children's Hospital of Philadelphia is one of the few institutions that routinely checks for them whenever it tests for influenza and other viruses.

Rhinovirus - named after the Greek word for nose - is known to circulate year-round, and typically to peak shortly before and after flu season. Children's recorded rising numbers in September, right on schedule. Then they kept rising.

"The rate of activity was unbelievably high," Richard L. Hodinka, director of the clinical virology laboratory, said yesterday. "What got my attention was not only the numbers we were seeing in the laboratory, but physicians saying there was severe disease."

 

'Looking back ...'

The hospital alerted the Philadelphia Department of Public Health. The city, citing reports from several labs, issued an advisory for the public-health community Oct. 9. They also asked the U.S. Centers for Disease Control and Prevention to investigate the outbreak; a CDC team returned to Atlanta last Wednesday after two weeks here but has not finished its analysis.

Meanwhile, people around the region were coming down with flulike illnesses. Two Catholic high schools, Archbishop John Carroll in Radnor and Bishop Shanahan in Downingtown, briefly closed after a third of the students were absent.

Doctors and hospitals had been expecting and preparing for swine flu. Yet laboratory data indicate that, while swine flu was present in the region as early as mid-September, it did not start to rise sharply until the third week of October.

"When this began happening, we all believed what we were seeing was influenza," said Coffin, speaking both as a physician and as the mother of a 16-year-old Lower Merion student who got sick in the middle of September.

"I went around telling my friends, 'I'm positive she had flu.' And now, looking back, I think she probably had rhinovirus."

Lab positives for rhinovirus at Children's continued at very high levels through October as swine flu also spiked. Emergency-room visits for flulike illness spiraled upward.

The ER was forced to convert part of the hospital's atrium lobby into a waiting area, and visits reached a record Oct. 26. (They have been gradually declining since then, and now are about 20 percent more than normal for this time of year.)

Although most ER patients were not tested, late October coincided with the laboratory's highest numbers for both swine flu and rhinovirus. More than 40 percent of them were the latter.

Besides the sheer numbers of rhinovirus, Coffin was surprised that it was causing more problems - wheezing, pneumonia, fever, and lower-respiratory-tract infections - than are normally associated with the common cold, which typically infects the upper respiratory tract. That has led her to suspect that a strain not seen here before may be responsible. The CDC's lab will attempt to identify the strain.

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Comments   
Posted 06:04 AM, 11/12/2009
Lil Bobby
Did I miss something, what are the symptoms for Rhino Virus versus Swine Flu?
Posted 08:00 AM, 11/12/2009
DaesReign
Yeah..you missed the memo that since they aren't getting the vaccine numbers they like the government is going in and changing up all the numbers on things to scare more people into vaccination. Now 4,000 people have died and now it's not all H1N1, it's the common cold so all those that were sick with what "had to be swine flu" don't have immunity and should run in and get their shots. (Rolling eyes.) It's manipulation at it's finest. They think we're all idiots.
Posted 08:23 AM, 11/12/2009
meez714
So if my kid had a temp of 103.5 that would drop only too 101.5 with motrin.tells me it's the flu not the cold . I wish they would of mention some real stats,not a vague story line
Posted 08:23 AM, 11/12/2009
meez714
So if my kid had a temp of 103.5 that would drop only too 101.5 with motrin.tells me it's the flu not the cold . I wish they would of mention some real stats,not a vague story line
Posted 08:37 AM, 11/12/2009
buggpop
Daesreign. Exactly! I find it a fascinating story about rhinovirus and truthfully am more concerned about a new strain of that rather than the 'pandemic of the century' and a vaccination that everyone 'must have'.
Posted 09:08 AM, 11/12/2009
ratbag
DaesReign, my husband says I'm as cynical as you and we ought to go out together! One thing is for sure, this thing is fraught with unbelievability, from top to bottom. The way i see it, there are two choices: either tell the truth-- all of it! Or at least coordinate the big lie and all the lying liars out front.
Posted 09:33 AM, 11/12/2009
Your Mamas OBGYN
OMG - if any of you people who posted above are parents, I questions you parenting skills and declare that you are boreline negligent. To not know the symptoms of rhinovirus (strain of the common cold) and the difference and dangers that swine flu poses to your child, is outrageous. You are on the internet and have access to search for this info, let alone that you should have asked this of your doctor long ago. Perhaps it is time ti implement a test before letting people pro-create anymore! Simpletons!!! BTW - go here:http://www.google.com/search?hl=en&source=hp&q=rhinovirus+symptoms&aq=1&oq=rhinov&aqi=g8g-s1g1
Posted 10:08 AM, 11/12/2009
buggpop
your mamas obgyn. The article is about doctor's misdiagnosing the common cold as h1n1. From the article "When this began happening, we all believed what we were seeing was influenza," said Coffin, speaking both as a physician and as the mother of a 16-year-old Lower Merion student who got sick in the middle of September." "I went around telling my friends, 'I'm positive she had flu.' And now, looking back, I think she probably had rhinovirus." Is Dr. Cross borderline negligent or a simpleton? Did she fail your test to "pro-create"?
Posted 11:31 AM, 11/12/2009
phillyPete
I had this cold. Achy with chills... Worst one I've had in YEARS. I'm convinced several people I know that think they've had H1N1, had this cold instead. H1N1 comes on FAST and knocks you out completely. Oh, and NEVER rub a kid down with alcohol, or dump them into a cold bath to bring down their temperature. Loosen their clothes and give them some Tylenol.
Posted 11:48 AM, 11/12/2009
TeresaBinstock
The CHOP findings suggest that testing for H1N1 is problematic and stands as a threat to "pandemic" fear-mongering and also to promotional hype regarding H1N1 vaccinations and profits therefrom. The data summarized in the graph may indicate a more important issue: why this fall were there sustantial increases in both rhinovirus and H1N1?
Posted 12:15 PM, 11/12/2009
cuso20
Phillypete you rub a lot of kids down with alcohol?
Posted 12:22 PM, 11/12/2009
Politburo
The headline doesn't appear to agree with the graph. This is not an either-or situation.
Posted 12:30 PM, 11/12/2009
JamesIgnatius
Don't worry about it - the "Public Option" will resolve all of this confusion.
Posted 12:49 PM, 11/12/2009
CBphilly
I think a lot of you missed the point...the rhinovirus is the common cold, so yeah we've all had it. The symptoms of a really bad cold are the same as the flu which are the same as early swine flu. Terrible science/medicine reporting (as usual) and terrible critical reading skills by the public. America needs some help haha
Posted 01:47 PM, 11/12/2009
DaesReign
Your Mamas OBGYN....I am a proud mother of three beautiful kids and let me tell you, I will dig up every bit of information I can and weigh the pros and cons of any choice I have to make regarding their health and well being. That's MY job. It is the parents who blindly jump in line with the status qua whom I deem negligent. Check the tract record of our FDA and tell me you aren't slightly nervous of having your kids injected with substances that may be proven 10 years from now to cause any range of illnesses or disabilities. All I am gathering from our government is that they have NO CLUE of what H1N1 is doing. Conflicting reports come out every day. It's one thing one day and another the next...well let me tell you, it'll be a cold day in h*#l before I trust their vaccines or recommendations. I'll stick with my God given mother's intuition.
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