Cases without fever - what the heck?!?

[Purple_Scrubs]

I have seen a couple of places on this board and elsewhere that many cases of swine flu are afebrile. This is exceptionally alarming to me, as a school nurse! Without fever, the traditional hallmark of flu, how in the world am I to know which of these kiddos are truly sick? I see tons of sore throats and runny noses, there is no way I can send them all home or have them see their PCP (heck, most of the kids at my school don't even have a PCP!) My district is no help, it is all business as usual with them.

Right now, I am going on how the kid "looks", which is completely unreliable. Maybe I will start refering them if they have at least 2 symptoms OR a fever. I just don't want an outbreak to occur because I missed a kid who was really sick. I have no idea what to do with this! Any advice?

[indigo girl]

Morning-glory, I think up to a week is about right, but remember not all of the people that you are exposed to are going to be symptomatic even if infected. People are infectious before showing s/s and even afterwards. You may never know who infected you.

This virus is now everywhere in the community. It is not something that is going to be avoidable except possibly by some prior immunity in older individuals.

[CrunchRN, ADN, RN]

Realistically though what can you do? I am running a 8 week study where subjects come every week and they cannot miss a week. I am the only one who does my job. I have to come in no matter what. I guess i can wear gloves and a mask, but I cannot stay home and ruin a study costing thousands of dollars..... unfortunately there is just no way possible to have back up as it is specialized, you must be on the protocol, and we are the only ones in the department dealing with human subjects.........