Influenza A (H1N1)

In the summer of 2009 a 12-year-old boy with a history of multiply relapsed acute lymphoblastic leukemia now in his fourth remission on an individualized chemotherapy protocol, presented to his local hospital’s emergency room with a two day history of fever to 102.5°C (39.2°C) and upper respiratory symptoms including cough, sore throat, and runny nose. His mother developed similar symptoms approximately one week ago. In addition, he complained of abdominal pain with persistent diarrhea and one episode of emesis. The patient had a history of obstructive lung disease of uncertain etiology for which he used an albuterol inhaler on an “as needed” basis. Since the onset of this acute illness he had been using his inhaler every four hours.