in focus:  H1N1 (Swine Flu)

HOW TO PREVENT SWINE FLU
WHAT TO DO IF YOU GET IT

The outbreak of H1N1 (swine flu) continues to expand in the United States and has many people worried.

We asked Dr. Timothy Burke, an infectious disease specialist with SMDC Health System, to help us understand this new flu virus and share his expertise on how to prevent it and what to do if you or a family member should come down with H1N1.
Dr. Burke has more than 30 years of experience dealing with infectious diseases, including the flu. He is also a healthcare epidemiologist and serves on SMDC's

Dr. Timothy Burke

Infectious Disease Specialist

emergency preparedness committee. Part of his work on that committee involves taking the lead on influenza preparedness and prevention.

Q. What are the signs and symptoms of H1N1?
A. Like seasonal influenza, H1N1 has a range of symptoms. Generally people experience these:

  • Fever lasting 5-7 days
  • A non-productive, dry cough
  • Watery nasal discharge
  • Sore throat
  • Body aches
  • Headache
  • Chills
  • Fatigue

As the fever subsides the cough will linger and become more productive.

Q. How severe is the illness associated with this flu?
A. It is about as severe as seasonal influenza, which is a big deal. Approximately 36,000 Americans die each year from seasonal flu.

Q. How does this flu spread?
A. H1N1 and other forms of influenza multiply in the throat and nose. As people with the infection cough, sneeze or breath, they spread the virus through droplets that become airborne and eventually fall to the ground.

Q. How long can an infected person spread the flu to others?
A. It varies. People with the virus are contagious for about 24 hours before symptoms start and until their fever is gone 7 to 8 days later.
The fact that people do not know they are contagious is a key factor in the spread of H1N1 and other forms of influenza. That is why it is so important for everyone to practice respiratory etiquette by coughing or sneezing into his or her upper arm or a tissue.

Q. What can I do to protect myself and my family?
A. Practice respiratory etiquette and teach your children how to cover up their coughs and sneezes as well. Wash your hands often or use alcohol-based foams and gels to sanitize your hands. Stay healthy, get plenty of rest and eat a healthy diet.

Q. What should I do if I suspect I have H1N1?
A. If you have mild symptoms, stay home from work. If your children have symptoms, keep them home from school or day care. If you are having severe symptoms, such as trouble breathing, you need to be evaluated at your doctor’s office, urgent care or, as a last resort, the emergency room. Public health authorities are asking that if you think you have H1N1 and need to see the doctor that you call ahead of time so they can take extra precautions before you arrive.

Q. Are there any medications to treat this new virus?
A. There are two effective medications that work against this virus. They are Tamiflu® and Relenza®. The benefits people experience from using either of these medications are best if they are started within 48 hours. If someone becomes ill enough to be hospitalized, we are also using these antiviral medications to reduce their chances of complications. In the late stages of the flu, some people can develop bacterial pneumonia. If you are feeling better and then redevelop a fever and start feeling worse, you need to be evaluated for pneumonia, in which case antibiotics would be prescribed.

Q. What do you anticipate will happen this fall when the regular flu season starts again?
A. Flu is very unpredictable. It keeps throwing us curve balls. When we look at flu pandemics in 1918, 1957 and 1968 they show us that there are multiple waves of illness over 18 months around the world. These waves are then followed by sub-waves, which act differently than the original wave. In 1957 and 1968, later waves were not as serious as the first wave. However, in 1918 the flu mutated and became more lethal. We are hoping H1N1 does not mutate into something more lethal than we are experiencing at this time.

Q. Should people consider a flu vaccination?
A. Yes. The Centers for Disease Control and Prevention recommends vaccination for

  • Children, 6 months up to their 19th birthday
  • Pregnant women
  • People 50 years of age and older
  • People of any age with certain chronic medical conditions
  • People who live in nursing homes and other long-term care facilities
  • People who live with or care for those at high risk for complications from the flu

There is a misconception that pregnant women should not be vaccinated, when in fact pregnant women are at greater risk for complications from the flu. Pregnant women should be vaccinated, regardless of the stage of their pregnancy.

Q. Will there be two separate vaccinations, one for H1N1 and one for this year’s anticipated seasonal flu?
A. It is unresolved at this time. The flu experts are considering what to do right now. We do know that people under age 60 have no protection from H1N1. To induce protection against H1N1, experts are thinking we may need to give one vaccination and then follow it up two weeks later with another vaccination.

Q. We’ve been hearing that people over 60, or even those born before 1957, appear to have some immunity to H1N1, what do you think about this?
A. It is probably due to the fact that older people have been exposed to different strains of the flu virus very similar to H1N1 over the years and have developed cross-reactive immunity.

Q. What is the most important thing people should keep in mind as we go through this pandemic?
A. Be aware of the latest developments and what’s going on. Be prepared, but don’t panic.

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