Dear Doctor Column, September 7, 2009

Question:

How many people have H1N1 flu? What is this flu and how is it different from seasonal flu? Will a flu shot keep me from catching it?

Answer:

During the week of August 16 to 22, 2009, the Centers for Disease Control (CDC) reported that influenza activity in the United States is either stable or is increasing in some areas. The total number of hospitalized cases during this week was 8,843. The Southeast is one area where the virus is spreading. Alabama reported 1,587 confirmed cases. For more details regarding influenza in Alabama, visit the Influenza Activity Web page.

Experts originally called this virus “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. According to the CDC, further study has shown H1N1 is different from the flu viruses that normally circulate in North American pigs. To avoid confusion the World Health Organization officially dropped the name “swine flu” and is calling this virus by its scientific name, influenza A H1N1. Most media sources simply refer to it as “H1N1.”

The current influenza A H1N1 virus spreads easily from person to person and in the same way seasonal flu spreads: through the coughs or sneezes of infected people and sometimes by touching something with flu viruses on it and then touching your nose or mouth (flu viruses can live on surfaces for up to 2 days).

People are contagious from 1 day before symptoms develop to as long as 7 or more days after becoming sick. Symptoms of H1N1 are similar to symptoms of seasonal flu: fever, cough, sore throat, body aches, headache, chills, and fatigue. Some people may have diarrhea and vomiting.

The seasonal flu vaccine now available does not offer any protection against H1N1; however, the CDC recommends you get the seasonal flu vaccine as soon as possible, because the usual seasonal influenza viruses are still expected to cause illness this fall and winter.

A 2009 H1N1 vaccine is expected to be available sometime this fall. More specific dates cannot be provided because vaccine availability depends on the time required to manufacture and test the drug in clinical trials, a process underway now.

Vaccine delivery will vary from state to state, but it will be available in settings such as health department clinics, health care provider offices, pharmacies, workplaces, and other public locations.

Experts believe supplies of the vaccine will be adequate, but they recommend (and may require) that certain groups receive the vaccine first. The may include health care workers, emergency service personnel, pregnant women, people who live with or care for young children (younger than 6 months), children between 6 months and 4 years, and children who are between 5 and 18 years and have chronic medical conditions.

The good news is that the virus is susceptible to the prescription antiviral drugs Tamiflu and Relenza, and adequate supplies of these drugs are available. When taken within 48 hours of symptom onset, antiviral medicines make your illness milder and help you feel better faster. In response to the H1N1 outbreak, the FDA is allowing children younger than 1 year to take Tamiflu. Relenza is not approved for children.

For up-to-date information about the spread of H1N1 in your area, contact your state department of health. In Alabama, the Web site is here. For up-to-date US data, visit the CDC Web site, and for updates on the international impact of H1N1 visit the World Health Organization site.

To protect yourself from getting sick, take these steps:

• Wash your hands often with soap and warm water. Wash hands for 15 to 20 seconds. Alcohol-based hand cleaners also are effective.
• Avoid touching your eyes, nose, or mouth.
• Avoid close contact with sick people.
• Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue in the trash after you use it.

If you or someone in your family has flu symptoms, stay home. Drink lots of liquids and take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for fever. See your doctor if you are concerned. Children younger than 2 years should see a doctor, and children older than 2 years should see a doctor if their fever is more than about 101 degrees, if they are lethargic, of if they have other medical conditions such as asthma or diabetes.

If you or your child experiences any of the following warning signs, seek emergency medical care:

• Trouble breathing
• Bluish skin color
• Dehydration (dry mouth, crying without tears, no urine output in 4 to 6 hours, sunken eyes)
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash
• Pain or pressure in chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

To read more about this topic visit the CDC’s Web site.