Thursday, October 29, 2009
Swine flu causes fever phobia

By Dr. Anthony Policastro
There is a medical diagnosis called fever phobia. This relates to individuals who panic when a family member gets a fever. There is a belief that the fever will be harmful to the patient. Fever is caused by the body fighting off an infection. Bacteria and viruses that cause infections grow best at 98.6 degrees. That is the reason they can infect humans. One of the body's defenses is to raise the body temperature until the immune system can fight off the infection. We treat fever to make the patient comfortable. We do not treat it to make the fever go down. Fever is a good thing. We are now into another kind of medical phobia. It is swine flu phobia. My last few night's on call, I have been flooded with calls from patients who want Tamiflu for their child's illness. Most illnesses are not swine flu. Most illnesses will disappear without treatment in 72 hours. There is not enough Tamiflu available to use it for everyone with every illness. If we use the stockpiles up before an epidemic hits, there may be none available for use when it is really needed. We need to be careful about overreacting. That being said, we should also not deprive someone of a medication that might prove useful to their disease. There are two questions that need to be answered when prescribing Tamiflu. The first is related to how sick the patient is. A fever alone is not a reason to treat for influenza. Runny nose alone is not a reason to treat for influenza. Cough alone is not a reason to treat for influenza. Another related item is that not all flu viruses respond to Tamiflu. Therefore, even if you have the flu, it might not be swine flu. The medication would not work. The same thing is true if you have a viral infection with a non-swine flu virus. Tamiflu is somewhat specific. It is not like an antibiotic that covers many bacteria. The second important point to remember is that for Tamiflu to be effective, it needs to be issued within 48 hours of symptoms beginning. If the symptoms have been present for over two days, it makes no sense to use the medication. With swine flu causing fever, we now have two phobias to worry about - fever and swine flu.

Delaware Division of Public Health reports two possible H1N1 deaths Delaware's Division of Public Health (DPH) has learned of the first H1N1-related death in the 2009 season, a 35-year-old female from Kent County. The individual had a number of underlying health conditions and had been hospitalized on Oct. 12 in Delaware but was later transferred to a Maryland hospital. DPH is also reviewing the Oct. 19 death of a 15-year-old New Castle County boy to determine if the cause of death is related to H1N1 influenza. The boy, who had a number of underlying health conditions, went to his doctor on Oct. 19 and was later transported to a Delaware hospital where initial testing for strep infection was positive and influenza was negative. Post-mortem test results were positive for H1N1 influenza and the death will be reported to the CDC as H1N1-related since flu was present. There have been approximately 292 flu-related deaths, seasonal and H1N1 combined, in the United States from Aug. 30 until Oct. 10. according to the Centers for Disease Control and Prevention. Certain groups of people are at higher risk of complications from the H1N1 flu, including people with chronic underlying health conditions such as asthma, diabetes, heart disease, obesity, and who are immunosuppressed. For most healthy people this has been a mild infection. Precautions to help stop the spread of flu include:
  • Get vaccinated against both H1N1 and seasonal flu.
  • Wash your hands frequently with soap and warm water or use an alcohol-based hand sanitizer.
  • Cover your cough/sneeze with a tissue, or cough/sneeze into your inner elbow and not into your hands.
  • If you are sick, stay home for at least 24 hours after your fever goes away. This means no fever for at least 24 hours after you have stopped taking any fever-reducing medication.

Employers are encouraged to be flexible with their employees on the issue of staying home when ill. Stay informed about the latest developments on the H1N1 flu, by visiting

Grief holiday workshop Delaware Hospice invites everyone who is grieving the loss of a loved one to "The Ups and Downs of the Holiday" workshop on Thursday, Nov. 19, from 4 to 5:30 p.m., at Nanticoke Memorial Hospital, Seaford. Paul Ganster, LCSW, grief counselor, will lead the workshop and discuss topics such as: why the holidays are stressful and difficult for those grieving; problem solving to reduce stress; suggestions on coping with the holidays; and rituals to honor your loved one. Each participant will receive a 64-page booklet, "How Will I Get through the Holidays?" by James E. Miller. Light refreshments will be provided. The workshop is free and open to the public, but registration is required as space is limited. To register, call Paul Ganster, 357-7147, or email

Fitness activities at Delaware Tech Have fun and stay active this fall by participating in fitness activities at Delaware Technical & Community College, Owens Campus. Build strength with excess bulk to create a sleek, toned body in Pilates beginning Monday, Nov. 2. Release tension and stress through meditation, breathing and stretching exercises in Yoga, beginning Nov. 2 and Nov. 4. Get a great workout in the Cardio Combo Class on Tuesdays and Thursdays beginning Nov. 3. Children and adults can learn basic karate movements, improve coordination and concentration in karate courses beginning Saturday, Nov. 7, at 10 a.m. for ages 7-12 and 11:10 a.m. for ages 13 and older. Learn about the culture of the Middle East through dance technique and music in Belly Dance Choreography or step up the pace in Belly Dance Aerobics, beginning Thursday, Nov. 12. Horseback riding is offered for beginners at Singletree Stables in Seaford; participants will learn the basics of safety, stable management and equestrian skills beginning Saturday, Nov. 14, for ages 8 to 14 and Wednesday, Nov. 18, for ages 15 and up. For more information, contact Delaware Tech's Corporate & Community Programs at 854-6966.

Seasonal flu shots offered It's time to get your seasonal flu shot.Influenza is a serious disease that affects many people, including the elderly and those with long-term health problems. Nanticoke Memorial Hospital will be offering seasonal flu shots to individuals 18 and older at Nanticoke Occupational Health, 743 Shipley Street, Suite F, Seaford, from: 9 a.m. - 12:30 p.m. and 4 - 7:30 p.m. on Wednesdays, Nov. 4; and 9 a.m. - 1 p.m. on Fridays, Oct. 30 and Nov. 6. Cost is $10 per adult. Medicare Part B billing is available with proof of Medicare insurance. Pre-registration is required. Call Nanticoke Occupational Health at 629-6875 to pre-register and schedule an appointment.

Professional Caregiver Retreat Day Delaware Hospice's Family Support Center invites all those who work or volunteer in a helping profession to attend the Professional Caregiver Retreat Day on Friday, Nov. 13, from 8:30 a.m. to 4 p.m., at the Delaware Hospice Center, Milford. Dr. Judy Pierson, licensed clinical psychologist, published author and dynamic speaker, will discuss topics such as: the cost of caring–assess your own well-being; understanding vicarious trauma and compassion fatigue; strategies for coping with the stress of this work; and creating your own personal self-care plan. The retreat is $99 per person (continental breakfast and lunch included). Application has been made for 6.0 continuing education hours for social workers and nurses. Participants will leave with information about the impact of their work, specific coping techniques, and a strategy for improving their work life tomorrow. Due to space limitations, early registration is recommended. To register and for more information, call Vicki Costa, associate director of the Family Support Center, 302-856-7717, ext. 1129.

Hospice offers Grief Support group Delaware Hospice is offering an eight-week group meeting for adults who have experienced the death of a loved one. The group will meet Wednesday afternoons from 5 to 6:30 p.m., until Dec. 2, at Nanticoke Memorial Hospital, 801 Middleford Road, Seaford. Find out what normal grief "looks" like; learn about the "tasks of mourning;" identify your coping style and develop coping skills that feel right for you; share as much or as little as you would like. This activity is provided free to the public by Delaware Hospice; however, registration is required. To register, call Paul Ganster at 302-357-7147.

Depression Support Group There is a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call Life Matters Counseling and Consulting at 302-465-6612.