Many Swine Flu cases have no fever

Up to a third of swine flu cases in Mexico have no fever. Be aware that students sick with this new flu may not have traditional symptoms of flu.

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May 13, 2009
Many Swine Flu Cases Have No Fever
By LAWRENCE K. ALTMAN

Many people suffering from swine influenza, even those who are severely ill, do not have fever, an odd feature of the new virus that could increase the difficulty of controlling the epidemic, said a leading American infectious-disease expert who examined cases in Mexico last week.

Fever is a hallmark of influenza, often rising abruptly to 104 degrees at the onset of illness. Because many infectious-disease experts consider fever the most important sign of the disease, the presence of fever is a critical part of screening patients.

But about a third of the patients at two hospitals in Mexico City where the American expert, Dr. Richard P. Wenzel, consulted for four days last week had no fever when screened, he said.

“It surprised me and my Mexican colleagues, because the textbooks say that in an influenza outbreak the predictive value of fever and cough is 90 percent,” Dr. Wenzel said by telephone from Virginia Commonwealth University in Richmond, where he is chairman of the department of internal medicine.

The rest of the article is at this url:
http://www.nytimes.com/2009/05/13/health/13fever.html