Fall 2009 Newsletter - Swine Flu
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Well, we’ve made it to fall and the obvious buzz is swine flu or H1N1. People often ask what is different about this strain of flu from regular garden variety flu. The apparent difference is that this strain of flu has persisted during months when the regular strains of flu generally become more quiescent. This may be due to the fact that the flu is so contagious. It appears that this flu can be contagious for up to a week after a person first shows symptoms of flu. In addition, people who have died from the flu have shown the virus deep in their lungs, affecting the alveoli or air sacs of the lungs where oxygen is exchanged for waste gases instead of the larger airways (bronchi and bronchioles) as seen in seasonal flu. People who die from swine flu also have a higher rate of infection with parainfluenza virus as well as bacteria such as Streptococcus pneumonia, the causative agent of the most common form of bacterial pneumonia.
What should you do to minimize your risk of getting swine flu? The US Center for Disease Control (CDC) has excellent information which can be found at http://www.cdc.gov/h1n1flu/. Good general disease prevention hygiene includes frequent hand washing and use of hand sanitizers such as Purel. I often recommend to patients that when attending social gatherings, before visiting the buffet line, visit the rest room to wash your hands or use hand sanitizer. Having both hands occupied with food or drink is a good way to avoid appearing impolite when people approach you and want a good handshake. A handshake may be a polite gesture at social gatherings, but it is also an excellent way to spread colds, flu, and numerous other types of infection.
Seasonal flu vaccines are available NOW and I would recommend getting yours NOW. Many people wonder if they should get their flu vaccine if they are ill. Theoretically any vaccine may not be as effective if given during a current illness because it is felt that the body will not be able to mount a good immune response to the vaccine while fighting off infection. It is sometimes a judgment call as to whether a patient should receive a vaccine when they are ill, but in the case of flu vaccine I generally err on the side of giving it if there is any doubt. The seasonal flu vaccine will NOT protect you against swine flu, but in the greatest majority of cases (70% or better) it will help prevent or lessen the severity of seasonal flu. Swine flu vaccine is not yet available, but the good news is that it appears to be on the way soon and it appears to be effective in only one dose. Following are excerpts from the Advisory Committee for Immunization Practices (ACIP) guidelines for swine flu vaccination:
Advisory Committee for Immunization Practices (ACIP) recommendations for the new 2009 H1N1 influenza virus.
ACIP advises the Centers for Disease Control and Prevention on vaccine issues. In July, 2009 the committee made recommendations on the use of vaccine for the control and prevention of 2009 H1N1 influenza. The committee considered several factors, including current disease patterns; who is most at-risk for severe illness, hospitalization or death; how much vaccine is expected to be available; and when the vaccine is expected to be available.
The committee recommended that vaccination efforts focus on five key populations. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with 2009 H1N1, and those who could infect young infants who cannot be vaccinated themselves. The ACIP has recommended that when vaccine becomes available, immunization programs and providers should focus first on vaccinating as many people as possible in the following five groups:
- pregnant women,
- people who live with or provide care for children younger than 6 months of age,
- health care and emergency medical services personnel,
- people between six months through 24 years of age, and
- people from the ages of 25 through 64 who are at higher risk because of chronic health disorders such as asthma, diabetes, or a weakened immune system.
These groups total approximately 159 million people in the United States.
Once the demand for vaccine for these groups has been met, the next group to be vaccinated includes everyone from the ages of 25 through 64 years. Unlike seasonal flu, people 65 or older appear to be less at risk of infection with the 2009 H1N1 virus than younger people. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.
In addition to vaccination, there are other actions everyone should take to help prevent the spread of flu. This includes coverings coughs and sneezes with a tissue; washing hands often with soap and water, especially after coughing or sneezing; and staying home when sick with flu-like symptoms except to seek medical care. People who become severely ill or have a medical condition that places them at high risk for flu-related complications and develop flu-like symptoms, including fever or chills and cough or sore throat, should consult with a healthcare provider. They might need to be treated with influenza antiviral medicines. High risk medical conditions include asthma, diabetes, or heart and lung disease.
I trust that you have found the above recommendations helpful and that you will have a safe and healthy fall.
Eldon S Beard, MD
