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Here’s how the flu season has played out in my own family (parents (38 and 40) and three kids, a daughter 10 years old, and twin boys 6 years old). I’ve added a couple of references for comparison with public health recommendations and published swine-flu info.
Late August 09: The boys were coughing and had slight fever, our daughter was coughing only. One son, the daughter and the father (me) tested positive for fluA, but negative for SwineFlu. At this time the public health information available said that only SwineFlu was going around since “Any widespread influenza activity in August is uncommon.” (ref). Clearly not in our family though – we had seasonal flu of some sort.
Late September 09: Our daughter gets high fever and headache. I felt scruffy, but did not have any fever. None of us were tested since we were abroad on holiday. We, gave our daughter Tamiflu®, since symptoms suggested possible SwineFlu infection.
Early November 09: One of the boys gets Swine flu vaccinated since he is in one of the risk groups (asthma). I get vaccinated for seasonal flu.
Mid November 09: The other boy gets high fever and headache. He is given Tamiflu®. He is later tested positive for SwineFlu. I tested negative. The rest of the family was not tested since they had no symptoms.
Late November 09: Our daughter is scheduled for SwineFlu vaccination.
This fall our family has had influenza two times, possibly three. We had seasonal flu first and this at a time where seasonal flu is not expected to be common. This infection had very mild symptoms in my family. Two of us then had more severe flu symptoms a month later, but this infection was not confirmed by testing. Some weeks later one of us gets a confirmed SwineFlu infection while the rest of the family apparently escapes disease.
One should not draw epidemiological conclusions based on results from one family, but nevertheless, working in a diagnostic lab being able to test so often has been an interesting experience. If i may, I’d like to speculate a little bit:
1. Seasonal flu may not be as “seasonal” as we think since seasonal flu can give very mild symptoms and remain undiagnosed.
2. Vaccination has worked fine in our family since the vaccinated boy did not get infected through his brother.
3. Seasonal flu does not protect against SwineFlu in children (same boy tested positive for seasonal flu and later on SwineFlu), but may protect against SwineFlu in adults. This is supported by a recent NEJM publication.
4. Following infections longitudinally could give valuable insight into the epidemiology of influenza and other seasonal viral infections.
5. Frequent testing reduces worrying to a minimum. While I realize that I am subjective since I have my own laboratory to develop tests in (and run them as often as I want), I strongly recommend that such frequent testing be performed for everyone.
BIOpinionated 
I read: “We, gave our daughter Tamiflu®, since symptoms suggested possible SwineFlu infection”. Horrible to say, according to Romans!The following Letter, accepted by The Lancet Editors (all documented) has been rejected by referees…
Please read and comment:
FLU Diagnosis and Differential Diagnosis between seasonal virus and A/H1N1.
Editors,
all around the world physicians are thinking erroneously that various types of flu, including A/H1N1, swine flu, can be diagnosed exclusively with sophisticated semeiotics (who’s specificity/sensitivity is about 60%!), certainly not applicable on very large scale. In addition, all antiviral drugs must be utilize in the first stage of disorder. In my opinion, this thought is not updated, since authors unfortunately ignore Quantum Biophysical Semeiotics (www.semeioticabiofisica.it). In fact, nowadays it is very difficult to know the real nature of an infectious disorder at both the bed-side and ER or hospital, as well as to recognize a lot of cases, not to speak of disorders recognizable by means of the academic, orthodox, physical semeiotics, as allows me to state a 53-year- long clinical experience. In fact, I am filled with wonder at reading that there are doctors who are sharing the uncertainty of the value of antibiotics for acute tonsillitis, pharyngitis, bronchitis in the form of written and verbal advice, although I do not know if these physicians are skill at performing the advancement in the field of physical examination (1). Interesting from diagnostic view-point, I underscore here the possibility of recognizing easily and quickly the “chronic” antibodies synthesis in the spleen during flu, as well as the spleen “small” antibody production, in case of Gram-negative bacteria (Esch.coli, HP, Clamidya, H. pyloris, a.s.o.), which play a pivotal role in bed-side diagnosis of virus or Gram- negative infections (1). Moreover, interestingly doctor can now a-day observes clinically, and in a “quantitative” way, the so-called Reticulo- Endothelial-System-Hyperfunction Syndrome (RESH), which parallels with ESR and Proteins Electrophoresis, but it is “more” sensitive and specific than both (2, 3, 7, 8). Certainly, most adults, and children, of course, with acute bronchitis who consult their general practitioner will receive antibiotics, although in many cases antibiotics do not modify the natural course of the disorder, at all. In my mind, the real problem is to recognize “clinically” both the nature of infectious disorder and the actual patient’s defence , including antibody and PCR synthesis (in above- cited website): first, the “ethiological” , complete diagnose, starting from bedside recognizing all constitutions (4, 6) and, then, the proper therapy (8) . Nowadays, we can solve such as problem, and a lot of others, if physicians, Referees, peer-review’s Editors, and particularly WHO Authorities are determined to be “open-minded”, farsighted, and free.
Regarding differential diagnosis between seasonal flu virus and A/H1N1, a central role are played by parametric values of BALT-gastric aspecific reflex, informing about antibody synthesis. In seasonal flu, starting from the contagious, as well as immediately after vaccine injection, latency time lowers to 4-5 sec. (NN = lt. 6 sec.), and reflex intensity is 3 cm. (NN = 2 cm.) (1, 2).
On the contrary, in case of swine flu, latency time is lowest, 2-3 sec, while reflex intensity is highest, i.e., 5 cm. In addition, even when gastro-entero-colitis is absent, antibody synthesis in the lever and intestinal lymph-nodules parallels that of BALTH.
1) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Ed. Travel Factory SRL., Roma, 2004. http://www.travelfactory.it
2) Stagnaro-Neri M., Stagnaro S., Appendicite. Min. Med. 87, 183, 1996[MEDLINE]
3) Stagnaro S., Sindrome percusso-ascoltatoria di Iperfunzione del Sistema Reticolo-Istiocitario Min. Med. 74, 479, 1983 [MEDLINE].
4) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004.
5) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005.
6) Stagnaro Sergio. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [MEDLINE]
7) Stagnaro S., Singh RB. Influence Of Nutrition On Pre-metabolic Syndrome And Vascular Variability Syndrome. Editorial, The Open Nutrition Journal. Bentham Sci. Publish. In press.
8) Stagnaro Sergio. Quantum-Biophysical-Semeiotic Bedside Diagnosis of Flu, since its earliest stage. http://www.CMAJ.com, 29 October, 2009, http://www.cmaj.ca/cgi/eletters?lookup=by_date&days=21#228652
Sergio. Your undocumented statement against a well established diagnostic molecular test is “…can be diagnosed exclusively with sophisticated semeiotics (who’s specificity/sensitivity is about 60%!)”. Your statement is wrong. Given that the samples are taken appropriately, our method (same as used by health agencies around the world) has a very high sensitivity 98-99 % or more, and a specificity of very close to 100 %. Thus, diagnosing this infection is currently not problematic at all, and any further improvements in diagnostics is going to be in the numbers of people we can test, not the method itself. If you want to challenge the established and well documented sensitivity/specificity numbers you need to dig out real facts and numbers.
In spite of the fact that there are at least 6 diverse test types in diagnosing flu,showing different sensibility and sensitivity, I think to the people living in mountains, in little towns, away from laboratores and hospitals, who cannot undergo to such as technological diagnosis. That’s true: thanks to the terrible Flu Pandemic, an enormous number of papers are written on behalf of mankind!