What you should know about the H1N1 flu virus

By MISTI CRANE

Any medicines containing aspirin should not be given to children or teenagers.

A new strain of flu called H1N1 has gained momentum in the past month and is circulating throughout the U.S.

Since it first appeared in the United States this year, the virus has generally caused mild illness, but in some cases has been deadly.

Health officials have adjusted recommendations and advice as they’ve learned more about the virus, and now are scrambling to get vaccine to the masses, in particular those most at risk.

And they’re enlisting your help.

“Clean your hands, cough in your sleeve, stay home if you’re sick. If you do not have a thermometer at home, buy one so if/when you call your doctor, you can tell them your symptoms. This will help them to help you faster,” said Dr. Julie E. Mangino, medical director of clinical epidemiology at Ohio State University Medical Center.

What you should know:

Q. How does H1N1 differ from ordinary flu?

A. This is a new strain of flu, unrecognized by most of our immune systems, which makes us more vulnerable to infection. So far, symptoms have not been particularly severe, nor has the strain been especially deadly. It was initially called swine flu because many genes in the virus were similar to those found in viruses that normally occur in pigs. There is no risk of infection from eating pork.

Q. How do I avoid getting sick?

A. Once H1N1 vaccine arrives, get vaccinated when public-health experts advise.

Flu spreads from person to person through coughing or sneezing. Sometimes people become infected by touching something that is contaminated. You can help reduce the risk of infection by washing your hands frequently, avoiding touching your eyes, nose and mouth and avoiding close contact with sick people.

Q. How do I know I have the flu?

A. You might have the flu if you have some or all of these symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue. Not everyone with flu will have a fever.

Q. How do people die from the flu?

A. Deaths from flu mostly occur because of lung failure (oxygen levels dip too low or carbon dioxide levels go too high) or because the flu leads to pneumonia. Complications are far more likely in people with compromised immune systems or other health problems. Seasonal flu kills about 36,000 people every year.

Q. How do I tell the difference between flu and a cold?

A. It can be difficult to tell based on symptoms alone. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness and dry cough are more common and intense. People with colds are more likely to have a runny or stuffy nose and less likely to have a fever.

Q. What should I do if I am sick?

A. Stay home and avoid contact with other people, except to get medical care.

Most people will have mild illness and don’t need to see a doctor, but some people might develop more severe illness.

Anyone concerned about their illness should consult a health-care provider, but those with the following conditions are at particular risk: cancer, blood disorders, chronic lung disease, diabetes, heart disease, kidney disorders, liver disorders, neurological disorders and weakened immune systems.

If you must leave home to get medical care, wear a facemask or cover coughs and sneezes with a tissue. Wash your hands often.

Q. What medicine can I take? Are there medicines that are unsafe?

A. The antiviral medications Tamiflu and Relenza can be helpful, but most people do not need to take them to recover from flu. Because of fears there won’t be enough for those who need them most, the CDC is advising doctors to be judicious when prescribing antivirals and to focus on hospitalized patients or those at increased risk of complications.

Some over-the-counter medications can be helpful in lowering fever and alleviating other symptoms, but any products containing aspirin should not be given to children or teenagers, who might develop a serious illness called Reye’s syndrome. Do not give over-the-counter cold medications to children younger than 4 without speaking to a doctor.

Q. How can I take care of sick family members?

A. Check with their health-care provider about antiviral medication. Make sure they get plenty of rest and drink clear fluids, such as water, broth, sports drinks and (for infants) electrolyte beverages. Have them stay in a room separate from common areas of the house and wear a facemask (if available and tolerable) when sharing common spaces with other household members. Be watchful of signs that the illness is getting worse. Don’t allow visitors other than caregivers, and, if possible, have only one adult (who is not pregnant) take care of them.

Q. How do I know if it’s the H1N1 strain or just ordinary flu?

A. You probably won’t. Most of us won’t have laboratory testing done to confirm flu type now that H1N1 is well-established within the U.S. Most of the flu circulating now is believed to be H1N1 because ordinary seasonal strains typically arrive later in the season.

Q. How do I know if I should go to the hospital, or take my child to the hospital?

A. Emergency warning signs in children include fast breathing or trouble breathing; bluish skin color; not drinking enough fluids; not waking up or interacting; a child so irritable that he or she does not want to be held; flulike symptoms improve then return with fever and a worse cough; fever with a rash.

Emergency signs in adults include difficulty breathing or shortness of breath; pain or pressure in the chest or abdomen; sudden dizziness; confusion; severe or persistent vomiting.

You should not go to the emergency department with mild flu illness. Going there might expose you to the virus if you don’t already have it.

Q. When can I go back to work or school?

A. Stay home until your fever is gone for at least 24 hours without the help of medication. People also should stay home until they can contain coughs and sneezes appropriately and the fatigue and body aches are gone.

Q. When can I get vaccinated?

A. Supplies are expected soon, but specific dates and times for vaccine clinics have not been set. Certain people will be first in line, including pregnant women, health-care workers, people who live with or care for infants, people 6 months to 24 years old and people with health conditions that put them at higher risk of complications. People 65 and older are not considered a priority group because they’ve so far shown less risk of infection, in part because many had previous exposure to a similar virus.

Q. How much protection does it offer? How quickly?

A. Trials of the vaccine have shown a robust immune response within eight to 10 days. Flu vaccines are typically about 90 percent effective against flu in healthy people.

What are the risks of the vaccine? Has it been adequately tested to ensure it is safe for everyone?

This vaccine is being made using the same methods and facilities used for seasona-flu vaccine, and federal health officials expect it to be similarly safe. The most common side effects after flu vaccinations are mild, such as soreness, redness, tenderness or swelling where the shot was given.

People who have a severe allergy to chicken eggs or to any other substance in the vaccine should not be vaccinated.

On very rare occasions, people develop Guillain-Barr syndrome after a vaccination. It is a disease in which the body damages its own nerve cells, causing muscle weakness and sometimes paralysis. People can also develop the disease after having the flu or other infections. Most people fully recover, but some die.

Q. Do I have to get vaccinated?

A. No. Vaccination is not mandated by the government.

Q. What’s the difference between the intranasal vaccine and the flu shot?

A. The nasal spray is made from live, weakened virus instead of virus that has been killed. It is not recommended for certain people, including those with weak immune systems and pregnant women.

Q. How many doses will I need?

A. The U.S. Food and Drug Administration has approved one dose of vaccine for people 10 and older. It is likely that younger children will require two doses.

Q. How much will it cost?

A. The vaccine will be free, although there may be some cost associated with the administration of shots.

Q. Do I need to get a regular flu shot or an H1N1 shot if I’ve already been sickened with flu?

A. Health officials recommend vaccination with both even if you’ve already experienced flulike illness.

Sources: CDC; Dr. Julie Mangino; Columbus Health Commissioner Dr. Teresa Long; Franklin County Health Commissioner Susan Tilgner; U.S. Food and Drug Administration Resources: www.flu.gov; www.plaind.com; www.ColumbusPandemicFlu.org; www.odh.ohio.gov