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(((((( An interesting article about an E.R. doctor dealing with H1N1 Flu ......)))))

New Mexico:

Fear & infection on the swine flu front lines: An ER doc’s snapshot of the virus

By Dr. Frank Huyler
Wednesday, October 14th 2009, 4:00 AM
http://www.nydailynews.com/opinions/2009/10/14/2009-10-14_fear__infection.html

The decontamination room at the ER where I work is like a fallout shelter from the Cold War: all steel and concrete and fluorescent lights. Four smaller rooms with heavy doors open from a single larger one. The smaller rooms can be sealed airtight, and everything can be hosed down and sterilized.

The room is new. It’s designed to treat victims of toxic exposures - acids and poisons and the like. Exposures like that are rare, so I’d never once set foot in it.

When I saw it for the first time this week, I realized that its purpose was not simply the rare semitruck full of pesticides rolling over on the freeway. Someone, somewhere had considered bigger things.

They were right, because now we’re using the room 24 hours a day. We’re filling it up with patients with swine flu, or H1N1, as it is properly known. We’ve got nowhere else to put them.

I’ve been practicing medicine for 15 years, and I’ve never seen flu like this. They’re coming in by the hundreds. Fevers of 103 or 104, shaking chills, misery. They wait for hours in the lobby or in the halls, and you know them because they’re wearing the yellow masks we give them at the door.

The masks make everyone feel better. Whether they have an effect, however, is less certain.

I wear a mask too, as much as I can. It’s uncomfortable and hard to talk through. I don’t want to get this flu, though, and I especially don’t want to bring it home to my 5-year-old son, so I wear it. I’m likely to get the flu anyway unless I am vaccinated soon, because my exposure, just like that of every other hospital worker in the United States right now, is extreme.

The vaccine, we’re told, will arrive any day.

As I write this, the intensive care unit at our hospital has 10 critically ill patients on ventilators because of this flu. All of them are relatively young, healthy adults. I’ve never seen that before, either.

When I go into the decontamination room, I don’t shake hands with the patients waiting there. They’re coughing and shaking, wrapped in blankets. They are mostly poor, and tend to be Native American and Hispanic. A half-dozen pairs of eyes look up at me over their yellow masks as I enter each smaller room. It’s like something out of the past.

I speak to the patients quickly, one by one. Through the masks, both my questions and their answers are muffled. I look at their vital signs. Those who are sickest, whose heart rates and fevers are high, get an IV and several liters of fluid. Those who have certain other conditions - diabetes, asthma, etc. - get a prescription for Tamiflu, an antiviral drug that has some effect.

Then we send everyone home, and the decontamination room fills up again.

The hospital was full before the epidemic began, and now patients in every high-risk category one cares to name - those with heart or lung or kidney disease, for example, or cancer - are being exposed. It is pushing our health care system, already in tatters, to the utmost.

I leave the decontamination room through three heavy steel doors, each opening at the push of a button. I wash my hands twice - first with water and soap, then with alcohol-based cleanser. I rub the cleanser on my stethoscope, and I rub it on my pens.

When I get home at 1 a.m., I take off my scrubs; my boxers and T-shirt, and my shoes and socks. I stuff all my clothes in a plastic garbage bag. Then I open the door to the house, where my wife and son lie sleeping, and walk directly down the hall to the shower.

Huyler is an emergency physician in New Mexico and author of the novel “Right of Thirst.”

Comment: A quick Google search indicates that Dr. Hulyer practices in Albuquerque and that he is certified in emergency medicine.

Rwanda: Swine Flu Cases Hit 25 - Report

Irene V. Nambi
14 October 2009
http://allafrica.com/stories/200910140067.html

Kigali — Laboratory confirmed cases of the Influenza A H1N1 (Swine flu) have increased with 11 new cases reported yesterday. This was revealed by Dr. Justin Wane, the head of the Swine Flu response team in the Ministry of Health.

According to Wane, two of the new cases are officials from King Faisal Hospital while the remaining nine are pupils from the previously reported Marie Auxiliatrice Private School in Kigali.

“All the new cases are people who came in direct contact with the initial family that tested positive for the virus. Just like the 14 cases that we had, these new cases have also been isolated and are being treated at home until the quarantine period ends,” Wane told The New Times.