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INFLUENZA PANDEMIC (H1N1) 2009 (114): UNITED STATES OF AMERICA (WEST
VIRGINIA), REPEAT INFECTION
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Tue 24 Nov 2009
Source: The Charleston Daily Mail [edited]
<http://www.dailymail.com/News/Kanawha/200911230838>
CDC confirms Kanawha County pediatrician had swine flu twice
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A West Virginia physician who claimed to have contracted the pandemic
(H1N1) 2009 virus twice now has proof -- from the Centers for Disease
Control and Prevention (CDC) in Atlanta, Georgia, no less -- that her
claims were true.
Dr. Debra Parsons, a pediatrician at Kid Care West in Cross Lanes,
was met with reactions of doubt from local health officials last
month [October 2009] when she said 2 flu tests had come back positive
for [pandemic] H1N1, or swine flu. Parsons 1st came down with the
virus, complete with all the telltale symptoms, in August [2009]. Her
son became ill at the same time with the same symptoms. Figuring they
had the same bug, Parsons tested herself to see what it was. The test
came back positive for Influenza A, so the lab at Charleston Area
Medical Center (CAMC) sent it to be sub-typed. Parsons was positive
for H1N1.
Parsons and her son recovered, but in October [2009] they started
having the same symptoms, but they became much worse. They were both
tested this time, and the results were the same -- they were positive
for Influenza A and then [pandemic] H1N1. "It was swine flu both
times," Parsons said.
Dr. Rahul Gupta, director of the Kanawha-Charleston Health
Department, and John Law, spokesman for the West Virginia Division of
Health and Human Resources (DHHR), were skeptical of Parsons' claim.
Law said the possibility of getting the flu twice was "very, very,
very rare." Gupta said he was "aware of no data or scientific body of
research or case reports" that indicated someone could contract H1N1
more than once.
So the specimen from the Parsons' 2nd flu test was sent to the CDC in
Atlanta, Georgia, where it underwent a preliminary strain reaction
test. Parsons says that test is the "gold standard" in
differentiating between seasonal and swine flu.
That sample came back a couple weeks ago, and it was positive for
H1N1. The CDC then requested a specimen from Parsons' August flu
test. Last Friday [20 Nov 2009], the results of that test came back
positive for H1N1. Parsons says she's spoken with CDC representatives
about the results, and they said the double infection isn't all that
unbelievable. "They said this happens every year with seasonal flu,
so there's no reason to expect that it wouldn't happen with swine
flu," Parsons said. "Every flu strain can change a little bit."
The pediatrician says there may have been a tiny change in the virus
that stopped her immune system from recognizing it or her body never
built up immunity to it. Parsons said the CDC's tests confirmed what
she already knew, "so I'd know what to tell people, and I could prove
that I wasn't trying to start a panic. I don't want to scare
anybody. I need to know, as a physician, if it is possible or not. I
want to tell my patients the truth," she said.
She says the confirmation also speaks well of CAMC's lab. "It feels
good to verify that the hospitals here are doing a good job and their
tests, for the most part, are accurate," Parsons said. Law, the [West
Virginia] DHHR spokesman, still says most people should "rest assured
if you've had it, you'll develop some immunity. "Can you ever say
never? No you can't."
Gupta says he needs to see Parsons' test results before he can change
his opinion. He says there are only 2 ways she could have contracted
the virus twice -- the virus would have had to change, which he
doesn't think has happened, or her body failed to develop an antibody
response to it. "That would mean you have a problem with your immune
function," he said.
Parsons says to her knowledge neither she nor her son has any
immunity problems. "He's welcome to see them," she said. "I've had
every test that he wanted done when he was on TV."
[Byline: Zack Harold]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[A map showing the location of Kanawha county in the state of West
Virginia can be accessed at:
<http://en.wikipedia.org/wiki/Kanawha_County,_West_Virginia>. The
location of the state of West Virginia can be found by accessing the
HealthMap/ProMED-mail interactive map of the USA at
<http://healthmap.org/r/009V>.
This reinfection in a mother and son contemporaneously is an
unexpected observation, and more specific information would be
desirable about the immune responsiveness of both the pediatrician
and her son (e.g., their hemagglutination inhibition [HI] antibody
titers). If repeat infections are a common occurrence, it might imply
that many individuals who have experienced inapparent or mild
symptoms may still be susceptible to reinfection and development of
serious disease. It would also diminish the potential effectiveness
of vaccination.
The UK Health Protection Agency (HPA) has reviewed blood tests which
showed higher levels of infection among children than originally
thought. In hotspot areas a 3rd of school-aged children may have had
the virus, but only one in 10 or fewer became ill. Across the UK, the
figure is probably about a 5th, the HPA said. However, such findings
reinforce the belief the pandemic virus is predominantly a mild
strain of influenza
<http://news.bbc.co.uk/1/hi/health/8375922.stm>. - Mod.CP]
[see also:
Influenza pandemic (H1N1) 2009 (113): Saudi Arabia, Hajj fatalities
20091122.4013
Influenza pandemic (H1N1) 2009 (112): Canada (MB), vaccine reaction
20091121.4009
Influenza pandemic (H1N1) 2009 (111): Norway, mutants 20091121.4005
Influenza pandemic (H1N1) 2009 (110): UK (Wales), Tamiflu resistance
20091120.4000
Influenza pandemic (H1N1) 2009 (100): Ukraine (DT) 20091114.3940
Influenza pandemic (H1N1) 2009 (90): Venezuela, Yanomami 20091105.3820
Influenza pandemic (H1N1) 2009 (80): Ukraine susp. RFI 20091031.3764
Influenza pandemic (H1N1) 2009 (70): Nepal 20091016.3563
Influenza pandemic (H1N1) 2009 (60): bacterial coinfection 20090930.3410
Influenza pandemic (H1N1) 2009 (50): oseltamivir-resistance 20090917.3260
Influenza pandemic (H1N1) 2009 (40): global update 20090906.3138
Influenza pandemic (H1N1) 2009 (30): assumptions 20090813.2879
Influenza pandemic (H1N1) 2009 (20): Peru, 33 percent asymptomatic
20090730.2668
Influenza pandemic (H1N1) 2009 (10): vaccine 20090720.2577
Influenza pandemic (H1N1) 2009 - Viet Nam: patient data 20090708.2450]
..................cp/ejp/lm
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