Background
This working paper examines a real patient who is admitted to hospital with influenza. The working paper further discusses the diagnosis that was conducted, as well as the treatment. Additionally, important information concerning the infection, spread and prevention methods are provided. Lastly, since influenza is commonly confused with common cold, the differences are also aptly discussed.
Mark, a 12-year old boy from Ontario is admitted at Hanover District Hospital for what appears to be signs of common cold. Mark has a running nose, body aches, sneezes occasionally and is evidently fatigued. On the first day, a family doctor working in the children’s department does a shallow examination of Mark’s condition, gives Mark pain relievers and antibiotics and assures Mark’s mother that her son would be well in a few days. He adds that since it was a cold month (March), it was common for people to develop common colds and that the infection was nothing to worry about. Nevertheless, after two days, Mark it readmitted at the same hospital, with his condition seeming to worsen. This time, Mark has developed symptoms of fever, muscle aches, headache and more fatigue. Mark also says that he experiences dry coughs, sore throat, chills and sweats, diarrhea, vomiting, and even loss of appetite.
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Mark’s case at first is examined erroneously. A significant number of doctors suspect common cold at the first instance if they come across a patient with symptoms similar to Mark’s. The prominent reason is that a majority number of people get infected with common colds during cold periods of the year, especially during winter. A few people with common colds seek for over the counter (OTC) drugs to treat their condition while others ignore treatment because common colds take a short time to heal.
According to Allan & Arroll, (2014), common cold and influenza share some symptoms. Some of the common symptoms include: running nose, sneezing, and body aches. One of the aspects that rules out common cold in Mark’s case is that he did not have a ‘blocked nose’, which is typical of patients suffering from common cold. Secondly, Mark had developed other severe conditions such as diarrhea, vomiting, and sore throat. If it were a case of common cold, Mark’s condition would have improved after taking the pain relievers and antibiotics.
Medical History and Cause of Influenza
Prior to the infection, Mark had spent the weekend skating on ice with friends at the Center Ice Arena. Skating was one of Mark’s favorite sports that he could do anything to play. According to his mother, Mark had been warned to stay indoors on the day he went out because the weather was too cold. Additionally, his mother had realized that a significant number of his friends had ‘common cold’. She, therefore, did not want her son to catch the ‘common cold’. However, Mark had sneaked out when his mother was busy doing house chores. Due to his passion for skating, he had even forgotten to wear heavy clothing to protect himself from the cold weather. On Monday, which was supposed to be a school day, Mark failed to wake up. Observably, he had all typical symptoms of common cold.
The narrative above highlights the history of Mark’s condition. Before going out to play with friends, he was well but after playing, he got the infection. That means that he most likely got the infection from friends. According to Sinha et al. (2018), people who are infected with flu pass it to others up to 6 feet away. On the same note, the author asserts that flu viruses are spread mainly through droplets which are made when people with the infection talk, sneeze, and cough. People consequently get infected with the virus when the droplets land into their mouths, noses or even be inhaled into the lungs. A person can also contract the infection through touching a surface or an object that has the flu virus. It is possible that Mark got the infection through any one of the ways.
On the same note, it is vital to analyze the type of virus that causes influenza. A detailed analysis of the causative agent is vital to understanding the severity of the condition, hence effective treatment. First, Sinha et al. (2018) define influenza as an “acute respiratory illness”. Such a definition implies that the condition is more than a common cold. Influenza is caused by influenza virus which manifests itself in three different forms that include: A, B, and C. Beginning with type A, it is prominently found in humans but also occurs in other mammals, as well as birds. This type of influenza virus is associated with the cause of influenza pandemics, that is, the outbreak of the disease on a large scale. Type B occurs in humans and seals while type C occurs in humans and pigs. Another thing to note is that type C occurs commonly in children, less than the age of six.
Ng et al. (2018 state that the virus is highly contagious and is common during the cold months, particularly during winter. Since the condition is a respiratory tract infection, large numbers of the virus particles are present in respiratory tract secretions such as sputum and saliva. Looking at Mark’s case, he went for skating during the cold periods (March). Secondly, his mother observed some of his friends with signs of ‘common cold’. It is likely that Mark’s friends were infected with influenza but were not seeking medical attention. Since a significant number of the children had common cold-like symptoms, there is a high probability that there was an outbreak of influenza in Ontario. Consequently, the analysis makes it possible to state that Mark had contracted the Type A virus.
Diagnosis
Proper diagnosis of Mark’s condition involved taking swabs from the back of the throat and nose. The samples were then taken to the laboratory for analysis. It was then that the doctor affirmed that Mark was suffering from influenza and further specified that it was type A. The diagnosis confirmed that the first examination had been done erroneously hence wrong medication had been given.
The diagnosis was informed by the history of the infection. Whereas the first doctor had not asked about Mark’s recent activities, the second doctor inquired about Mark’s activities. Since Mark’s mother also stated that he had seen a significant number of children in the neighborhood with similar symptoms, which never seemed to heal, it was only proper for the doctor to conduct a conclusive diagnosis. As it turned out, there was an outbreak of influenza in Ontario. Usually, diagnosis of influenza is only done when there is public interest. In the prevailing circumstances, the virus threatened the wellbeing of a significant number of members of the public. Therefore, it was necessary for the healthcare workers to offer both treatment and prevention measures.
Treatment
Treatment of Mark’s condition involved the use of neuraminidase inhibitors, mainly oseltamivir (Tamilfu) and zanamivir (Relenza). Other typical treatment methods included: ingestion of body fluids, bed rest, and the use of analgesics to curb fever.
Before the introduction of neuraminidase inhibitors, the common types of drugs which were used to treat influenza were amantadine and rimantadine. However, the resistance of the influenza virus to the two drugs rendered them ineffective. The most prominent factor that makes the neuraminidase inhibitors to be preferred over amantadine and rimantadine is that the former inhibits both influenza A and B viruses. Additionally, it is recommended that teenagers and children who have contracted the flu not be given aspirin because it is associated with Reye syndrome, which is a severe illness.
Prevention
It is evident from the history of Mark’s infection that Ontario was at risk of having an outbreak of influenza. Children were at the highest risk because they are very social and do not understand the dynamics of the virus. Adults also were vulnerable because they would get the infection from children. Therefore, the healthcare workers found it necessary to employ some prevention strategies to stop the infection from becoming a pandemic. The prevention strategy mainly involved of a vaccine that contained the influenza viruses, mainly type A and B. According to Aoki et al. (2013), these viruses are manufactured in chick embryos and rendered noninfective afterward. The strategy of administration of the vaccine mainly involved visiting schools to immunize the children. For adults, they were encouraged to be responsible enough and visit the nearest health centers. Overly, the public was advised to avoid congested areas, body contacts, and playing outside in the cold. People were advised to stay indoors after coming from work or after enaging in various activities. The public was also educated on the symptoms of the infection so that in case they experienced any, they would seek the services of a healthcare worker before the situation became severe.
Conclusion
Summarily, Mark’s condition was erroneously examined, a typical case that occurs due to the similarity of some symptoms between common cold and influenza. From this case, it is essential for healthcare workers to conduct conclusive diagnosis to offer effective treatment solutions. Assumptions lead to wrong medication just the same way the first doctor had administered wrong medication. Influenza is common during winter and it vital for the public to take all the necessary precaution to avoid the infection.
References
Allan, G. M., & Arroll, B. (2014). Prevention and treatment of the common cold: making sense of the evidence. Canadian Medical Association Journal , 186 (3), 190-199.
Aoki, F. Y., Allen, U. D., Stiver, H. G., Laverdière, M., & Evans, G. A. (2013). The use of antiviral drugs for influenza: A foundation document for practitioners. Canadian Journal of Infectious Diseases and Medical Microbiology , 24 (Suppl C), 1C-15C.
Ng, C., Ye, L., Noorduyn, S. G., Hux, M., Thommes, E., Goeree, R. ... & Bowie, W. (2018). Resource utilization and cost of influenza requiring hospitalization in Canadian adults: A study from the serious outcomes surveillance network of the Canadian Immunization Research Network. Influenza and other respiratory viruses , 12 (2), 232-240.
Sinha, S., Dunning, J., Wong, I., Nicin, M., & Woodward, S. (2018). The Underappreciated Burden of Influenza Amongst Canada’s Older Population. And What We Need to Do About It.
