The Facts about the Flu

This flu season has been like no other in recent history. It started early with the advent of the influenza virus H1N1 (or Swine Flu). This strain has spread rapidly since its inception in April of 2009, so much so that in June the Swine Flu was officially dubbed a “global pandemic” by the World Health Organization.
Initial reports from around the world, concerning H1N1, have stirred up fear across the United States. Since flu season typically begins to peak in December and lasts through March, HealthScope magazine has compiled the latest information about seasonal flu and H1N1 flu to keep readers informed and to help them protect their families and themselves.
What You Need to Know for the Flu Season
By Julianne Hale
What is influenza?
Influenza is a contagious respiratory illness caused by viruses that spread from person to person and can cause mild to severe illness; in some cases, it can lead to death. Two strains of flu, seasonal flu and H1N1 flu, are currently circulating in the United States. A third and highly lethal H5N1 (Bird Flu) is being closely tracked overseas.
While flu outbreaks normally happen as early as October, most influenza activity peaks in December or later.
 What are the symptoms of H1N1?
Just like seasonal flu, H1N1 typically causes fever, cough, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue. With H1N1 flu infection, nausea and vomiting may also occur. Signs of a more serious H1N1 infection might include pneumonia and respiratory failure. The majority of people who contract H1N1 suffer with flu symptoms for a few days and then get back to normal without any complications.
 How serious is the H1N1 virus?
Recent estimates suggest that the death rate for H1N1 compares to a moderate year of seasonal influenza. In the United States, the average death rate per year from seasonal flu is around 36,000. Officials with the U.S. Centers for Disease Control and Prevention (CDC) estimate that nearly 2 million people nationwide have been infected with the H1N1 virus and more than 1,000 have died. About two-thirds of the people hospitalized with H1N1 had underlying medical conditions, such as asthma, diabetes or heart disease, or they were pregnant.
As of October, Tennessee recorded 28 deaths from H1N1. This number includes eight children and three residents of Hamilton County.
“The virulence of a virus can be defined by how toxic it is to cells or by how strong of an immune response it can trigger,” says Dr. Ken Hayman, president of the Chattanooga-Hamilton County Medical Society and medical director of the emergency department at Parkridge Medical Center. “When a virus mutates or, in the case of H1N1, infects people (when previously only found in animals), its actual virulence is initially unknown and is subject to certain variables. Thankfully, the initial fears of repeating the 1918 (Spanish Flu) pandemic have not come true.”
 Which populations are most impacted by H1N1 flu?
According to the CDC, most people who get the flu (either seasonal flu or H1N1) will have mild illness, will not need medical care or antiviral drugs, and will recover in less than two weeks. Some people, however, are more likely to get flu complications that result in being hospitalized and occasionally result in death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications.
The flu can also make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu.
The list below includes the groups of people more likely to have flu-related complications if they get sick from influenza:
• Children younger than 5, but especially children younger than 2 years old
• Adults 65 years of age and older
• Pregnant women
• People who have medical conditions
including:
• Asthma
• Neurological and
neurodevelopmental conditions
• Chronic lung disease
• Heart disease
• Blood disorders
• Endocrine disorders
• Kidney disorders
• Liver disorders
• Metabolic disorders
• Weakened immune system due to disease or medication
According to the CDC, at least 114 children in the U.S. have died from H1N1 flu. About two-thirds of the childhood deaths are among children with other health problems.
Dr. Marian May, a pediatrician with Highland Pediatrics in Hixson, explains the effect that H1N1 has on the pediatric population: “For the majority of children, H1N1 is a self-limited illness, but those that become very ill do so rapidly and of the children admitted (to the hospital), 40 percent go to the ICU. The other thing that distinguishes H1N1 is that it was spreading four times more rapidly than the seasonal flu and we never totally stopped seeing cases during the summer months.”
 Is the H1N1 vaccine safe?
The H1N1 flu vaccine was manufactured in the same time frame as the seasonal flu vaccine. Seasonal flu vaccines have a strong safety record and have been given hundreds of millions of times. Each season the flu shot contains three strains of flu virus that scientists predict will be circulating the globe. The 2009 H1N1 strain surfaced too late to be included in this season’s regular flu shot, but it will likely be included in the 2010 seasonal flu vaccine.
The H1N1 vaccine has been a controversial topic since it first surfaced, although there seems to be no reason for the hype. “Serious complications can occur with any vaccine,” says Dr. Hayman. “However, the H1N1 vaccine appears to be safe and effective. The 2009 H1N1 influenza vaccines are expected to have safety profiles similar to the seasonal flu vaccines, which have very good safety track records.”
According to the CDC, vaccines can reduce the chances of getting the flu by 70 percent to 90 percent in healthy adults.
 What is the difference between the flu shot and the nasal spray?
The virus in the nasal spray vaccine is live but weakened; it multiplies in the nasal passages, but cannot survive in the lungs. The virus triggers an immune response, but rarely causes any symptoms. The nasal spray, which does not contain preservatives, is only approved for people ages 2 to 49 who do not have underlying medical conditions such as asthma, diabetes, cerebral palsy, heart disease or pregnancy.
The virus in the shot is dead so it cannot cause the flu. The shots come in two forms: multi-dose vials that contain preservatives to prevent cross contamination and single-dose vials that are preservative-free. Some people do experience side effects with the shot that mimic flu symptoms, including low fever, aches and nausea.
The vaccines are made by CSL, MedImmune, Novartis and Sanofi Pasteur; companies with a record of producing seasonal flu vaccines using the same methods and distribution systems.
Is there a shortage of flu vaccine?
The supply of H1N1 vaccines has frustrated the public and health care officials, who say that some viruses are slow growing in laboratories, delaying the pace of vaccine production through no fault of the vaccine maker. Over the longer-term, U.S. health care officials said they’re hopeful that the nation will shift vaccine production from 1950s-era technology that relies on growing vaccines in egg cultures and move to faster cell-based technologies.
Vaccine supplies and shortages have varied from region to region. For instance, North Georgia did not have any H1N1 injectable vaccines until early November. Jennifer Yin, public information officer for the Chattanooga-Hamilton County Health Department, is upbeat about the continued availability of the H1N1 vaccine in Chattanooga. “We anticipate that we will have enough H1N1 vaccine for everyone who wants one,” she says.
The CDC recommends that available vaccines be directed to five groups at high risk from the H1N1 flu: pregnant women; infants and children and young adults up to age 24; infant care givers; health and emergency services personnel; and adults with compromised immune systems or other chronic problems, including asthma and diabetes.
 How can I keep from catching the H1N1 virus?
Regardless of whether or not you have had an influenza vaccine, there are simple ways to protect yourself from all forms of influenza virus. According to Dr. Hayman, wash your hands frequently, avoid sick people, and follow recommendations for school/event closures.
Dr. Hayman also suggests being prepared just in case you do get the flu. “Have a supply of over-the-counter medications, alcohol-based hand rubs (for when soap and water are not available), tissues and other related items to help avoid the need to make trips out in public when you are sick and contagious,” he says.
I think I have the flu. Should I go to the doctor?
If you think you have the flu, call your doctor first so waiting rooms and clinics do not become overcrowded and the virus does not spread further. Some symptoms require immediate medical attention, including difficulty breathing, severe dehydration, changes in consciousness, fever with a rash, symptoms that return after improving, chest pain, dizziness or persistent vomiting.
If you do get sick, do not go to work or school – going out in public when you have the flu only causes the influenza virus to spread. Stay home and rest until you are symptom-free without medication for at least 24 hours.
For the latest information about seasonal flu and H1N1 flu, visit the Chattanooga-Hamilton County Health Department’s Web site at http://health.hamiltontn.org or call the Flu Hotline at (423) 209-8393.
Julianne Hale and her family reside in Cleveland. She earned a Bachelor of Science degree from Illinois State University and then an MBA from the University of Phoenix. Julianne is a member of the Chattanooga Writers Guild, is married, and has two children.