No, Vanderbilt isn’t just testing cases for H1N1 on Mondays to keep numbers down, and no, classes won’t be cancelled anytime soon, although a record number of students have gone to the Student Health Center over the past couple weeks.
Those myths are just a few of the rumors flying around campus seemingly as fast as the H1N1 virus, a strain of influenza A that is commonly referred to as swine flu.
About 350 campus cases of an influenza-like illness had been diagnosed as of Thursday morning, dating back to mid-August. Nearly all of those who have the flu, both seasonal and H1N1, recover within three to four days. Dr. Louise Hanson, the medical director for student health services, said in an e-mail Thursday morning that the number of patients seen by Student Health over the past week has “settled down somewhat,” as well. About 30 patients per day had presented with an ILI two weeks ago, but that number dropped to about 15 patients per day this past week.
And Hanson wants to stress that the university is still testing for H1N1.
The Student Health Center sends cases to state testing centers on Monday per the request of the Tennessee Department of Health. Student Health is part of the state’s Sentinel Provider Network, made up of hundreds clinics, hospitals, and doctors’ offices across the state that each have an assigned day on which to send cases for testing. The state’s purpose is to find and monitor what illnesses are out there, not to individually treat patients, Hanson said in an earlier interview.
The routine of sending Monday’s cases for testing has been in place for a long time and continues regardless of the presence or absence of specific illnesses, including H1N1.
“We know from our data, as well as data from other Sentinel Providers, that the novel H1N1 influenza strain is the dominant one now and that minimal to no seasonal flu is circulating at this time,” Hanson wrote, adding that the university has not received any other confirmations of seasonal flu since a case in late August. “Most of the samples that we (and others) have sent to the state have been positive for H1N1 influenza.”
Every day Student Health evaluates students for ILIs, regardless if the state is testing the case. The TDOH Web site says since confirmation can take up to two weeks, a patient’s treatment should not depend on what the state test reveals.
“The decision to treat patients is based primarily on their history (including exposures) and physical exam, combined with other testing at the Student Health Center, depending on the clinical scenario,” Hanson wrote. “If we see a patient with fever and sore throat, for example, it may not be clear to us on physical exam whether that patient may have flu or something else like mono or strep throat. Most flu patients are fairly easily identified as having flu based on their exam and history, but sometimes early in these illnesses, it's hard to tell.”
Since other illnesses can be counted within the ILI number, it is not always a good indicator of the number of flu cases on campus or how sick a community is.
And students who are presenting with these other illnesses are going to Student Health in record-high numbers.
“We've been seeing about 220 total patients per day, which is far busier than even our most busy winter day,” Hanson wrote, “meaning that we are seeing high numbers of other illnesses and injuries that actually far exceed the number of daily influenza cases.”
Students are encouraged by the Centers for Disease Control and Prevention to try to isolate themselves as much as possible while they have flu-like symptoms, including for at least 24 hours after their fever leaves. Student Health won’t have a Sunday flu clinic this weekend, but it will be open on Saturday morning for its regular hours.
