411 on H1N1!

Here it comes again. Most of this calendar year, we’ve been hearing about this new disease and the “pandemic” resulting from it, the increased burden of sickness and deaths from it, and the efforts to minimize its effects on us, our children and our communities.

The disease is officially called “The Novel H1N1 influenza A of 2009”. The same virus exists in pig and bird populations, but there is not any good evidence that this pandemic started with pigs—or birds. It transmits from person to person, like other virus infections, and very much like the “seasonal” flu, the one we battle every year. The word pandemic has a scary sound to it, like “plague”, but what it simply means is that this virus slips around the world, being documented in large numbers in multiple countries, pretty much like the seasonal flu. It may not even be as dangerous as the seasonal flu, but it’s an added contagious disease, and it can make a lot of people pretty sick. So it has become a public health nuisance; and it has also become a model disease for organized healthcare systems to design and mobilize methods to prevent, and to contain it. So far this year, 97% of influenza A infections have been this type. The usual, seasonal “flu” typically hits in January through March around here.
Media hype can easily distort the true impact of this virus. It is controllable, preventable, usually not dangerous, and even treatable with medicine when necessary and appropriate. The public health agencies have been doing a good to excellent job of rallying the troops of vaccine makers, health care providers, and local health departments to increase awareness about how to minimize this virus’s impact on us.

Some guidelines:
1. Wash your hands frequently.
2. Cough into your sleeve.
3. If you or a family member has a fever, sore throat, headache, body aches, and/or cough-- stay at home. Don’t go to work or school, and don’t travel unless absolutely necessary.
4. If you have a chronic illness and have these symptoms, call your healthcare provider for advice.
5. If you or your child is short of breath, call your healthcare provider.
6. Try to avoid contact with others outside your home.
7. Immunizations:

There are 5 priority groups that are being targeted for vaccine:
1. Pregnant women,
2. Caregivers of babies under 6 months old,
3. Healthcare workers,
4. People 6 months to 24 years old,
5. 25 to 64 year olds with chronic health conditions,

Then there’s the rest of us:
o Everyone else 25 to 64,
o Those 65 and older (probably exposed earlier in life, so not as susceptible).

To complicate matters, there are two different vaccines:
1. A live virus nasal mist, for people 2 years to 49 years old, but not pregnant women or persons with unhealthy immune systems.
2. A killed vaccine (the shot), which anyone can get unless they’re allergic to eggs.

Neither of these vaccines protects against the seasonal flu. The vaccine for seasonal influenza A is available now. The Novel H1N1 vaccine is supposed to become available later this month, through your health care provider, vaccine clinics or the public health department. The two flu shots can be given at the same time, or close together. The nasal mists need to be separated by about 3 weeks.

Once a person comes down with the infection, medicine is usually not helpful. The two medicines that have some effect against the virus are being reserved for high-risk people, those sick enough to be in the hospital, and the very frail. Over-using the medicines (tamiflu and relenza) will inevitably lead to their being ineffective.