As you well know, 2009 H1N1 is back in a neighborhood near you. Fortunately, it seems that so far the illness is fairly mild in most people. That can always change if the virus starts to mutate as it continues its journey. As the virus spreads, public health officials and providers are continually getting updates from CDC and other health organizations about care guidelines. Here’s what we know right now.

A vaccine is currently being developed. Late this summer many volunteers were tested to determine if one or two doses would produce enough protection. While I’ve heard from one source that one dose may suffice, the jury is still out and two doses may need to be given. Distribution is expected later this fall, but will depend on the time to conduct the needed clinical trials and manufacturing times. The H1N1 vaccine will be in addition to the regular flu shot you normally get each year. While both vaccines could be administered at the same time, the H1N1 vaccine probably won’t be ready yet when the regular flu shot is available.

The target groups recommended to get the vaccine are:

• Pregnant women,
• People who live with or care for infants under 6 months (because children this young can’t get the vaccine),
• Healthcare and emergency personnel,
• People between 6 months through 24 years,
• People 25 through 64 years who have chronic illnesses or compromised immune systems.

According to the CDC the 1976 swine flu virus and the 2009 H1N1 virus are different enough that it’s unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1. People vaccinated in 1976 should still be given the 2009 H1N1 vaccine.

If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)

Meanwhile everyone should use these precautions, including children:

1. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash immediately after you use it.
2. Wash your hands often with soap and water, especially after you cough or sneeze. Alcoholbased hands cleaners are also effective. Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface.
3. Avoid touching your eyes, nose or mouth. Germs spread that way.
4. Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. This fall, antivirals may be prioritized for persons with severe illness or those at higher risk for flu complications and/or hospitalization.

If you are the caregiver:

• Avoid being face-to-face with the sick person.
• When holding small children who are sick, place their chin on your shoulder so that they will not cough in your face.
• Clean your hands with soap and water or use an alcohol-based hand rub after you touch the sick person or handle used tissues, or laundry.
• Talk to your health care provider about taking antiviral medication to prevent the caregiver from getting the flu.
• If you are at high risk of influenza associated complications, you should not be the designated caretaker, if possible.
• If you are in a high risk group for complications from influenza, you should attempt to avoid close contact (within 6 feet) with household members who are sick with influenza. Designate a person who is not at high risk of flu associated complications as the primary caretaker of household members who are sick with influenza, if at all possible. If close contact with a sick individual is unavoidable, consider wearing a facemask or respirator, if available and tolerable.

Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers who have the flu;
this can cause a rare but serious illness called Reye’s syndrome.

• Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin.
• Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
• Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.
• The safest care for flu symptoms in children younger than 2 years of age is using a coolmist humidifier and a suction bulb to help clear away mucus.
• Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS) such as Aleve.
• Remember, that if you are generally healthy and have a good immune system, then you should be able to deal with H1N1 just as you do the regular flu.

The CDC has a lot of additional current information on its website about H1N1 care guidelines. If you are interested, please go to:

http://www.cdc.gov/h1n1flu/.

Also, Public Health-Seattle-King County maintains an active website for H1N1. You can visit this website at:

http://www.kingcounty.gov/health/H1N1 .

In health,
Janet Wildeboor, RN, MS

Health Ministries Committee