The World Health Organization made it official on June 11, 2009: The H1N1 influenza (swine flu) was declared a pandemic. The virus has rapidly established itself and is now the dominant influenza strain affecting a high proportion of the population in most parts of the world, including the United States.
From April 2009, when the first US patient was confirmed to have H1N1, through July 2009, the Center for Disease Control and Prevention (CDC) estimates more than one million US citizens became ill with the flu, and 99 percent of the viruses identified were H1N1. Countries in the northern hemisphere are advised to prepare for a comeback of the respiratory illness this fall and winter.
It is uncertain as to the number of cases of H1N1 that may afflict Ohio this flu season, but Cindy Modie, preventative health supervisor of vaccine services at the Cuyahoga County Board of Health (CCBH), says: “It’s likely patients will be flooding local emergency rooms. H1N1 is virulent and spreads quickly.” She encourages everyone to pay attention to the recommended preventative measures prescribed by CCBH nursing director Donna Fligiel:
1) wash hands with soap and water or alcohol-based hand rub
2) cover nose and mouth with tissue when you cough or sneeze
3) stay home from school or work if ill at least 24 hours after fever subsides.
“Seasonable flu and H1N1 are vaccine preventable,” Fliegiel says, “but this goes hand in hand with following these basic rules.”
Dr. Susan Rehm, vice chair of the department of infectious disease at Cleveland Clinic and medical director for the National Foundation for Infectious Diseases, says H1N1 symptoms are similar to seasonal flu including onset of headache, muscle ache and fever. Patients may also report cough, sore throat, runny or stuffy nose, chills, fatigue, nausea, vomiting and/or diarrhea. Seasonal flu and H1N1 may be closely related, but the CDC states that H1N1 has been affecting children and young adults more than those 64 and older, as typically seen in seasonal flu.
You are contagious one day before symptoms appear, and approximately one week thereafter. Antiviral medications are available, notes Rehm, but contact your physician before using. “We are discouraging stockpiling these medications in anticipation of possible influenza.” If you have the flu, get plenty of rest, drink fluids and take fever-reducing medication. “If, however, you develop breathing difficulty, changes in consciousness or confusion, blue discoloration of the fingers and toes, seek medical attention immediately,” warns Rehm.
On September 15, the Food and Drug Administration (FDA) approved the H1N1 vaccine and it’s currently available in northeast Ohio. According to FDA, clinical studies for the H1N1 vaccines performed over the last several months induced a robust immune response in most healthy adults eight to 10 days after a single dose. It’s important to note that the H1N1 vaccine does not protect against seasonal flu.
Vaccines will be allocated to states based on population size. Target groups at highest risk will be eligible to receive vaccines first. Those include pregnant women, caregivers for children younger than six months, healthcare and emergency medical personnel, anyone between six months and 24 years, and those between 25 and 64 with a medical condition that increases risk of complications.
H1N1 vaccines come in two forms: injection (inactivated) and intranasal spray (live, weakened), though only healthy, non-pregnant people between 2 and 49 are eligible to receive the nasal spray. Rehm says it appears only one shot or one nasal application is necessary for adults, and for those under 10, two may be necessary. “Contraindications to the vaccine are very few,” she adds, “and those include people with allergies to egg or egg products, or with a history of Guillain-Barré syndrome.”
Be prepared for whatever the flu season brings to this region and follow Rehm’s advice: “Plan and educate yourself on H1N1.” For more information on the H1N1 virus or vaccine, contact your physician, or visit www.cdc.gov/h1n1flu or www.flu.gov.
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