COLUMBIA, Mo. — Anticipating that the fall flu season may bring an influx of patients with two types of flu – seasonal influenza and the novel H1N1 strain – MU Health Care infectious diseases specialists are meeting weekly to ensure adequate beds, staff, anti-flu medications and flu vaccines are available.
Since April and continuing through the summer, physicians at MU Health Care have been seeing approximately five to 11 patients weekly who test positive for type A influenza. Since Aug. 30, an additional 15 patients tested positive for type A influenza.
“Because seasonal flu does not normally occur here during the summer months, we believe these patients we are seeing now have the novel H1N1 flu virus,” said Michael Cooperstock, M.D., medical director of the Infection Control Department at MU Health Care.
Symptoms of the H1N1 virus are the same as seasonal flu. Typically, patients are experiencing rapid onset of a high fever that is usually accompanied by a severe headache. Other symptoms of influenza include cough, sore throat, runny or stuffy nose, body aches, chills and fatigue.
Most people with the H1NI or seasonal flu recover on their own and do not require medical care. However, influenza can cause serious illness and even death in persons at high-risk due to chronic health conditions, for example.
“We do not anticipate a shortage of the seasonal flu vaccine, and the vaccine for the H1N1 virus is expected to be available sometime in mid- to late October and be administered in two separate injections,” said Linda Johnson, R.N., M.S.N., director of the Department of Infection Control at MU Health Care.
Being vaccinated against the seasonal flu as well as the H1N1 strain this fall is going to be very important, Johnson said.
Each type of flu – seasonal and H1N1 – has different risk groups that should receive the vaccines first. High-risk individuals for H1NI include pregnant women, people who live with or care for children younger than 6 months old, health care and emergency medical services workers, persons between the ages of 6 months and 24 years, and people between the ages of 25 and 64 who have chronic health disorders or compromised immune systems. High-risk groups for seasonal flu include children 5 and younger, particularly young infants, the elderly, and people of any age with chronic diseases. Also at risk are pregnant women or those who are immuno-suppressed.
Influenza is spread mainly from person to person by people with the condition who cough and sneeze in public. Sometimes people may become infected by touching something with the flu virus on it and then touching their mouths or noses.
“The best way to avoid spreading the flu is to stay home when you are sick,” said Kristin Hahn-Cover, M.D., director of the Office of Clinical Effectiveness at MU Health Care. “If you are sick with flu-like symptoms, stay at home for more than 24 hours after your fever is gone and you have stopped using fever-reducing medications such as ibuprofen or acetaminophen.”
Some simple steps can help you avoid the flu this season, according to infectious diseases specialists at MU Health Care:
• Cover your nose and mouth with a tissue when coughing or sneezing, and then throw the tissue away.
• If you do not have a tissue, cough or sneeze into the crook of your arm.
• Wash your hands often with soap and water, especially after you cough or sneeze.
• Use a hand sanitizer containing alcohol if washing your hands is not an option.
• Avoid touching your eyes, mouth or nose, which will help stop the spread of germs.
• Avoid close contact with people who are ill.
When the H1N1 virus was first identified it was called “swine flu” because laboratory testing showed that many of the genes in this new virus were similar to influenza viruses that normally occur in pigs. Further studies indicated H1N1 contained two genes found in the swine population in Europe and Asia. But the new virus also contained avian (bird) genes as well as genes found in human flu viruses.
“This combination of four genes is known as a quadruple reassortant virus and is very different from influenza viruses we have experienced in recent decades,” Cooperstock said. “This could explain why H1N1 influenza has become a pandemic, and why cases are being seen here in the United States and throughout the northern hemisphere during the summer months when we normally wouldn’t expect to see them.
“Drier, less humid indoor air allows for the spread of the disease during the wintertime, so this is why winter is the usual ‘flu season,’” Cooperstock said. “What makes this particular H1N1 strain spread during the summer is not known, but we suspect it is because there is so little pre-existing immunity in the population. We do know that the vast majority of cases have been no more severe than what we typically encounter with the normal seasonal flu. Like normal seasonal flu, it can be severe at times, although in most the symptoms have been mild.”
Another unique aspect of the novel H1N1 type A strain of influenza is that those 65 and older, who usually are hit most severely, have been the least affected in this particular pandemic.
“There is reason to believe that people in this age group have the benefit of immunity or partial immunity from exposure to similar strains many years ago,” said Cooperstock. “Along with a separate H1N1 vaccine that is being developed for the 2009-2010 flu season, antiviral drugs such as Tamiflu and Relenza continue to be effective in combating almost all the strains of flu that are being encountered,” he said. “To be effective, these prescription antiviral medicines must be started early after the onset of flu symptoms and are only recommended for hospitalized patients, persons with chronic medical conditions, pregnant women and children younger than 5.”
For the most up-to-date information about H1N1 please visit www.muhealth.org/Alert.
Kristin Hahn-Cover, M.D., director of the Office of Clinical Effectiveness at MU Health Care