Frequently Asked Questions About H1N1

WHAT IS H1N1? 
H1N1 (aka “swine flu”) is a new strain of an influenza virus.  It is spread through airborne droplets from coughs or sneezes; or sometimes people may become infected by touching something-such as a surface or object—with flu viruses on it and then touching their mouth or nose.  It presents with fever >100, cough, and at least one of these other symptoms:  body aches, joint pain, sore throat, runny nose, shortness of breath, vomiting, or diarrhea.  Incubation period is 1 to 4 days and possibly 1 to 7 days.

IS THIS REALLY DIFFERENT FROM INFLUENZA?
Yes, absolutely.  It is a different virus.  However, it causes an illness that is essentially indistinguishable from Influenza.  There are a couple of other notable differences as well.  It is about three times more contagious than Influenza is, and it seems to strike younger patients with greater symptoms than Influenza does.

DON’T YOU THINK THIS IS ALL MEDIA HYPE?
Not at all.  At this point, Influenza and H1N1 seem to be equal in the amount of damage they can do to our health.  1% of Influenza patients typically need hospitalization, and we expect that 1% of H1N1 patients will need hospitalization.  The mortality rates for both illnesses are expected to be about 0.1% of infected patients.  The primary difference is that because most of us under the age of 65 years have little or no natural immunity, H1N1 is expected to be about THREE TIMES more contagious than influenza.  Therefore we expect three times more patients to be infected . . . and three times more patients to need to be hospitalized with the illness.

WHO NEEDS IMMUNIZATION AGAINST H1N1?
Pregnant women
People who live with or care for children younger than 6 months of age
Health care workers
People aged 6 months to 24 years of age (or 6 months to 4 years of age if there is a vaccine shortage)
People with chronic health disorders (such as lung disease including asthma, heart disease, diabetes, seizure disorder, and tobacco addiction) or people with immune suppression (such as people on chronic steroids, chemotherapy, or people with diseases that affect the immune system)
Anyone who wants to avoid getting infected with H1N1 (assuming the vaccine is not being rationed)

WHO CAN’T GET IMMUNIZED?
You cannot have the vaccine if you have an allergy to eggs
You cannot have the vaccine if you have had a severe reaction to a flu shot in the past, including Guillan Barre.
You cannot have the vaccine if you have an evolving neurologic diagnosis
Your child cannot have the vaccine if he/she is under 6 months old

DOES MY “FLU SHOT” PROTECT ME AGAINST H1N1?
No, these are two separate viruses and therefore need two separate vaccinations.

CAN I GET MY FLU SHOT AT THE SAME TIME AS MY H1NI VACCINE?
Yes, but you cannot get the flumist at the same time as the H1N1mist.

I JUST GOT THE FLUMIST (nasal flu vaccine)—CAN I STILL GET THE H1N1 VACCINE?    The nasal mist preparations can not be given within 30 days of each other.   But there is no restrictions for when you can get the shots—you can get the influenza shot and the same time as the H1N1 shot if you’d like.
WHY SHOULD I IMMUNIZE MYSELF/MY CHILD?
We know that this virus has the potential to affect over 30% of our population.  Chances are that you will be exposed to the virus and if you are, there is a 15 to 30% chance you will become infected.  If you do become infected, you are putting your own health at risk as well as the people around you.  Should you or your child develop fever of >100, cough and one other symptom (sore throat, body aches, runny nose, vomiting, or diarrhea) they are recommending that you stay at home until your fever is gone or 7 days, whichever is LATER.  Can you imagine taking a week from work each time you get a cold?  Or each time your child does?  If not, you should get immunized!

I’M NERVOUS ABOUT THIS VACCINE—WOULD YOU CONSIDER IT EXPERIMENTAL?

We completely understand your concerns.  We are not enthusiastic about standing in the front of the line for a brand new vaccine, nor do we want to give our families and our patients immunizations that have been incompletely tested.  However, that is NOT the case here.  This vaccine is made by the same manufacturers using the same process that produces the traditional influenza vaccine.  The only difference is the DNA in the vaccine is H1N1 DNA rather than influenza DNA.  As you know, they change the DNA in the flu vaccine every year, also.  So in that respect this year’s H1N1 vaccine is no more new or experimental than this year’s influenza vaccine.

WHO NEEDS EVALUATION IN THE OFFICE?
Any patient who is considered to be at high risk for complications from H1N1
    Children under 5 years of age
    Pregnant women
People with chronic health disorders (such as lung disease including asthma, heart disease, diabetes, seizure disorder, evolving neurologic disorders, and tobacco addiction)
People with immune suppression (such as people on chronic steroids, chemotherapy, or people with diseases that affect the immune system)
Anyone experiencing warning signs of severe illness:
    Fast breathing
    Trouble breathing
    Bluish or gray skin color
    Not drinking enough fluids or urinating as much as usual
    Not waking up or interacting as usual
    Being so irritable your child does not even want to be held
Significant worsening of your fever or fever that returns after being gone
for 24 hours
If you are not in the high risk group and you do not have any of the worrisome findings outlined above we respectfully ask that you consider recuperating at home.  Creekside Medical plans on following the CDC recommendations for the prescription of Tamiflu.  Unless the patient is at high risk or unless the patient is seriously ill with symptoms described above we will likely NOT prescribe Tamiflu for you.  If you are at all worried about your health, please let us evaluate you.  Otherwise, please feel free to convalesce at home.

WHAT CAN I DO TO FEEL BETTER IF I CONTRACT H1N1?
Drink plenty of fluids
Take Tylenol or Ibuprofen for fever and symptom relief  (NO ASPIRIN for children)
Get plenty of rest
Stay home to keep from spreading the disease;  if you must come out then you really should wear a mask.  For the safety of our staff and patients, patients coming to Creekside Medical with suspected H1N1 will be expected to put on a mask as soon as they enter our office.

HOW LONG SHOULD I STAY HOME FROM WORK/SHOULD THE KIDS STAY HOME FROM SCHOOL?
Your child should stay home until he/she has gone at least 24 hours without a fever and with no Tylenol or Motrin.  Some experts are recommending waiting until at least 7 days have passed from the start of your symptoms.

HOW CAN I PROTECT MYSELF FROM H1N1?
GET VACCINATED!!!!!!!
Make sure you are well rested and well nourished.
Cover you cough when you sneeze and cough.
Do not touch your mouth, nose, or eyes without first washing your hands.  Wash thoroughly with soap and water—wash at least as long as it takes to sing the ABC song.
Did we mention getting vaccinated?

I’VE BEEN EXPOSED TO SOMEONE WITH H1N1—WOULD MEDICATION HELP ME?
If you are a high risk patient (<5 years of age, pregnant, health care worker, care facility resident, someone with chronic lung or heart disease or immune system problems) AND it has been < 48 hours since exposure, Tamiflu may help you stave off the disease.

WHERE CAN I GO FOR MORE INFORMATION?
Our health department has set up a hotline with experts who can answer your call: 360-397-8021 or toll free at 1-877-510-2772
You can also visit www.flu.gov or www.cdc.gov.