Pertinent questions about H1N1 Influenza answered by NERAC

Dec 11 2009

Municipalities in Massachusetts should assume that the H1N1 Influenza is now present in their communities, schools, and work places, and should take appropriate precautions to prevent the spread of this virus as well as the seasonal flu. According to the Northeast Homeland Security Regional Advisory Council (NERAC), doctors throughout the State are reporting 3.5% of their office visits in the last week have been for influenza-like illness (ILI), this in comparison to only about 1% of those visits at this time last year. Most patients are not having a laboratory test performed, so the statewide numbers of actual H1N1 cases could be higher than the 1,768 confirmed cases that have been reported in the state of Massachusetts. While case rates are currently falling, history shows that flu pandemics run in cyclical patterns, and that officials do not believe the outbreak is over.

"We have been reaching out to people throughout the State during the past two months and have heard many concerns from pregnant women, mothers of young children and the elderly. We are educating everyone that the first line of defense is to get the H1N1 vaccine when it becomes available," said Thomas Carbone a member of NERAC Pandemic Flu Subcommittee. "We get vaccinated not only for ourselves, but for the good of our family, friends, and community. As more people become vaccinated, we develop what is a called a 'herd immunity.' The herd immunity helps to slow transmission of the virus, and protects those who are unable to be vaccinated, or those that have underlying medical conditions which can lead to life threatening complications."

Following are answers to other pertinent questions being asked.

Are we still under a pandemic with the H1N1 flu? World Health Organization officials recently noted that the virus has spread to virtually every country in the world, reaching as far as remote tribes in Venezuela and aboriginal populations in Australia. Although the number of deaths attributed to H1N1 this year (over 7,000 to date) remains low compared to a normal seasonal flu outbreak of several hundred thousand deaths in a year, health officials remain concerned because of the instability of H1N1 combined with its tendency to affect younger healthier people.

What is the difference between the H1N1 and the seasonal flu? 2009 H1N1 influenza (sometimes called Swine Flu) is caused by a new strain of influenza virus that is different from the seasonal flu we usually see each fall and winter. This year, the flu virus that is spreading is new and different enough so that many people, especially younger people, do not have much resistance. While the H1N1 virus started in April 2009 the seasonal virus, which has appeared, usually peaks in January or February.

Are the vaccination clinics still administering doses only for the high risk and first priority population? The initial doses of vaccine were targeted at medical professionals with direct care duties, pregnant women, and families and caregivers of children under the age of 6 months since those infants cannot be immunized. Once those groups are covered adequately, clinics will expand vaccination coverage to children under the age of 25 years of age. Vaccine supplies have reached a point where some communities are now opening clinics up to all persons under the age of 25 years. Each community should be contacted individually for specific clinic information and restrictions.

Is the nasal spray safe for children? The live, attenuated intranasal vaccine (or LAIV) is recommended for people from 2 through 24 years of age who are healthy and that people in this age group get vaccinated as soon as the vaccine is available. Children through 9 years of age should get two doses of vaccine, about a month apart. Older children and adults need only one dose.

What steps should I take to keep my children protected from the H1N1 flu virus? People are reminded that they can reduce their exposure to flu virus by washing their hands regularly, using hand sanitizer when needed, and covering their cough and sneezes. To protect others, keep a child home from school or stay home from work when fever is present, and do not return until you are fever-free for 24 hours without the help of medicine.

Why shouldn't pregnant women get the nasal spray form of the vaccination? Pregnant women should get the "flu shot" -- a vaccine that is given with a needle, usually in the arm. The other type of flu vaccine -- nasal-spray flu vaccine -- is not currently approved for use in pregnant women. This vaccine is made with live, weakened flu viruses that do not cause the flu. LAIV is approved for use in healthy people 2-49 years of age who are not pregnant.

How do we learn about more vaccination doses as they become more available? Visit http://flu.masspro.org limited numbers of public clinics are now posted which you can search by zip code. More clinics will be added to this database as they are scheduled. We encourage parents to contact their kids' pediatrician or their own doctor to see if s/he has H1N1 vaccine and if an appointment can be scheduled to receive it.

Where can I learn more about vaccination recommendations and updates?

-- http://www.cdc.gov/h1n1flu -- www.flu.gov -- www.mass.gov/flu -- Call Mass 211 which will provide you information on where clinics are in your vicinity

About The Northeast Homeland Security Regional Advisory Council (NERAC)