Overview

Name: H1N1 (Swine) Flu Prevention

Description: Social distancing and nasal spray and injectable vaccines

Creator: Arrowsmith

This casebook is published and has been read 626 times.

The author of this casebook has identified the following medical topics as being highly relevant to this casebook.

• Influenza A virus -- A negative-strand linear single-strand RNA virus with an 8 segment genome. Virions are enveloped and usually spherical or pleomorphic, 80-120 nm in diameter. Subtyping is based on the antigenic properties of the hemagglutinin and neuraminidase proteins. Influenza type A viruses can infect people, birds, pigs, horses, and other animals, but wild birds are the natural hosts for these viruses.
  
  
• Swine influenza -- disease caused by strains of influenza A virus, causing influenza and pneumonia in domestic pigs.
  
  
• Influenza -- acute viral infection involving the respiratory tract; marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia.
  
  

Notes

1. There are simple, everyday measures you can take to reduce the risk of catching both H1N1 and regular, seasonal flu:

• Avoid touching your mouth and nose
• Clean your hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub, frequently
• Avoid close contact with people who might be ill
  
• Reduce the time spent in crowded settings if possible
  
• Keep your living space or work place well-ventilated
• Get adequate rest and nutrition

2. Vaccination
You need two vaccines to be fully protected this year. The seasonal flu vaccine is different from the H1N1 (Swine) flu vaccine. The CDC is encouraging people to get both vaccinations. Get both vaccinations as soon as possible. You can find a clinic near you using the American Lung Association's Flu Clinic Locator where you enter a zip code and the locator will give you the locations within 5 to 25+ miles of the zip code you entered. You can find out about influenza resources in your state using the Flu Shot Locator.

There are two kinds of 2009 H1N1 vaccines being produced:

• A 2009 H1N1 "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The indications for who can get the 2009 H1N1 flu shot are the same as for seasonal flu shots. The flu shot is approved for use in people 6 months of age and older, including healthy people, people with chronic medical conditions and pregnant women. The same manufacturers who produce seasonal flu shots are producing 2009 H1N1 flu shots for use in the United States this season. The 2009 H1N1 flu shot is being made in the same way that the seasonal flu shot is made.
• The 2009 H1N1 nasal spray flu vaccine — a vaccine made with live, weakened viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine"). The indications for who can get the 2009 H1N1 nasal spray vaccine are the same as for seasonal nasal spray vaccine. LAIV is approved for use in healthy* people 2 years to 49 years of age who are not pregnant. The nasal spray vaccine for use in the United States is being made by MedImmune, the same company that makes the seasonal nasal spray vaccine called “FluMist®.” The 2009 H1N1 nasal spray vaccine is being made in the same way as the seasonal nasal spray vaccine.

About 2 weeks after vaccination, antibodies that provide protection against 2009 H1N1 influenza virus infection will develop in the body. The 2009 H1N1 vaccine will not protect against seasonal influenza viruses.

When to Get Vaccinated
Vaccination against 2009 H1N1 should begin as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of flu activity can vary. Flu seasons can last as late as April or May. By early October 2009, extensive 2009 H1N1 flu activity was being reported in the United States. It’s possible that there may be waves of 2009 H1N1 activity during the 2009-2010 flu season that hit communities more than once over the course of the season. While 2009 H1N1 viruses are likely to be the most common cause of influenza this season, CDC still expects that seasonal influenza viruses will circulate and continues to recommend that people get a seasonal flu vaccine to protect against seasonal flu viruses.

Who Should Get Vaccinated
CDC’s Advisory Committee on Immunization Practices (ACIP), a panel made up of medical and public health experts, met July 29, 2009, to make recommendations on who should receive the 2009 H1N1 vaccine when it becomes available. While the U.S. government has purchased enough vaccine so that anyone who wants to get vaccinated can, ACIP recommended that vaccination should be given first to people in five groups who are at higher risk for 2009 H1N1 influenza or related complications, are likely to come in contact with influenza viruses as part of their occupation and could transmit influenza viruses to others in medical care settings, or are close contacts of infants younger than 6 months (who are too young to be vaccinated). These five groups make up an estimated 159 million people in the United States and include:

• Pregnant women
• People who live with or provide care for infants younger than 6 months (e.g., parents, siblings, and day care providers), health care and emergency medical services personnel
• People 6 months through 24 years of age
• People 25 years through 64 years of age who have certain medical conditions that put them at higher risk for influenza-related complications (see our companion Casebook H1N1 (Swine) Flu Diagnosis).

Who Should Not Be Vaccinated
There are some people who should not get any flu vaccine without first consulting a physician. These include:

• People who have a severe allergy to chicken eggs.
• People who have had a severe reaction to an influenza vaccination.
• People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously. (For information, see General Questions and Answers on Guillain-Barré syndrome (GBS).
• Children younger than 6 months of age (influenza vaccine is not approved for this age group), and
• People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Vaccine Side Effects
The same side effects typically associated with the seasonal flu shot and the seasonal nasal spray vaccine are expected with the 2009 H1N1 flu shot and 2009 H1N1 nasal spray vaccine.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Minor side effects that could occur are:

• Soreness, redness, or swelling where the shot was given
• Fever (low grade)
• Aches

If these problems occur, they begin soon after the shot, are usually mild, and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. The nasal spray: The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness.

In children, side effects from the nasal spray vaccine can include:

• runny nose
• wheezing
• headache
• vomiting
• muscle aches
• fever

In adults, side effects from the nasal spray vaccine can include:

• runny nose
• headache
• sore throat
• cough

3. Taking Care of a Sick Person in Your Home

• Check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
• Check with their health care provider about whether they should take antiviral medications
• Keep them away from others as much as possible. This is to keep from making others sick. Do not let them go to work or school while ill. They should stay home for at least 24 hours after fever is gone, except to seek medical care or for other necessities. (Fever should be gone without the use of a fever-reducing medicine.)
• Have them get plenty of rest
• Have them drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
• Cover coughs and sneezes. Wash hands often with soap and water or use an alcohol-based hand rub.
• Have them wear a facemask when sharing common spaces with other household members to help prevent spreading the virus to others. This is especially important if other household members are at high risk for complications from influenza. 
• Be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention (companion Casebook H1N1 (Swine) Flu Diagnosis).

Bookmarks The following information, which has been distilled by the casebook author from this and other websites is particularly relevant to this casebook.