How, Gulp!, You Get Sick
During the Swine Flu Season, Think Before You Share a Drink With Someone

By Brigid Schulte
Washington Post Staff Writer
Saturday, September 5, 2009

On a Saturday in mid-August, my friend Molly and I were on our way back home to Alexandria after picking up our sons, Liam and Colby, from their weeklong summer camp on Virginia's Eastern Shore. The boys were tanned, not nearly as dirty as I thought they'd be, and waiting for us on the front porch of Cottage 16 in no hurry to go home. They burbled excitedly at first about badges won, banana boat rides and being named the "honor cottage" of the week.

Then for the next few hours, even after a quick lunch, all we heard were complaints of starvation from the back seat. Just before the Bay Bridge, I'd heard enough. I pulled off, found a restaurant and the four of us grabbed a table. The day was sweltering. Breezeless. I caved and let Liam, my 10-year-old, order a sticky sweet Mountain Dew, but it hadn't come yet.

"Mom, can I have a sip of your water?"

"Sure," I said.

My son looked perfectly healthy. Like everyone else, I'd read the reports of the coming school year and the specter of suffering children and as many as 90,000 people dead by spring. Still, I didn't think twice. I should have.

Back in the car on Route 50, Molly's cellphone rang. It was another mother who had picked up her camper that morning. Had we seen the pink flier in the packet of information the camp gave us about signing up for next year? Molly dug around the junk at her feet on the passenger side of the car and unearthed it.

Several campers had been sent home with "flu-like symptoms," the flier said. And their parents later called the camp to confirm they'd had the flu.

Swine flu.

Molly immediately called the camp on her cellphone as I drove. Her husband has virtually no immune system, the result of chemotherapy for cancer, so bringing a sick child home was potentially life-threatening. She had to find out whether 11-year-old Colby had had any direct contact with anyone who'd become sick.

"He was in Cottage 16," she said into the phone. She waited. Nodded.

"I see."

Their counselor, the one who slept in the bunk under Liam's, had been stricken and quarantined in an isolated cottage once his fever and symptoms appeared. So the boys had been exposed. But would they get sick?

Molly had been through this drill earlier in the summer. When her 15-year-old daughter's camp closed because of swine flu, her doctor recommended that her daughter, Lauren, stay with friends for seven days, the incubation period for any flu exposure to blossom into illness. But Lauren never became ill.

"Colby can stay with us," I said as soon as she'd hung up the phone.

* * *

I wasn't worried. I figured we were just being cautious. I'd read the stories of this "novel H1N1" pandemic planning all spring and summer. And I had heard that health officials were warning people against throwing swine flu parties to expose themselves to this milder form of virus to become immune in case it mutated and became more virulent. And, being a writer, of course I'd been trying to find someone crazy enough to actually do that. But other than that, I didn't think much about it.

Perhaps I was being fatalistic. But it's a little like the panicked news that an asteroid may one day hit Earth. You'll deal with it if and when the moment comes. And there's nothing you can do to stop it anyway. In the meantime, there's piles of laundry to fold, mountains of school supplies to buy, bills to pay . . .

The next day, Sunday, both boys were listless and wanted to just lie around. We figured they were just tired after a week's worth of camp activities and forced them to go to the pool with us. On Monday, they were still dragging. Molly and I figured they were being lazy and decided to sign them up for a white-water rafting camp the next day.

I'd been working at home that day and not paying much attention to them. By the time I checked on them in the evening, they were sprawled on the beds in my son's room. Crumpled tissues littered the floor like snotty flowers. Both boys were hot, their teeth were chattering and they were coughing. My son, who has asthma, sounded like he had gravel in his lungs. Colby sounded worse. I threw them each into a hot, steamy shower and gave them Motrin. They put themselves to bed.

At 7 p.m.

The next morning, my 8-year-old daughter, Tessa, had a fever and sore throat. I kept her home from school and canceled the boys' camp. But I still wasn't worried. My kids had had the flu before. I left them all in their pajamas with a babysitter and headed to work.

I felt fine in the morning. And if I was lightheaded around noon, I thought it was because I hadn't eaten lunch yet. Then, at an afternoon meeting, I began to notice a rattling cough that started deep in my lungs. By the time I left work, my cheeks right under my eyes were sweaty and my head felt fogged in.

That night, with three coughing kids and a forest of wadded up tissues around the floor of the house, I put peppermint oil on three cool washcloths and laid them on three hot little foreheads. Their temps were running about 100.7.

The next morning, I called the pediatrician. She assured me they weren't treating this flu any differently than any other and told me to keep the kids home, to make sure they rested, drank fluids and stayed away from other people until their fevers had been gone for 24 hours. Let them cough, she said, to clear the mucous from their chests. And call back if they got worse. With the stakes so much higher in their home, Molly had her visiting sister and mother take Colby to the doctor. He tested positive for 2009 H1N1.

She brought him back to my house.

* * *

I felt like a pariah as I hobbled down the front steps to the car to retrieve Colby, wearing the same pair of sweatpants I was to wear for days. I was coughing so much my stomach muscles ached. My muscles ached. Even my eyes hurt.

That night, I logged on to the CDC swine flu Web site and browsed the Web to figure out what was going on.

That's when I started to worry. This 2009 H1N1 A flu, which first appeared in Mexico in the spring, has now hit 177 countries. More than 550 people have died in the United States. And unlike in seasonal flu outbreaks, where 90 percent of the 36,000-some people who die every year are elderly, the ones dying or on respirators are children.

Health officials are thinking that people who were alive in the 1950s must have been exposed to a similar virus and developed antibodies that are helping them fight off this new flu virus. That might explain why my husband, Tom, never got sick. (His constant barking "Stay away from me!" probably helped.) But children and young adults have no antibodies. That's why they're so susceptible to getting sick. Also, flu studies over the last 50 years have found that women have higher rates of contracting the flu than men, even in the same household, says Carolyn Bridges, associate director for science in the influenza division at CDC.

"The supposition is that women tend to be more the primary caregivers," she said. "Everyone wants Mom when they're sick."

And, like any flu, this one is highly contagious.

The flu virus spreads through "respiratory secretions." Someone coughs, sneezes, blows their nose, talks even, and big, infected drops, "usually greater than 10 microns," spray out around them. A small number of people "excrete" the virus in even smaller particles. These tiny, unseen drops of nuclei have the potential to float around in the air longer and be inhaled far deeper into the lungs, causing an even more virulent infection. "They can hang around in the air" for hours, Richard Wenzel, chairman of the Department of Internal Medicine at Virginia Commonwealth University, told me later.

Hours.

Floating malignantly about like dust. Lurking on boogery doorknobs, telephone receivers or light switches. Wenzel went to Mexico to study the disease not long ago. They found the virus on doctors' hands in the hospital. On bedside tables next to patients. On computer keyboards and mice.

I thought of Liam sipping my water at the Crab Deck.

How many micron-size drops of infected saliva had back-washed into my glass?

* * *

The next few days passed, like any flu, in a cranky, phlegmy haze. Crabby kids lay around, read, stared at the ceiling. They hung out in the basement, playing computer games, littering the floor with sticky, used tissues. I began to realize how being stuck indoors can feed homicidal or consumerist tendencies. "Take that, sucka!" Liam or Colby's yell would invariably float up the stairs as they blasted some animated Nazi or Evil Empire Stormtrooper to bits. Tessa spent hours buying and selling fountains, patio furniture and decorating and redecorating the virtual rooms of her virtual pets on Webkinz, wheedling me to buy her a deluxe membership for only $49.95.

One afternoon, I tried to rush up the stairs with some hot mint tea to answer the phone. I was so weak, I tripped. The tea went sailing through the air. I slammed down hard on the wood floor, somehow landing on my back in a puddle of scalding liquid. The tea soaked through my hair and the back of my shirt. The phone had long stopped ringing.

And I just lay there. It seemed like a good idea at the time. The tea felt warm against my skin. And the thought of hauling myself upright was exhausting.

Two weeks later, Liam, Colby and Tessa are fine and no longer contagious. Colby, happily, is home. Molly never got sick. Yet I still have what my doctor calls acute bronchitis and am sucking on so many Ricola cough drops that I worry my teeth will rot.

I now am a reformed swine flu believer. There's a reason why Virginia Gov. Timothy M. Kaine had a photo op washing his hands at a school earlier this week in anticipation of the new school year and the germ factories that they are likely to become. And why health officials want people to blog, tweet and Facebook about their symptoms to better track the flu.

Although I was too spaced out to read the newspaper at the time, much less have the energy to panic about it, I'm now aware that the President's Council of Advisors on Science and Technology has released an alarming report warning that the coming school year could be worse than the camp outbreaks of the summer. Much worse, with potentially close to half the population of the country infected, nearly 2 million people hospitalized and 90,000 dead, 2 1/2 times the number killed by the seasonal flu every year. And they will most likely be children, although many will be adults -- some of them mothers of thirsty children begging to share a glass of water.

For more information, go to http://www.cdc.gov/H1N1FLU.

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