June 8th, 2009

H1N1: A Tale of Two Practices

As an adult ID/HIV doctor, I must say the clinical impact of H1N1 thus far has been underwhelming, notable more for the calls about prophylaxis or suspected cases than the real thing.

(Last week, one patient with fever and “suspected swine” — hard for people to shake that name — turned out to have … Lyme disease.  Ah, New England in June.)

But for my wife, the pediatrician? There’s a full-blown epidemic out there, with outpatient visit volumes way up, and nearly continuous oseltamivir prophylaxis among her staff.  As in mid-winter, she and her practice partners are routinely making the influenza diagnosis based on symptoms alone.

And while this report suggests the age cut-off for partial immunity to H1N1 is 60, I suspect strongly — based on our highly-anecdotal, two-doctor-family, completely non-scientific observation — that it’s going to turn out to be quite a bit younger.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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