Ask the Doctor: Swine Flu

1.) I remember last spring and the daily barrage of swine flu news, with news conferences from Washington, scary statistics from Mexico, and sick students back from spring break. Did we learn anything?

Response: When I did my swine flu segment- now mostly called H1N1 -it was April 29th, a date after which we hardly ever thought of influenza in the past. On that day there had not been a confirmed case in New England, but we now know that there were nearly 500 cases in Massachusetts over the next four weeks. I learned one more time, that influenza can be unpredictable and that it is better to be prepared, which we appear to have taken to heart in the health and school communities at least. Since schools got ready to open two weeks ago, there has been abundant evidence of preparation.

2.) What can we expect to have changed?

Response: Beside there being two separate flu shots this year, schools and public health departments are clear that school aged children bring lots of illness home, so that preventing transmission in the school is more important. [Graphic #1] This means lots of handwashing, but for the first time the schools will make it possible for some kids, whose parents permit, to get their H1N1 flu shots in school, once the vaccine is available. If the flu is serious, children and school employees may be isolated in school if they appear to be ill, and sent home quickly. Children will be able to come back to school when they are without fever for 24 hours off fever medication, rather than only after 7 days of illness. Because more severe illness was seen with H1N1 in younger people than in the elderly, more attention will be paid to younger people at high risk.

3.) Does this preparation mean that things will go better?

Response: Everyone involved hopes so. The influenza, mostly H1N1, in South America right now seems no more severe than ours was, but ours is already here in Georgia, Florida, Mississippi, and South Carolina in numbers unusual for this time of year. The H1N1 vaccine which may be available in October may take 5 weeks from the first shot and the administration of a second shot to provide immunity in children and possibly even young adults. Vaccine testing is still in progress. Antiviral medication works only if started in the first 48 hours of illness. If each of us takes our responsibilities seriously it will be better than if we don’t. So everyone needs to listen to the guidelines and recommendations as they emerge. As usual I recommend staying aware of the Massachusetts Department of Public Health and the CDC websites.

Critical web links:

http://www.cdc.gov/h1n1flu the main CDC page for flu info

http://publichealth.blog.state.ma.us/h1n1-swine-flu/ mass public health info