A Portland teen was misdiagnosed with the flu and died days later on Feb. 19. The cause of her death has yet to be determined, but one thing is for sure: if 15-year-old Sarah-Jane Harth hadn’t spent her final days thinking her “flu” was under control with anti-viral drugs, she may not have died.
Harth’s story is an extreme example of what some medical experts think is a tendency to over-diagnose the flu.
As many as 70 percent of doctors mistake other ailments for the flu, according to registered nurse Lee Youngblood, product manager for ZymeTx, a company which sponsors of the National Flu Service Network.“Because of the wide array of flu symptoms, many doctors just diagnose the flu,” he said. “Doctors think they know how to diagnose the flu because they’ve been seeing it for years, but almost half the time they’re wrong. It’s a problem in the medical community.”
Influenza costs the nation from $12-20 billion a year.
Youngblood said both doctors and patients share common misconceptions about the flu. Registered nurse Trudy Trezona of Doernbecher Children’s Hospital in Portland, Ore. — the hospital that treated Hearth before her death — said that most people think the flu is “just the flu.”
But the flu can be deadly. On average, influenza is associated with more than 20,000 deaths nationwide.
Currently, flu epidemics are plaguing Oregon.
“Each year, 120 million Americans present to their physicians with flu-like symptoms,” said Dr. Robert Hudson, medical director of ZymeTx. “Of those, 50 million actually have the flu. Some 150,000 people will be hospitalized and 40,000 will die, all within a four-month season.”
According to Maria Pedersen, marketing manager for influenza at Quidel Corporation, a pharmaceutical company, the best way to avoid misdiagnosis is simple: take a test.
Before the development of flu diagnostics, physicians relied on their clinical judgement to determine if patients had the flu.
“But the interpretation of symptoms can be unclear,” Hudson said in a written statement.
Pedersen said the four rapid flu tests on the market are about 50-90 percent accurate — more so than clinical diagnosis.
The most accurate test on the market, ZstatFlu, tests for influenza A and B, the two less severe forms of influenza, with a 99 percent success rate. Influenza C is rare and can lead to deadly conditions like pneumonia.
To use ZstatFlu, a nurse swabs the back of a patient’s throat to obtain a specimen. The specimen is incubated with a reagent, a protein that will turn blue a specimen positive for influenza. The test is stable for up to 30 hours, allowing physicians who do not have a laboratory in their offices to transport the specimen to an outside lab.
INFLUENZA
UNDERSTOOD
Influenza, or “the flu,” is a viral infection afflicting the respiratory tract. Typical influenza symptoms include fevers ranging from 100-103 degrees, cough, sore throat, runny or stuffy nose, head and muscle aches and other extreme fatigue. According to the Centers for Disease Control, the term “stomach flu” describes a non-existent misnomer.
There are currently three flu tests on the market that seek to help curb misdiagnosis and a number of studies underway to uncover the most effective and accurate diagnostic techniques.
A FLUKE
This month marks the end of a particularly “strange” flu season, Youngblood said. Distribution of flu vaccines were delayed several months when the CDC recalled vaccines from two of the four companies that manufacture the drug. The other two manufacturers also experienced problems growing one of the main components of the vaccine.
And in a season when a dearth of flu vaccines forced the sick and elderly to scramble for shots, the University of Oregon Health Center doled out a share of its own limited supply to some of the healthiest students on campus.
Last November, the Health Center gave the athletic department 50 of its 300 doses.
Oregon Public Health Officer Sarah Hendrickson said in a written statement: “It’s counter to the recommendations that were made by every ethical medical body.”
Dr. Bob Crist, team physician for the athletic department at Oregon, said he didn’t administer the vaccine to any starters for fear they might suffer an adverse reaction before a game.
But according to Youngblood, concerns such as these represent a general ignorance surrounding the flu.
“Some people feel you can catch the flu from the vaccine,” he said. “You cannot.”
Youngblood said the vaccine uses a deactivated strain of the virus, which cannot possibly infect a person with influenza.
“Another reason a lot of people avoid it is that there are some questions about how effective it is,” Youngblood said. “Reports say vaccines range from 70 to 90 percent effective.”
The CDC recommends on its website that health official give top priority to “high risk” patients and their families, which include those 65 and older, pregnant women, sufferers of hypertension and asthma, and those with immune problems and HIV.
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