Diagnosing swine flu
Diagnosing Swine Flu
A survey of GPs reported on the ITN website this morning found that 90% of them are concerned that diagnosing swine flu over the phone could lead to other diseases, like meningitis, being missed.
More details on my "support West Cumbria Hospitals" blog (see link at right.)
It's a small sample, but the overwhelming nature of the response is statistically significant and suggests that the fears described by the NHS Blog Doctor (see post "How not to deal with swine flu-or anything else" on the hospitals blog) are shared by many other doctors.
While the levels of suspected wine flu are above what normal NHS capacity can deal with it may be regrettably necessary to keep the current special measures such as internet and telephone diagnosis in place, but this survey reinforces my view that we should return to normal methods of diagnosis as soon as practical when infection rates trend down.
POSTSCRIPT 8 AUGUST - TRAGEDY STRIKES
Sadly it appears that the prediction of the NHS Blog Doctor and others has come true. Sky News reports today that the parents of a toddler who died in a Norfolk hospital on Tuesday believe that she died of meningitis after being misdiagnosed with swine flu.
The report says that two-year-old Georgia Keeling's family say they were twice told their daughter had the H1N1 virus and should stay at home.
Her father Paul Sewell, 21, told Sky News she was misdiagnosed, despite displaying the symptoms of meningitis.
"She was showing the three most basic signs of meningitis - the rash, the temperature and the drowsiness. Plus she was sick the night before," he said.
"I told NHS Direct the symptoms and they said 'sounds like a virus' and to give it 48 hours to see how it goes."
He added: "Then I left for work and that was the last time I saw her."
Tasha Keeling, the toddler's mother, initially contacted her local health centre, who said it could be swine flu. The pandemic flu helpline advised calling NHS Direct as the symptoms did not match, but they advised keeping Georgia at home unless her temperature rose.
Ms Keeling eventually resorted to dialling 999 but claims a paramedic arrived first, diagnosed swine flu for the second time and said an ambulance was not necessary. The family were left with Calpol and Tamiflu and instructed to leave Georgia in bed.
When another ambulance was called later, the toddler was taken to the Norfolk and Norwich University Hospital where she died.
The hospital suspect Georgia died from meningitis, according to a spokesman. An investigation will be carried out by the ambulance service and NHS Norfolk, although no official complaint has been made.
A survey of GPs reported on the ITN website this morning found that 90% of them are concerned that diagnosing swine flu over the phone could lead to other diseases, like meningitis, being missed.
More details on my "support West Cumbria Hospitals" blog (see link at right.)
It's a small sample, but the overwhelming nature of the response is statistically significant and suggests that the fears described by the NHS Blog Doctor (see post "How not to deal with swine flu-or anything else" on the hospitals blog) are shared by many other doctors.
While the levels of suspected wine flu are above what normal NHS capacity can deal with it may be regrettably necessary to keep the current special measures such as internet and telephone diagnosis in place, but this survey reinforces my view that we should return to normal methods of diagnosis as soon as practical when infection rates trend down.
POSTSCRIPT 8 AUGUST - TRAGEDY STRIKES
Sadly it appears that the prediction of the NHS Blog Doctor and others has come true. Sky News reports today that the parents of a toddler who died in a Norfolk hospital on Tuesday believe that she died of meningitis after being misdiagnosed with swine flu.
The report says that two-year-old Georgia Keeling's family say they were twice told their daughter had the H1N1 virus and should stay at home.
Her father Paul Sewell, 21, told Sky News she was misdiagnosed, despite displaying the symptoms of meningitis.
"She was showing the three most basic signs of meningitis - the rash, the temperature and the drowsiness. Plus she was sick the night before," he said.
"I told NHS Direct the symptoms and they said 'sounds like a virus' and to give it 48 hours to see how it goes."
He added: "Then I left for work and that was the last time I saw her."
Tasha Keeling, the toddler's mother, initially contacted her local health centre, who said it could be swine flu. The pandemic flu helpline advised calling NHS Direct as the symptoms did not match, but they advised keeping Georgia at home unless her temperature rose.
Ms Keeling eventually resorted to dialling 999 but claims a paramedic arrived first, diagnosed swine flu for the second time and said an ambulance was not necessary. The family were left with Calpol and Tamiflu and instructed to leave Georgia in bed.
When another ambulance was called later, the toddler was taken to the Norfolk and Norwich University Hospital where she died.
The hospital suspect Georgia died from meningitis, according to a spokesman. An investigation will be carried out by the ambulance service and NHS Norfolk, although no official complaint has been made.
Comments
Unfortunately this does not alter the fact that over-concentration on swine flu could have fatal consequences for patients with other diseases - and how apparently has had, see postscript to the above post.