The August 2010 issue of the American Journal of Infection published a study that showed that individuals with mild H1N1 infection may go undetected using standard diagnostic criteria. The study concluded that coughing or other respiratory symptoms are more accurate in determining influenza infection than a fever.
At present, the only way the H1N1 infection is determined is by relying on body temperature - the higher the temperature, the higher the chance of H1N1 detection. In this case, the study found that coughing and not fever, is a more reliable indicator of infection and not fever, because nearly half of the individuals with a mild infection may not have a fever.
During a pandemic, standard screening at airports or medical triage units relies on body temperature scanners to detect the presence of a fever, which may not be correct. So individuals with mild infection and no fever probably evaded detection, which is why the study showed that in the early stages of the pandemic in 2009, only 45 percent of those who were hospitalized actually had a fever.
