Facts about the H1N1 Virus

Nov 2, 2009

Many people have been asking me about the H1N1, or “Swine Flu”, virus and about it’s vaccine. My wife, Stephanie, is a Family Medicine doctor who recently wrote an excellent article about this topic for “Space Coast Living.” I would like to take this opportunity to share Stephanie’s article with you.

What You Should Know about the H1N1 Virus


by Stephanie Haridopolos, MD

 

There have been many misconceptions regarding the H1N1 virus and vaccine and this article is an effort to provide a concise flu avoidance and flu management roadmap.


The 2009 H1N1 flu virus (formerly known as swine flu) was declared a pandemic earlier this year with widespread activity here in Florida and the flu season will extend well into spring. The most significant difference between the H1N1 and the seasonal flu viruses is that H1N1 has a higher incidence in the younger population and pregnant women.  People born before 1950 have some immunity (antibodies) to H1N1, therefore protects them from this virus.  The virus is continuing to spread and it estimated that possibly 40 percent of the U.S. could be affected to some degree with this virus.


The viral illness presents with symptoms including fatigue, fever, sore throat, runny or stuffy nose, cough, and body aches.  Sometimes it may present with vomiting and diarrhea as well.  The severity of the illness has a wide range from mild flu-like symptoms that can be self-limiting and treated with supportive care to severe respiratory symptoms requiring hospitalizations.  It is spread through person-to-person contact by respiratory droplets (coughing and sneezing) and can stay alive on inanimate objects up to 8 hours.  The H1N1 virus has an incubation period of 7 days and can be contagious for a week to 10 days.

 

It is not currently recommended to confirm the H1N1 with testing because the rapid test (RIDA) has a low sensitivity rate.  Meaning, there are many false negatives so you can still have the disease if it negative.  The gold standard test is RT-PCR, however results can take up to 4 days to become available, therefore it is reserved for the hospitalized severe cases for confirmation.  Treatment should be started within 48hrs of onset of symptoms regardless of testing.


The H1N1 flu vaccine is the best weapon against the flu. The vaccine is currently available and manufactured the same way as the seasonal flu vaccine under rigorous oversight and approved by the Food and Drug Administration.  In fact, had the World Health Organization predicted the H1N1 was going to be a pandemic this year; it would have been included in the production of the seasonal flu vaccine this year.  The vaccine is available in different forms and depending on your age and underlying medical conditions, your health care provider can best guide you.  The FluMist is a live attenuated intranasal vaccine (LAIV).  It uses weakened (attenuated) virus to stimulate your body to produce antibodies to protect you.  It is a good option for patients you do not want an injection.  The vaccine is also produced in an injectable inactivated viral form. Recent studies have shown the vaccine produces a robust immune response in adults after one vaccine. Patients less than age 10 need to have two vaccines four weeks apart because there immune system is not primed and thus need two doses to get similar results.


There are certain target groups who should receive the H1N1 Flu vaccine:


*Pregnant Women
*Health care workers and emergency medical responders
*People who live with or care for infants less than 6 months of age
*Children and adults from 6 months-24 years
*People age 25-64 years of age with underlying medical conditions.

 

(The FluMist is available for ages 2 – 49, non pregnant patients who do not have asthma, sinus problems and underlying immune deficiency.
The injection is available for ages 6 months to 64 years.)


To help prevent the spread and reduce your risk of contracting H1N1:


*Get the vaccine if you are meet the above criteria.
*Cover your nose and mouth with a tissue when coughing or sneezing then discard the tissue immediately and encouraging others to do so.
*Frequent hand washing with soap and water for 20 seconds or the use of alcohol-based hand sanitizers is also effective.
*Avoid touching your eyes, nose and mouth to avoid spreading germs.


If flu symptoms do take hold, contact your physician for guidance.  Once diagnosed, those who become infected must remain home from work or school for at least one week. The virus is most contagious when fever is present.  It is imperative to drink plenty of fluids and get adequate rest.  You should remain at home for at least 24 hours after the fever has resolved without fever reducing medications to help prevent the spread of the flu.


There are antiviral medications that can help lessen the severity and duration of the H1N1 virus if started within 48 hours of the start of symptoms. Tamiflu and Relenza are medications effective against H1N1. Each requires a prescription from your healthcare provider if deemed necessary. Both can also be used for prophylaxis if exposed.  Most people do not need the antiviral medication to fully recover from the flu.  Remember to be proactive as we all weather this flu season.


For additional information contact the Center for Disease Control (CDC) at: http://www.cdc.gov/h1n1flu/ or phone the CDC hotline1-800-CDC-INFO.


Stephanie Haridopolos, M.D., is a Board Certified Family Practice physician in Melbourne, Florida.

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