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CASE HISTORY
Eighteen-year-old Aisha was a first-year student at a small private college in New England.In the fall of 2009,the campus implemented management procedures for the expected H1N1 influenza pandemic.Students with flu symptoms were told to "self-isolate" and to report their status on a college webform.By the end of October,there were 50 students reporting per week.
One night,Aisha felt hot,flushed,and unsteady on her feet.Her thermometer showed a temperature of 39°C (102°F).She started coughing,and she felt extremely tired.She managed to find the webform on her computer,although her arm was shaking and made false starts.Finally,she typed her information and confirmed her status report.A college security officer arrived at her room wearing a face mask.The officer gave Aisha a face mask and told her to collect her essential personal items and books;Aisha did the best she could in her fevered state.The officer drove her to a separate residence reserved for suspected H1N1 cases.There Aisha lay in the bed and tried to sleep.In the morning a nurse's aide brought a tray of food and medication including oral oseltamivir (Tamiflu)and inhaled zanamivir (relenza).The tray was left on the floor in the hallway,outside Aisha's isolation room.Aisha had to drag herself out of bed to open the door and get the tray.She was required to stay in the isolation room until two days after her temperature returned to normal.She and most other infected students made a full recovery,although one student was hospitalized with life-threatening complications.
The college security officer who interacted with Aisha when she contracted H1N1 influenza had received a flu shot earlier in the season,before this strain was included in the vaccine.He had also previously been infected with influenza as a child.Why did this officer exercise such precaution (e.g. ,wearing a face mask)in interacting with Aisha? How is the influenza virus able to infect a person with previous immunity?
Pons
A part of the brainstem that links the medulla oblongata and the thalamus, important for sleep and arousal.
Starve Themselves
The act of deliberately depriving oneself of food for extended periods, often associated with eating disorders or fasting practices.
Hypothalamus
A critical brain region involved in regulating physiological processes, including temperature, thirst, hunger, and emotional responses.
Thalamus
A small structure within the brain that acts as a relay station for sensory and motor signals to the cerebral cortex, playing a key role in regulating consciousness and sleep.
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