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Facts about H1N1 (swine flu) and flu pandemic

With the recent outbreak of H1N1 (swine flu) in the United States and around the world, it is important to know the facts.

H1N1 Virus is one of a group of respiratory diseases caused by a type A influenza virus most often found among influenza outbreaks in pigs (hence the name “swine flu.”) Swine flu does not normally infect humans; however, human infections with swine flu do occur. Public health officials in the United States and throughout the world have determined that this new strain of the H1N1  flu virus  (now called “novel influenza”) spreads easily from human to human and can cause illness.

It is important to note that although influenza can occur at any time, the typical flu “season” in the U.S. usually lasts from October through the following spring; however, the H1N1 virus remains active in the community this summer. The spread of H1N1 flu from person to person is similar to the way the seasonal flu spreads – through coughing or sneezing by people with the influenza virus. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Symptoms of H1N1 (swine flu) are similar to the seasonal flu and include fever, cough, sore throat, body aches, headaches, chills, and fatigue. Some people have reported diarrhea and vomiting associated with swine flu.

Vaccines Against Flu

Every year the flu has the potential to cause a lot of illness, missed school, missed work, doctor’s visits, hospitalizations, and even deaths. This year may be a particularly severe flu season due to the new H1N1 flu virus. Vaccines are the best tool we have to prevent influenza. IBC hopes that our members will go out and get vaccinated against seasonal influenza as soon as vaccine become available, which could be as early as the end of August. The seasonal flu vaccine is unlikely to provide protection against novel H1N1 influenza. A special H1N1 vaccine is in production and may be available as early as mid-October. The H1N1 vaccine is not intended to replace the seasonal flu vaccine – it is intended to be used alongside seasonal flu vaccine. On July 29, 2009, the CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met to make recommendations about who should receive the new H1N1 vaccine when it becomes available. The H1N1 vaccine may require up to two shots a month or so apart, unlike seasonal flu vaccine, which only requires one shot per season.

The groups recommended to receive the H1N1 influenza vaccine include the following:

• Pregnant women. They are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
• Household contacts and caregivers for children younger than 6 months of age. Younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants.
• Healthcare and emergency medical services personnel. Infections among health care workers have been reported, and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce health care system capacity.
• All people from 6 months through 24 years of age
• Children from 6 months through 18 years of age. We have seen many cases of novel H1N1 influenza in children, and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread.
• Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

While there is not expected to be a shortage of H1N1 vaccine, vaccine supply and demand may be unpredictable. Therefore, the ACIP made recommendations about which groups should be prioritized.

Once the demand for vaccine for the prioritized groups has been met, programs and providers should also begin vaccinating everyone from the ages of 25 through 64 years. The risk for infection among persons age 65 or older is less than the risk for younger age groups according to recent studies. Once the vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.

Protect Yourself and Your family

Washing your hands, covering your mouth when you cough or sneeze, and practicing overall good hygiene is the best defense against germs. If you feel ill, have high fever, cough, and/or sore throat, you should limit your contact with people as much as possible. If you are worried about your symptoms, you may want to contact your health care provider. Your health care provider will determine whether influenza testing or treatment is necessary.

In certain circumstances, the CDC recommends antiviral drugs for the treatment and/or prevention of infection with swine flu. In the case of a pandemic, the regional government health departments would coordinate distribution of antiviral medication through recommendations about the priority order of patients to doctors. More information on antiviral drugs is available on the CDC website.

It is important to note that although the virus is most common among pigs, there is no reason to restrict pork or pork products from your diet. Eating properly handled and cooked pork products is safe. You should always prepare pork to 160 degrees F or 70 degrees C. Fortunately, most cases of the new H1N1 flu (swine flu) run their course without complications. Although most patients require no medical treatment, about 2% of patients develop severe disease. Most deaths have occurred in adults between the ages of 30 and 50, a marked change from seasonal influenza, for which most deaths occur in fragile, elderly people.

Most of those who have died suffer from underlying illnesses, including asthma, heart disease, diabetes, obesity and immune deficiencies.

Flu Pandemic, H1N1 (Swine Flu) and Beyond

According to the CDC, a flu pandemic is a global outbreak of influenza. A flu pandemic happens when a new influenza virus emerges. This is called “antigenic shift” – where a sudden change causes the virus to infect humans effectively. The virus becomes highly infectious and contagious in humans. No prior immunity would exist from exposure to seasonal influenza, and no vaccine would be available for wide distribution. It can spread easily from person to person, cause serious illness and death, and sweep across the country and around the world in a very short time.

Three conditions must be met for a human pandemic to start:

1. A new influenza subtype that can infect humans emerges.
2. It must cause illness in humans.
3. It must spread easily between people and continue spreading among humans without major interruption.

H1N1 (swine flu) has met all three criteria according to the World Health Organization (WHO). To date, swine flu virus outbreaks have been detected in more than 168 countries around the world, all 50 states in the U.S., plus Washington, D.C., Puerto Rico, U.S. Virgin Islands, and Guam.

The United States is working with other nations and the WHO to strengthen systems to detect and contain outbreaks of viruses that may cause a pandemic. The WHO uses a series of six phases of pandemic alert to inform the world of the seriousness of the threat and of the need for progressively more intense preparedness. The WHO raised the swine flu alert to its highest level – Phase 6 – saying the H1N1 virus has spread to enough countries to be considered a global pandemic. Increasing the alert to Phase 6 does not mean that the disease is deadlier or more dangerous than before, just that it has spread to more countries. The current WHO phase of pandemic alert is 6 – evidence of increases in human-to-human transmission.

World Health Organization Pandemic Alert Phases

Inter-pandemic phase	Low risk of human cases	1
New virus in animals, no human cases	Higher risk of human cases	2
Pandemic alert	No or very limited human-to-human transmission	3
New virus causes human cases	Evidence of increases in human-to-human transmission	4
	Evidence of significant human-to-human transmission	5
Pandemic	Efficient and sustained human-to-human transmission	6

• The United States is improving vaccine technology in order to produce vaccines quickly and in large quantities.
• Preparedness information and checklists have been developed for different sectors of the economy and for individuals, families, and communities to help reduce the effects of a pandemic.
• The government is providing funding, advice, and other support to states to assist with pandemic preparation.
• The government is providing up-to-date information through www.pandemicflu.gov.
• The United States is stockpiling antiviral medicines, such as oseltamivir (brand name Tamiflu), to treat certain high-risk people who may get sick with pandemic flu.

Information gathered from WHO and www.pandemicflu.gov.

*WHO only reports laboratory-confirmed cases.

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