Hospital: Man treated for flu before diagnosis


The chief nursing officer at MountainView Hospital said Tuesday that the 33-year-old man who died last weekend as a result of the H1N1 virus was treated as though he had the disease from the day he was admitted, despite the fact that he was not diagnosed until well into his 13-day hospitalization.

According to registered nurse Helen Vos, John Talley told hospital officials he had been ill "for more than a week" before he turned up at the hospital's emergency room for treatment of flulike symptoms on June 15.

She said doctors suspected the H1N1 virus, also known as swine flu, but a so-called "rapid" test came back negative.

Though the anti-viral drug Tamiflu is largely effective only when given in the first 48 hours after an individual shows symptoms, Vos said doctors working on Talley quickly gave him the drug in hopes it could still help fight off the virus.

"We had all the specialists available immediately working on the case," she said. "He was seriously ill."

Nothing, Vos said, stopped Talley's feverish body from shutting down.

"He was critically ill almost from the first day," said Vos, who noted that the hospital followed the isolation protocols recommended by the Centers for Disease Control and Prevention in treating Talley. "He was supported by equipment for breathing."

Talley's family, who held a memorial service for him Tuesday at Palm Mortuary-Summerlin, was unavailable for comment. Physicians said that Talley had no underlying medical conditions prior to contracting H1N1.

It wasn't until a couple of days before Talley died that doctors found through a sophisticated Polymerase Chain Reaction test that what they first suspected was correct: He had the H1N1 virus.

The state's chief health officer, Dr. Mary Guinan, told the Review-Journal on Monday that she wants physicians to immediately give the more sophisticated test to patients hospitalized with flulike symptoms. Too often medical officials have found, she said, that "rapid tests" register a false negative.

The diagnosis of H1N1 could be critical, given that the best treatment, Tamiflu or Relenza, is most effective in the first 48 hours after symptoms are seen.

Officials with the Southern Nevada Health District reported Tuesday that two of the hospitalized patients with H1N1 are in serious condition and the other is "improving."

An emergency room physician who contacted the Review-Journal on Tuesday said he believes the health district, which for several weeks has followed the CDC recommendations by tracking only H1N1 cases requiring hospitalization, is doing the public a disservice by issuing a number of "confirmed cases" that make it appear that the Las Vegas Valley isn't hard hit by the virus.

District health officials on Monday said Clark County has 80 confirmed cases, which the district's chief health officer called "the tip of the iceberg."

"You can bet the 80 number is really the tip of the iceberg," said the emergency room physician, who asked for anonymity because he worried that his hospital might see his comments as negative and take a job action against him. "We passed 80 way back in March. That number is now meaningless. I don't get swine flu cases on every shift, but almost."

Most, he said, aren't sick enough to require hospitalization.

The physician said every patient he sees who tests positive for a strain of influenza A receives Tamiflu, regardless of the outcome of another test H1N1.

"I'm treating all my patients who have flulike symptoms like they have the swine flu," he said.

The physician said he understands the CDC's reasoning in concentrating only on hospitalized cases. District officials have said it is established that the virus is everywhere in the county and precautions must be taken.

"Yes, the swine flu is really here," the physician said. "That's been established. And we have to act like it is. But it's not helping people take it serious when we make it sound like we have just a few cases here."

As of Friday, state officials said the rest of Nevada had 160 cases and Clark County 80.

The CDC now estimates that more than 1 million people in the United States have been infected with the H1N1 strain.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

 

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