The national panic about the emergence of swine flu in the UK may well have long since abated, but even the existence of the illness continues to cause significant health problems. With well over a 1,000 suspected diagnosis of swine flu a week, and thankfully very few deaths occurring as a direct result of the H1N1 virus, the related problem of wrongful diagnosis with swine flu has been attracting more frequent media attention in recent months.

The problem with swine flu, as with most other forms of influenza, is that the symptoms are wide ranging and generally non-specific. Whilst a fever is usually present, the NHS website also lists a number of other symptoms that may be present in an individual suffering from swine flu. These include fatigue, headache, runny nose, shortness of breath or cough, diarrhoea and vomiting, sore throat, loss of appetite and aching muscles.  The trouble is that many of these symptoms are present, particularly in the early stages, in a number of potentially much more serious illnesses. Staff at the National Pandemic Flu Services, who manned the much publicised hotline service, had no real medical training and were simply asked to identify whether or not these symptoms were present and to prescribe Tamiflu if required. Government policy to try and limit the spread of the virus is to discourage patients with swine flu from attending their GP practice or hospital. This unfortunately means that the vast majority of patients with these symptoms do not receive a trained medical examination and simply receive a telephone diagnosis.

There have been reports of individuals who have been misdiagnosed as suffering from swine flu, and have subsequently become seriously ill or even died, of a number of much more serious illness over the past year. Illnesses which have resulted in death include tonsillitis, meningitis and pneumonia. In the last two weeks there have been at least two coroner's inquests held into the deaths of people who had mistakenly been diagnosed with swine flu and discouraged from seeking proper medical attention. One was into the death of a mother of two, who died of Legionnaire's disease, and another into the death of a young boy who was found to have died from a rare form of diabetes. All these cases are of course very tragic for the families and friends involved, as well as for the NHS staff concerned, and highlight the importance of ensuring that the correct diagnosis is made in a timely fashion.   

Although the National Pandemic Flu hotline has now closed down, patients who have flu-like symptoms still often find themselves being diagnosed with swine flu following a simple telephone encounter. Whilst in the majority of cases this will either be correct or certainly not result in additional harm, GP practices and medical helpline staff, such as NHS Direct, do need to be very alert to the fact that these symptoms could be indicative of a much more serious underlying cause. Individuals who genuinely feel very unwell, particularly if their symptoms are worsening, should not be put off from insisting upon personal medical attention, and if they are experiencing real difficulties, should seek help from their local A&E department.            
   
Kym Provan

Senior Solicitor