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Monday, September 21, 2009
~~PART ONE~~~~~~~by SmokinOnion
Before we get started I’d like to cover some definitions, both generally accepted ones, and my own. I also want to state that I live on my BOL and have I have no intention of bugging out unless I have been burned out and a “Custer stand” isn’t on my list of things to experience.
Also, this review will come in segments, initial impressions, modifications, what it holds, final configuration and impressions, and finally a detailed explanation of the gear vest, contents and how the concept is working out for me, so if the concept interests you check back for updates from time to time.
There are several definitions for bug out bags; they are commonly referred to as follows:
INCH Bag = “I’m Never Coming Home” Bag, this is the actual basis for some peoples BOB’s.
BOB = Bug Out Bag, most commonly discussed option, traditionally a 72 hour bag, not INCH.
G.O.O.D Bag = Get Out OF Dodge Bag, original disaster bag, get out fast, keep going if you have to.
G.H.B. = Get Home Bag, original I’m at work SHTF get back home bag.
Those are the traditional definitions that I am familiar with.
This Edition of an Onion bag is a bit of a hybrid. This is the bag that is always in the truck on road trips and trips to the office for that matter. It can serve as a BOB if you like but to me and my definitions it isn’t quite big enough for a full on BOB, but is too big to be considered the typical GHB designed for the office. I can press this into a 72+ hour bag but that isn’t as dependent on the gear and is more skill related. Proper training, with skill added to a good plan trumps gear every time, so if you are going light or taking a minimalistic approach; the training and skill become paramount.
In building this one I wanted the maximum amount of flexibility in load out options while not having to carry a super large bag. I wanted to be able to modify it to my mission at hand, be it a trip to the local office, a 3 to 5 day road trip or a 3 day patrol. I wanted modular compartmentalized packing capability as well, so I could remove pieces of it and leave them on my gear rack; add them back when a task was going to call for them. I prefer a modular packing system as described, I like having seasonal capability without repacking the main, so I have set out seasonal additions, (Spring/Fall) summer, and winter. Spring and fall where I live are very similar in nature so these remain the same. Winter is a bear here and often this bag will get replaced by a larger full BOB version.
I also wanted to combine some common carry concepts, those being 1st, 2nd, and 3rd line gear. I’m going to use a vest for common carry items that are needed in any SHTF scenario, the gear vest will be packed in the bag. When needed I can pull out the gear vest from the pack, put it on and then slap the pack on. In this way, if I do become separated from the pack I still have my key 2nd line gear to keep me going, but have it in a non-threatening non-combat looking set up.
In beginning this project I had three packs in mind, a Kifaru Pointman, a Maxpedition Vulture II, and a Blackhawk Cyclone pack.
Of the three the Kifaru is the largest at 3,000ci, the Vulture comes in at 2900ci, vs the Cyclone at 1900ci; while the Kifaru is superior quality of the three and the attachment points and expandability matched what I was looking for, however, the $400 price tag, the fact that is larger than I wanted, (it qualifies as a full BOB to me), along with the fact that it is top and bottom loading took it out of the selection process early on. The Maxpedition is high quality and the size is right but the overall layout along with the limited modular addition capability took it off the table.
I prefer a smaller profile pack, slim and close to the back rather than deeper with more load further from the back. I like to keep things tight and close to the torso, I’ve got a wide set of shoulders, 30” across the back, so width I don’t mind as much as bulk going backwards. In the end I went with the Cyclone and what follows will explain why, and also I hope, provide some ideas to anyone else looking for additional ideas for their own operational needs regarding the get out of dodge bag.
1. Includes 100oz. BLACKHAWK Hydration System
2. Drink system protected by Microban antimicrobial technology
3. Market proven bite valve and patent pending quick disconnect system
4. Twin compartments for extra storage
5. Large compartment has internal pouch for radio packs and 3 antenna ports with flaps
6. Over 100 external S.T.R.I.K.E. webbing attachment points
7. Anodized D-rings and quick cinch buckles for compatibility with 3-Day accessory pouches
8. Reinforced waist belt with additional attachment points
9. Contoured, padded shoulder straps and sternum strap for comfort
10. Rubber drag handle
This is the pack I started with:
Extremely well stitched and solid. The back panel offered some excellent channels to keep a nice flow of cool air circulating across the back. The waist belt is not meant to be load bearing but rather to assist in stabilizing the pack and load, key for when you need to move fast but want your pack to hug you during the process. The flap covers an exit port for the secondary water bladder or a radio, there are 3 of these across the top of the pack, for antenna ports and additional water bladders.
The gear vest remains packed in the main compartment of the bag. When it’s go time, it’ll be worn allowing me to carry the necessities on my person in case of separation from the pack. The vest has a total of 16 pockets including a larger pocket on the back and 2 inside the vest pockets as well as four front cargo, three front zip-closed pockets and several other smaller pockets. On the inside right there is a diagram showing the front and some of the uses for the pockets.
The vest is a simple Safari vest from Cabelas:
I do want to point out that LAPG has a pack than many Survival Board members have bought, the configuration of that pack, externally is somewhat similar to the Cyclone. It is quite robust, I bring it up here because the concept of what I am trying to do, could be applied to that pack at a MUCH reduced cost compared to the Cyclone. That pack is $29.99, a compadre of mine has that pack and has been using it now for about 8 months. His is rigged much like mine with some minor differences. So far he claims mine is more comfortable to hump after four or fine miles. The shoulder straps are wider, firmer and helped to stabilize the pack better.
So while the cyclone looks large, it's not as big as it looks. It is adjustable for body frame size in a couple ways.
For me, I chose this size based on what I knew I needed to carry, not what I might need to carry. I think too many people do not take into consideration the minimum load-out for their specific needs. My guidelines were:
5 day road trip, either via flight or by vehicle I wanted to be able to take one bag for 5 days. In this case I don't need to pack much in the way of food/water but have access ability to acquire it.
3 day patrol, in this case I have to carry food and water for three days in addition to shelter, food prep, field first aid, clothing appropriate for climate/terrain.
If you make a list of everything you need, from your perspective, to accommodate necessities for 3 days afoot in the field with no resupply or access to additional gear/food and also to accommodate 5 days with access or limited access to additional food/gear it make packs selection a little easier.
Take the items on your list and work out a visualization of the space required for those items, AND, most important to me, how you will carry that load-out. Access, organized, compartmentalized. Everything has a place and everything is in its place is where the organization starts and it ends with streamlined gear loads, lighter weight, easier access in a more organized manner. Helps with efficient use of space I guess.
1900ci packs are not as big as one thinks. My full INCH bag is 7,000ci for comparison and my full BOB is 5000ci. For me, to get what I wanted in a get out of dodge fast bag, I needed 1900ci, anything bigger and I get slowed down too much, anything smaller and I have to start deciding what to leave behind or toss out.
For comparison, here's another bag that is 1900ci - the Osprey Circuit Daypack:
Coming in Part Two - what's in the bag?
Saturday, September 19, 2009
Do you make a list and head into it, trying to get everything accomplished as quickly as possible?
Do you pick an area where you feel you are weakest and try to get it up to speed?
Do you pick an area that is your favorite and charge ahead?
Do you have areas that you don't really know much about, so you put them on the back burner?
There is a tendency for most people to pick areas they know and love to work on, because it is comfortable. If you love to collect guns and ammo, for example, it definitely isn't hard for you to concentrate on this area. If you love to cook and can, as I do, then food preps are always on my list of "we can never have enough".
But it pays to take a little time to do an overall assessment of what you have, where you are, where you are headed and where you'd like to end up. For many preppers, prepping is something that is never quite "done", it is an ongoing process.
I think that is how it is for us. We know our major areas of concentration: food, light, heat, shelter, first aid, sanitation, backup power, communications, etc... We have our lists of what we have now, what we need immediately, what we need in the next 3-6 months, what we need long-term (when the budget allows) and what is on our "dream" list. Then we try to keep adding to our lists - usually we try to do something to add to our preparedness activities at least weekly.
We are always on the lookout for something that is on sale or a good deal, even if it isn't on our immediate list, because it might represent a buying opportunity.
And my husband is constantly reading and trying to learn new ways of doing things or adding to our preparedness "skills" in addition to our prep items. Knowing that with a young family it is not possible to budget for "unlimited" preps, it is important for us to know how to "regenerate" some of the items that might get used up in a time of extended emergency.
So while it is good to have a basic level of preparedness "items", it also pays to constantly try to learn preparedness "skills". For example, you can store water but at some point it might be really prudent to know how to make a rain catchment and filtration system. You can store propane for cooking, but at some point it might be nice to know how to make a wood-fired stove or oven, or how to solar cook.
There is a wealth of information across the internet about many different preparedness skills - so don't forget in your efforts to put up preparedness "items" to take some time to learn preparedness "skills" along the way as well.
NOTE: Stay tuned this weekend for a guest post - Everything you want to know about how to build a great Get Home Bag (GHB). Many of us carry these in our vehicles wherever we go, just in case there is an emergency while we are out; these bags have the essentials we need to get us back home.
Tuesday, September 15, 2009
Link: National Terror Alert.com - Swine Flu Spreads Long After Fever Stops
When the coughing stops is probably a better sign of when a swine flu patient is no longer contagious, experts said after seeing new research that suggests the virus can still spread many days after a fever goes away.
The federal Centers for Disease Control and Prevention has been telling people to stay home from work and school and avoid contact with others until a day after their fever breaks. The new research suggests they may need to be careful for longer _ especially at home where the risk of spreading the germ is highest.
Swine flu also appears to be contagious longer than ordinary seasonal flu, several experts said.
“This study shows you’re not contagious for a day or two. You’re probably contagious for about a week,” said Gaston De Serres, a scientist at the Institute of Public Health in Quebec.
Sunday, September 13, 2009
Physician researchers across the U.S. are noting that about 2/3rds of the pediatric deaths from swine flu so far have had underlying conditions such as asthma, diabetes, epilepsy, MD or other diseases that suppress the immune or respiratory systems.
In 1/3rd of pediatric cases, however, they are unsure why otherwise normal, healthy children have died from this virus.
They do note that these seem to be exacerbated by a bacterial infection:
But they did say that when influenza combines with a bacterial infection, such as pneumonia, the patient often follows a pattern in which his symptoms start to subside but then suddenly worsen. That pattern — which includes symptoms such as vomiting, chest pain, a racing pulse, breathing trouble, bluish skin or trouble staying awake — is an indication that the flu has turned deadly, and it means a sufferer should talk to a doctor immediately.
So don't panic, treat this flu as you would any other, but pay attention for the trend noted in the quote above. We definitely don't want to overwhelm our Emergency Room facilities unnecessarily, but you should take your child immediately if you notice any of the symptoms above.
Wednesday, September 9, 2009
This is a bit long, but for those of you who are interested, I hope it contains information that will help you in your preparedness efforts for Swine Flu.
By now, most people are well aware of the fact that swine flu is still making its way across the country and picking up speed in the Southeast where schools have been in session since early August.
Just last week in TN alone, a 5 year old died in
Most of what is causing deaths is not the swine flu itself, but a viral pneumonia that hits some people along with the swine flu. Some also are getting a bacterial pneumonia that is very antibiotic resistant. And some perfectly healthy people are experiencing what is known as a cytokine storm – their immune system goes to work too well and overwhelms their lungs fighting off the virus - in essence they drown. Research so far is showing that in many of those who have died due to “swine flu”, their lungs look remarkably like those who died from Bird Flu (H5N1). There are avian components to this flu, in addition to swine and human.
Overall, the death rate from this particular strain of H1N1 is very low. In reality, there is little you can do other than the usual good hygiene to try to avoid getting this virus. However, you just never know when you are going to touch a door handle, shopping cart, ATM touch pad, bank ink pen, gas pump handle or something else that has the flu virus on it.
Even if you homeschool and are relatively out of the mainstream, you need to consider all the opportunities for exposure you still have: church, the grocery store, the bank, the post office, the gas station, homeschool events, etc. And if there are children in your neighborhood who attend public or private school and your children play with them, they might as well be in the same classroom with them, because they will be exposed to whatever is in that school.
I’ve been tracking and researching this virus daily since it first appeared this April. I’ve watched what happened in the southern hemisphere – to our neighbors in
Also unique is that over 50% of the people who get the H1N1 flu never have fever. H1N1 flu is a form of Influenza A. At this time of year, approximately 99% of the flu being seen in our country is H1N1, since seasonal flu likes the cold and hasn’t gotten started yet.
Think about this for a minute – if you were pregnant and planning a hospital birth, would you really want to have to go to a hospital inundated with swine flu to give birth? If ambulances are backed up taking sick flu patients to the hospital, what happens to the severe traffic accident on the way to work in the morning? You need to think about the greater impact of the flu than just the sickness. You must think about the overall impact to your way of living, because this flu might cause some minor to major disruptions in the way you are accustomed to doing things.
That said there are several ways we can prudently prepare for the swine flu in our areas this fall and winter.
First, you need to make sure that you have everything you need at your home to care for a family member that might get sick with this flu. Medications, soothing foods and drinks for rehydration, disinfectants, laundry detergent, dishwashing detergent, perhaps gloves for cleaning, N95 face masks to protect those in the family who aren’t sick, separate toothpaste tubes for each family member, separate hand towels for each family member, a working thermometer, a humidifier – anything that comforts you when you are sick – make sure you have it on hand NOW. You don't want to wait until you need it and you certainly don't want to wait for tons of people to get sick and stores to be out of what you need.
Basically, think about what you might need to get through 2-4 weeks of flu making the rounds of your family. If someone gets the flu in your family, the CDC recommends that all other family members who have been exposed plan to stay at home from school and work for at least 5 days to avoid transmitting the virus to others. If you do get the flu, the CDC recommends staying at home for a full 24 hours after your last fever (without fever meds) before going back out into public.
If you like to scratch cook, you might want to consider taking a weekend and making a few foods to put in the freezer that could be pulled out and heated by any family member – things like meatloaf, lasagna, soup, stew and the like. Have easy breakfast items like oatmeal or cereal. Keep some powdered milk on hand. If you run out of fresh milk, believe me you can use powdered milk in oatmeal and cereal and hardly tell the difference.
Mom or Dad, if you are the primary cook, think about what your family can make for themselves if you get sick. Perhaps you want to get some easy to make or heat items that even younger children can make – cans of soup, ravioli, fruit cocktail, peanut butter and jelly or peanut butter and crackers, cheese sandwiches and the like. This is the time to have some easy to make meals on hand.
Having someone sick in the home means you will be doing more laundry. Make sure you have plenty of soap, laundry detergent, dishwashing detergent and/or liquid, hand sanitizer, toothpaste. You’ll want to make sure you have new toothbrushes on hand to give everyone after illness runs through your family. It is a good idea for everyone to have their own tube of toothpaste anyway to keep germs from spreading. Don’t keep all the toothbrushes all together in one place bumping into each other. Keep them separated so germs aren’t being passed from one to the other.
Have plenty of towels and washcloths on hand and ready to go. Cold washcloths on the throat and forehead help with nausea. And for little children, we line their beds and the hallway with towels all the way to the bathroom. Believe me, it is much easier if someone gets sick to pick up a towel and wash it then have to strip the whole bed and remake it.
You can get small buckets or waste cans that children can use by their bed as sick pans if you don’t want them trying to make it down the hall to get sick and spread their germs everywhere.
If your whole family ends up at home for several days, you will want to have things on hand to keep everyone occupied. CDs, DVDs, books, readers, workbooks, coloring books, pencils, crayons, sticker books – we keep several items such of these tucked away so we can pull out something new whenever the need might arise.
Remember that if you aren’t leaving the house, you might need to have some cash at home – you never know when you might need something delivered; perhaps a neighbor or relative is willing to run an errand for you and you’ll need to be able to reimburse them.
Make sure to keep gas in the tanks of your cars. If someone needs to go to the emergency room in the middle of the night, you certainly don’t want to have to stop for gas first. We never let our tanks get below ½ full in case an emergency comes up.
It also pays to think about what might happen if the flu takes a severe turn and there are quarantines in your area. Imagine that your city or county is placed under a 7-14 day quarantine. No going out of your homes for any reason. How prepared are you for something like that to happen?
Even if there are no mandatory quarantines in your area, are you prepared to self-quarantine if necessary to protect your family? What are your parameters? What has to happen to trigger a self-quarantine for your family? It pays to think some of these things through.
If you have questions about the risk factors for flu for any of your family members, be sure to talk to your family doctor. Have a plan. Know what you need to do for those in your family who are in a higher risk group (those with asthma, diabetes or pregnancy). Know ahead of time what your parameters are for going to the doctor or hospital if someone in your family gets sick. Obviously, if we all rush to the doctor at the first sign of a cough and muscle aches or fever, our medical facilities will be over-run.
Know if your doctor will prescribe Tamiflu or Relenza over the phone. Know whether or not you even want to take either of these medications to begin with. Do your research. The FDA has a warning letter about Tamiflu use in pediatrics. You can read it here: Tamiflu Warning Letter. Know that there have been many identified cases of Tamiflu-resistant H1N1. Know that Tamiflu and Relenza are not cures for the flu – they are just supposed to reduce the severity and duration.
Right now it appears that the H1N1 vaccine will not be available until sometime between mid-October and November. It is planned for 2 doses, approximately one month apart. It is estimated that it will then take approximately 2 weeks for immunity after both vaccines. This means late this year for most people - around the end of December or so. You need to be prepared that swine flu might visit you before you are ever able to get in line for a vaccine. Know that even if you get the vaccine, you might still get H1N1 flu – especially if the virus mutates so that it is significantly different from what is contained in the vaccine. Know if the vaccine is even the right choice for you or your family – do your research and be an informed consumer.Remember that it is important that we don’t panic, but that we arm ourselves with knowledge and do the preparations NOW that are necessary to keep our families as safe and healthy as possible.
Monday, September 7, 2009
In the author's own words:
Another excerpt I like - in his story about heading out ahead of Katrina:
Listening to Katrina is a record of my personal experience of hurricane Katrina, and a guide to help you prepare for emergencies and disasters of all kinds. This work is very straightforward and available entirely online. I am not selling anything.
This site has several uses. I have been told that it is enormously entertaining - so if nothing else, it's good for goofing off at work. You can access all of the content of this site through the CONTENTS menu at the left side of any page.
MEDIA & LINKS - Links to other sites and other media that reference this site.
WORKBOOK - The site encourages you to create and maintain a Workbook for your family. As you read the Listening to Katrina sections, you'll be taught how to do this. I don't sell the workbook. You have to build your own, but you can print all the pages for free from that link.
PREPAREDNESS PROJECTS - The site encourages you to make certain preparations, but does not provide much depth on some technical details. The Preparedness Projects pages provide that detail. They are also designed so that you can accomplish each project in your own time frame in small steps.
LISTENING TO KATRINA - This is the main portion of the site. It is the story and the guide. While I use my experience of Katrina as an example, the preparations I talk about aren't just about hurricanes. The preparations I cover are useful for every sort of emergency - from a simple house fire to global thermonuclear war. Every page has a place in the context, and I invite you to read the site page for page in sequence. There are very few pages that are extraneous, and if you skip around you will lose the context and the site will not be very useful to you.
A good measure of the mental condition of your fellow evacuees is litter. The more panic people feel, the less they care about the niceties of society. Litter is a direct correlation with the mental condition of the people. The roadside, rest stops, and refueling stations were quickly full of litter. Not a good sign.This is a very extensive website with TONS of useful information that will make you think and get your preps into gear - you need to check this site out no matter where you might be on your preparedness journey.
Saturday, September 5, 2009
This forum board is FANTASTIC for keeping up with the status of H1N1 in schools in your area. People are doing a fabulous job of keeping the information current; doing what would take one of us hours of internet searching. I highly recommend that you follow this forum if you want to keep tabs on what is going on in schools in your area.
Also, if you zero in to TN on the FluTracker Map, it is interesting to me to note there is a lot of flu in middle and eastern parts of TN being reported, but virtually none in West TN. I for one find this very difficult to believe and wonder why it seems as though there is very little in the West TN area. I would tend to think it is because of lack of reporting and or testing.
Especially given this:
190 Students at One Shelby County School Sick with Flu Symptoms
(Memphis 9/4/2009) - The student population at Shadowlawn Middle School is the latest to feel the effects of the flu.
Twenty percent of the students have been out sick the last few days.
"Today they did have 190 students out. That's out of a population of 880. That's approximately 20%, which is high." says Mike Tebbe, spokesperson for Shelby County Schools.
Shawdowlawn alerted parents by letter, saying many of the absences were due to flu-like symptoms, such as cough, sore throat,, runny or stuffy nose, body aches and fever.
Parents are told if your child is ill or shows any of the above symptoms, keep them home.
"A little nervous because I have two children here. Then I have two in elementary and one in high school, so you know it could spread through all of them, so it's very concerning." says Paula Csap, a Shadowlawn parent.
With the H1N1 threat, parents at Shadowlawn are being urged to take precautions.
"Students do need to stay home if they are ill. If they do have flu like symptoms, they need to seek medical attention for that." says Tebbe.
Parents, whose kids are ok right now, are doing what they can to keep it that way.
"Make sure they wash their hands. Anybody coughing, try not to be so close. If they have to cough, cover their mouth and everything." says Csap.
Shelby County school officials say during the flu season, it's normal to have 140 students miss school.
So 190 out is very high.
Anyone in West TN have first-hand experiences to report? Also, others from around the state are welcome to comment about what you are seeing in your areas.
Backpack Survival - by Duncan Long, 1989
Many of us who are preppers know a person or two who plans to just "bug out" at the first sign of anything bad - let's look at this in more detail and see what it would actually take for someone to survive with just what they could carry on their back.
There's a lot of confusion about what survival means. To some, it's getting through the aftermath of an airplane wreck in a desolate area. It can mean knowing when to avoid walking in radioactive wastes. Or, it can mean knowing how to barter with troops in the aftermath of riots, war, and looting. To others, survival has to do with avoiding danger and knowing how to deal with it when it breaks into your home in the dead of night.
Survival ideas abound and there are as many definitions and strategies as there are survivalists. Some have good ideas for survival and some have unsound tactics. Bad ideas can mean extra work or trouble in everyday life; bad ideas during a survival situation get you killed. On-the-job training doesn't work when you're dealing with poison and gunfights. Or survival.
One of the most dangerous ideas--as far as I'm concerned--is that of "backpack survival."
A "back-pack survivalist" is a survivalist that plans on leaving his home ahead of a disaster and taking to the woods with only what he can carry out with him. He plans to survive through a strategy that is a sort of cross between the Boy-Scout-in-the-woods and Robinson Crusoe. The backpack survivalist plans on outrunning danger with a four-wheel drive or a motorcycle and hopes to travel light with a survival kit of everything he might need to cope with the unexpected. He hasn't cached anything in the area he's headed for because, chances are, he doesn't know where he's headed. Somehow, he hopes to overcome all odds with a minimum of supplies and a maximum of smarts. Certainly it is a noble cause; but it seems like one destined to failure. And that's not survival. . . . .more here
Comments welcome, as always!
Friday, September 4, 2009
FluTrackers H1N1 Interactive Map for Tennessee
(although you can get the tracker for any state in the U.S.)
Notice how the explosion of cases is moving up from the south - where schools started in early August.
And read this link:
Explosion in Student Deaths Link to School Openings from Recombinomics
US Pediatric Deaths Raise Pandemic Concerns from Recombinomics
What are my fellow Tennesseans seeing out there in your communities?
Wednesday, September 2, 2009
Here's the link from Recombinomics, 02 Sep 2009:
Tennessee School Closings Raise Pandemic Concerns
Mounting illnesses have forced the Alcoa City Schools to close through Labor Day.
The 1,800-student system decided Tuesday to extend the holiday for its elementary school, middle school and high school after the absentee rate hit 30 percent. Normally it's around 5 percent.
According to Director of Schools Tom Shamblin, some of the illnesses are confirmed flu cases. Other illnesses included stomach viruses, fevers and upper respiratory infections. Shamblin said middle schoolers were impacted the most, with a nearly 30% absentee rate.
The above comments describe a large pandemic H1N1 outbreak in schools in Alcoa, TN, which is just south of Knoxville (see zoomed map). Although other schools in the area also have high absenteeism rates (see broader view), they have followed the CDC recommendations on keep schools open. These other schools also cite a wide range of symptoms, as noted above. All of these symptoms have been previously reported for swine flu, and it is likely that the vast majority of these students are H1N1 infected. The number of infected students is much high than confirmed cases, due to limited testing of patients who meet the CDC case definition, as well as the high frequency of infections which not not develop a fever (and therefore do not meet the H1N1 case definition).
The absence of fever has been reported previously in Mexico and Chile, but a fever is included in the CDC case definition, so the symptoms listed for hospitalized H1N1 confirmed cases is 93%, leading many to assume the lack of a fever signals the lack of infection. Consequently, a runny nose is frequently diagnoses as allergies, and gastro-intestinal problems are called "stomach flu", and other flu-like symptoms are called "upper respiratory infections" and in some cases an influenza A positive result is interpreted as seasonal or "normal" flu, even though 99% of influenza A positive patients at this time are swine flu because the traditional flu season has not begun.
Thus, the swine flu cases are easily noticed, even though the diagnosis, as seen above, is incorrect. These mis-diagnosis, especially those which attribute symptoms to allergies, lead to more H1N1 infections because students come to school, and remain in school because they have no fever. Moreover, the lack of testing leads to misconceptions about the H1N1 frequency in the area.
This lack of testing has been prevalent for months, so confirmed cases suggest that H1N1 levels in the region are low, and the explosion of cases creates "sticker shock" for returning students and parents. The high level of infections cited above is not limited to Tennessee. H1N1 is widespread throughout the south because the school year began in early August. However, high levels are being reported elsewhere. Almost 30% of students are also absent in Iowa, were there were large outbreaks last spring and around Marshalltown (see map). However, the limited number of swine flu testing kits shipped by the CDC precluded testing of the hundreds of symptomatic patients at the local clinic. Therefore these patients were not confirmed, even though attending physicians were certain that the patients were H1N1 infected.