I have been getting a lot of questions recently about the flu, swine flu, and the flu vaccines, so I thought I would just review some important facts:
1. Influenza is a viral infection that typically occurs in the late fall and winter, although in 2009, we have seen cases of H1N1 (swine) flu occur in the spring and persist through the summer. Symptoms include high fever, body aches, sore throat, headache, dry cough, fatigue, and sometimes nasal congestion, nausea, vomiting, and/or diarrhea. Most people will recover spontaneously in 7-10 days without treatment. Some people get very sick and can even die of this infection. Young children, pregnant women, older people, and others with chronic health problems are at higher risk of a severe influenza infection.
2. Influenza is not “a cold.” People have erroneously used the term “flu” over the years to describe a multitude of other types of viral infections. Symptoms of a “cold” or other viral upper respiratory infection include nasal congestion, runny nose, cough, sore throat, and low grade fever. The fever, headache, fatigue, and body aches that typify the flu can occur to some degree with a cold, but will not be the primary symptoms, and generally not as significant.
3. Influenza spreads when someone with the flu releases droplets with virus in them by coughing, sneezing, etc. Other people get the flu by breathing in these droplets, getting them on their nose or mouth, or touching a contaminated surface and then touching their nose or mouth.
4. A person sick with the flu is contagious from one day before symptoms start to up to seven days after getting sick. Most experts feel that the contagious period is past after 5 days of symptoms and 24 hours with no fever.
5. People can protect themselves and loved ones by doing several things:
1. Get the flu vaccine. Flu vaccine is recommended especially for all children 6 months and older, people over age 50, and anyone with chronic health problems. Even people who are not in one of these high risk groups can protect themselves by getting the flu vaccine. H1N1 (swine) flu vaccines should be available in mid-October. Children and young adults will be the highest priority in getting this vaccine because it appears their immunity to this virus is much less than that of older adults.
2. Clean your hands frequently throughout the day. Washing or using a hand sanitizer, especially after contact with other people and potentially contaminated surfaces, is important.
3. Stay away from people who are sick.
4. Keep hands away from your face. If the virus is on your hands, but doesn’t make contact with your nose or mouth before you clean your hands again, you are unlikely to get sick from the virus.
5. Protect others by covering nose and mouth when coughing, avoiding contact with others when sick, and keeping yourself and children home from work and/or school when having symptoms.
6. The flu vaccine can be administered in two different ways. You can get the shot or a nasal spray. The nasal spray should only be given to people age 2-49 years who do not have any history of lung disease (like asthma or emphysema), and do not have a suppressed immune system (due to medications or a chronic disease such as HIV). Children under age 9 should receive two doses of the vaccine one month apart if they have never had flu vaccine before.
7. H1N1 flu vaccine will be available in mid-October. This will also be available as a shot or nasal spray. Children under age 9 will likely need 2 doses one month apart of this vaccine as well. Seasonal nasal flu vaccine and H1N1 nasal flu vaccine cannot be administered on the same day. They must be dosed at least 2 weeks apart. Any other combination of seasonal flu vaccine and H1N1 vaccine (e.g. a shot of one and nasal spray of another, or shots of both) can be administered at the same time.
8. Medications such as Tamiflu and Relenza can be used to treat the flu, but are generally only effective if started within 48 hours of symptom onset. H1N1 (swine) flu has been sensitive to both medications thus far, but some other influenza strains have developed resistance to Tamiflu. No significant resistance to Relenza has been seen yet. This medication is inhaled and should not be used in children under the age of 7 or anyone with lung disease.
9. Many people ask for Tamiflu to prevent the flu after an exposure to influenza. The CDC currently recommends this only if you fall into a high risk category (young children, elderly, chronically ill, etc.) and have had direct contact with someone during the symptoms of documented flu. The CDC wants to avoid using the medication for prevention in most cases because they fear that resistance will develop quickly if the medications are overused.
Shari S. Phillips, M.D.