Let’s assume that you have a fever greater than 100, sore throat and cough and you have traveled to communities where there has been confirmed cases or you’ve been exposed to someone who has a confirmed case of H1N1 ‘flu. Should you see your health care provider and be tested by having a nasal pharyngeal swab?

The CDC has issued new guidelines for clinicians regarding who should be tested for the H1N1 virus. When the virus was still rare in the majority of states in this country, anyone suspected of having the H1N1 (swine ‘flu) virus was asked by the CDC and state boards of health to be tested. The reason for this was to determine how quickly the virus was spreading and where it was spreading to. However once epidemiologists knew where and how quickly the virus was spreading, there was little point in continuing testing – except in certain cases.

So if you think you may have the H1N1 virus, the CDC recommends nasopharyngeal swabs only if you fall into the “high-risk category”. If you have any chronic, underlying conditions that would put you at greater risk for complications and possible death, they you will undergo the nasopharyngeal swab testing. Those at high risk include those with:

• pulmonary, cardiovascular, metabolic, blood, neuromuscular, hepatic or neurologic disorders,
• pregnant women
• children less than 5
• persons 65 or over
• children or adolescents on long term aspirin therapy or who might be at risk for Reyes syndrome
• adults or children who are immunosuppressed either through disease or medication
• residents of nursing homes or long-term care institutions

If you fall into any of these categories and you have flu-like symptoms, then you will need to have a swab taken and analyzed at your state lab. If you do not, then swabs do NOT need to be taken even if there is a strong likelihood that you have the H1N1 virus. Why?

The reason for this is that the H1N1 viral infection generally produces only mild symptoms in people who have no underlying chronic conditions. For those with chronic health problems or who are at high risk for death, then it is very important to confirm the diagnosis.

The CDC is recommending that unless you fall into the high-risk category,

• You do NOT need to see your health care provider
• You do NOT need to be treated w/anti-virals AND
• You do NOT need to be tested.