Cabin Fever

Photograph of campers and counselors by Stockbyte/Getty Images Creative.

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For three summers, my 12-year-old son, Joshua, has attended Camp Modin, a beautiful camp in rural Maine. This year, when we dropped him off at the northbound bus, something was different: The counselors were taking children's temperatures before letting them onboard. It seemed a wise precaution, as the new influenza A H1N1 swine flu strain continues to spread and the weather in Maine in June was cool this year, which would facilitate an outbreak of the virus. But as a physician who has studied the flu for many years, I was still worried. An infected person can be contagious even if he doesn't have a fever.

My concern was justified. Three days after camp started, I called the camp director, Howard Salzburg, and discovered that he was beside himself. One of the parents, another physician, had used Tylenol to deliberately suppress his child's fever so he wouldn't be held back. There were already 16 cases of the flu, confirmed by the Maine Center for Disease Control and Prevention to be the H1N1 swine flu strain. Desperate to contain the infection, Howard had created a quarantine bunk for the sick and was having all the bunks cleaned with hospital-grade disinfectant. One other tool could help stem the spread of infection—but using it would go against CDC protocol.

The Centers for Disease Control has a national policy to reserve the anti-flu drug Tamiflu, which works by blocking the flu virus from detaching from one human cell and spreading to the next one, for only severe cases. But with the new pandemic strain circling the globe and more than 1 million people already infected, it seemed to me it was time for our public health authorities to employ a more aggressive strategy. Clinical trials have shown that Tamiflu, when taken within 48 hours of exposure, is 92 percent effective at preventing flu in adults and 82 percent effective in children. Since we don't yet have a vaccine, it was clear that the best strategy was to use the drug, which decreases the severity and the duration of the illness and helps prevent people who are in contact with flu patients from getting sick themselves. I e-mailed the camp parents to let them know that Tamiflu is well-tolerated and safe and that I was starting my son on a 10-day course of it; it would be wise, I recommended, for them to do the same. Prescriptions were soon flooding the camp's fax machine; out of the 350 campers, 250 campers were started on the drug, as were more than 100 staffers.

Read the rest of this article in Slate.-->