Many H1N1 (Swine Flu) Cases Have No Fever
By Julie Stachowiak, PhD
Multiple Sclerosis Guide; Guest blogger
That's right, fever is not always present in H1N1 cases. The CDC mentions it in the middle of their text about H1N1, and early reports from Mexico say that 30% of confirmed cases of H1N1 did NOT have fever. In Chile, 50% of cases did NOT have a fever.
"Why is this important?" you might ask. Well, think about the last time that you called the doctor or your child's pediatrician with respiratory symptoms. If your doc is like mine, the first question was "how high has the fever gotten?" If the answer was that there was no fever or that there was just a rise of a degree or two, that may have been the last question you were asked before you were told that it was probably nothing and to stay home and take care of yourself.
The fact that some cases of H1N1 present without fever means that the cases are most likely underreported, as many people would not consider going to a doctor for respiratory symptoms or malaise alone. Perhaps just as important, many doctors would not even consider testing or treating for influenza with antivirals in the absence of a flu, even though some of the people that did not develop a fever have gone on to need hospitalization.
There are also implications around the spread of H1N1. In my childrens' school, runny noses are considered normal, with kids kept home for fevers over 100 degrees. That means that some kids could be spreading the virus at the peak of viral shedding with their fever-free sneezes and coughs.
What does this mean for us? Well, it looks like most people do have respiratory symptoms and malaise, so watch for that. If you do develop these symptoms, take them seriously and talk to your doctor. Ask for a test (even though they have a notoriously high rate of false negatives) for peace of mind. However, don't assume that every little sniffle is H1N1 - be smart and vigilant, but stay calm and rational.
I appreciate this article, as I am on day four of being “sick with something” that is starting to sound a lot like H1N1 without fever. I started on a Friday with headache and sudden cough — deep, congested feel without any preamble. Saturday I felt the same plus fatigue but controlled it fairly well with Motrin. Sunday I could only lie in bed, barely move. Monday, lessoned symptoms but still low energy and mild headache. One bout of diarrhea. (TMI, maybe, but I know it helps me when I can find info that’s similar to what I’m going through.) Anyway, I think I’ll not go back to work tomorrow — call my doctor and ask whether I should be tested even though I’m feeling over the hump.
THANK YOU for posting this information. I live in SW France and have been going crazy trying to get anyone to listen round here. My step-son and step-daughter came for a weekend visit from Nimes that ended up being a week because of us all of getting a version of swine flu without fever, in fact, with below-normal temperatures.
Last week there were 9 suspected case of Swine flu in his school, what we didn’t realise until we’d picked him up was that 7 were in his class! He arrived Friday night with a cough. Saturday morning he curled into a ball, with headache, stomach and neck cramps, chills, sweats, eyes sensitive to light and a fast worsening cough. But NO FEVER- in fact, his temperature was hovering around 36°C, about 97F, below normal. I called the national “flu helpline” who confirmed to me that you can have H1N1 without fever (or Grippe “A” as they call it here, because it is A/H1N1) and they told us to get him seen by a doctor as soon as possible.
Ha. When we telephoned to ask if we should bring him down, A&E refused (!) to let us come down to get him checked, because he had no fever, although I explained that in the family there were 3 at-risk people with asthma or underlying medical conditions, and that he had 7 suspected cases of swine flu in his class, their response was, well, if anyone reports “trouble breathing” then you should call the GP. Great.
The GP, whom we tried next, told me that it was “absolutely not” swine fever, because there was no fever. Within 36 hours of their arrival, Elliot’s older sister, my husband, and I had all come down with splitting headaches, stomach and neck cramps, chills, sweats, vertigo and exhaustion, and the adults also had diarrhea and vomiting and nausea, and 24 hours later, coughs and sneezing. Their mother back in Nimes reported back to us that she had headache, stomach and neck cramps, the same day, and within 48 hours she also had cough and cold symptoms. (She, also, was told by A&E in Nimes when she telephoned that it was not Swine Flu because she didn’t have a fever). So she trusted the Dr, and went back into work, where there is a pregnant woman, and sneezed and coughed all over everybody there all this week.
Within another 24 hours the other 2 children in the family both had coughs, headaches, chills, and neck and stomach cramps, and one had vomiting. Furthermore, within 3 days of Elliot’s arrival the 3 at-risk people in the family (2 adults and 1 child) had heart rates of over 110bpm and respiration rates of over 33 breaths per minute. (Way above normal)
A second Dr STILL refused to believe that it was swine flu because there was no fever, diagnosed bronchitis in my daughter without checking her pulse or breathing rate, and prescribed steroids. A&E again refused to see us when we telephoned a second time- because, you guessed it, there was still no fever! In fact, every single member of the family had the same, below-normal temperature readings, whether they were shaking with chills or damply perspiring with hot flushes, day and night.
We are very lucky as our pharmacist is trained in the use of essential oils and had given us TEA TREE and RAVINTSARA oils, with instructions to put them on each wrist and in the throat area every two hours. I am firmly convinced that due to these oils, Elliot (10) recovered from being so weak that he could not sit up to eat, and the three of us who had signs of pneumonia now have nearly normal heart and respiratory rates again (3 days later).
I spoke to the head of Elliot’s school yesterday and they have 20 children off, 5 of whom had parents willing to PAY for the laboratory tests, all 5 of which came back positive for A/H1N1. We cannot get the laboratory test as no Doctor round here is aware that swine flu exists without fever, and A&E is the only place you can get the test done, and they now only test pregnant women and children under 1. They will not even see anyone who has not been referred by a GP, and all the GPs think you cannot get it without a fever…..!
I cannot stress enough to anyone out there who might read this, YOU CAN HAVE IT WITHOUT A FEVER. If you want to examine the anecdotal evidence, try putting into Google, “can you have swine flu without a fever” and you will get 11 million results. 11 million times that question has been asked.
Here, it is becoming not only nigh on impossible to get anyone to actually test you without paying for the test, but also with stocks of masks for sale in pharmacies running low, now only available to those with prescriptions, and Doctors, GPs as well as in A&E, insisting that without a fever it is not swine flu, it is very worrying.
What I wish I’d known to begin with, although it sounds drastic, is that it is very important to act very fast to protect the rest of the family if you have good reason to think that someone has Swine Flu. I was advised by the national flu helpline, whose advice come from the World Health Organisation, to get masks for every member of the family straight away. I also implemented, after reading through many sites online, constant hand washing and and disinfection of every common-use hard surface in the house, taps, light switches etc, as many times as I could. I have been paranoiacal about washing and re-washing hands whilst preparing food and washing up used dishes, cutlery, have disinfected the bath after anyone has had a bath, and have immediately wash used clothes and towels. It does sound like drastic measures, but there is a good reason for it.
This virus, or at least the version we’ve had, can re-infect the same people, it is different in different people, and you can go 5 days with headache, chills, neck and stomach cramps and vertigo and then suddenly come down with a cough and sneezing and sore throat, the main symptoms of a version that another family member caught to begin with. That has happened to 3 out of the 6 of us. DO NOT allow an infected person to sneeze in the air without a mask. They spread 100,000 droplets at 90mph.
There are also essential oil sprays that you can spray into the air that help to kill airborne viruses, I used a spray called Aromaforce spray, by Pranarom, but I don’t know if it is available outside France.
According to the flu helpline, Swine Flu is infectious from 24 to 48 hours before the symptoms show, for as long as you have symptoms. Personally, I am keeping my children home until their coughs have gone.
Although I think that it is important not to be paranoid in assuming that every cough or cold is Swine Flu, it is also important to know that if you have every single symptom of Swine Flu without a fever, or with lower than normal temperatures, or a selection of the symptoms, and a bug has gone round the family frighteningly fast, to beware. The children have had several “bugs”, coughs, sniffles and colds, since school started, and none of them was anything like this, either in speed of onset or in contagiousness and severity.
I am furious and horrified by our experience. I wonder how many undiagnosed Swine Flu cases are ending in tragedy because of this stupid, misguided arrogance, and apparent misinformation, of the Doctors? I hope and pray that the World Health Organisation realises what is happening in time to get the message out to the govermental health agencies responsible for informing the Doctors, that it can exist without fever.
I’m starting to feel ebtter after 3 days of severe body aches, sore throat and headaches, which followed two days of headaches, but never any fever! I don’t remember feeling such intense body pain. I was sure it couldn’t be H1N1 as there was no fever, but it sure was no cold. After reading this and other writings, I’m seriously thinking it was H1N1. Obviously, the health authorities are missing something big here. Luckily my family has already been vaccinated against H1N1. The funny thing is, the only reason I bothered measuring my temperature was that on the first day of the body aches, I was scheduled to get the H1N1 vaccine, and I knew I couldn’t get it if I had fever, and I didn’t, so I went to get the shot. Three days later I’m feeling much better, only a sore throat that should be healed within the next 2 days. Strange thing this H1N1!