SPECIAL REPORT—As of last week, the Center for Disease Control and Prevention (CDC) stated that 47 states (including Washington D.C. and U.S. territories) had reported 5,514 cases of the novel influenza A (H1N1) influenza virus, known by many simply as the “swine flu.” A total of 353 deaths had also been contributed to the virus.

According to the North Carolina Department of Health and Human Services (DHHS), the H1N1 vaccine is anticipated to be made available to the public sometime in October, however no set date has been given. There are five manufacturers of the vaccine listed, with the bulk of the vaccine doses to be injectable with a smaller supply of nasal spray vaccine. The vaccine will be given in two-dose intervals about one month apart and will not protect against seasonal influenza. Therefore, a third inoculation for seasonal flu will be required for the best protection against influenza this season. The CDC states that the annual vaccine for seasonal flu can be administered the same day as one of the two inoculations for H1N1 flu.

“We know that the H1N1 flu virus is very easily spread from person to person, and we know how it is spread,” Dr. Jeff Engel, the State Health Director stated in a videotaped message. “It is spread by the cough or sneeze that comes out of our nose or mouth, and on our hands. This is known as the droplet transmission or direct contact transmission through our hands. So the way to prevent spread is really easy. When you think about that. So if you have the sickness of flu you want to cover your nose and mouth when coughing or sneezing into a tissue. You want to throw that tissue away promptly, and wash your hands as soon as possible after that. You also want to, just in general, wash your hands frequently in the daytime whether or not you’re sick, which is always a good health practice.”

Engel encourages citizens to take note of flu-like symptoms such as coughing, sneezing, sore throat, and usually a fever greater than 100 degrees with headache, muscle aches and sometimes stomachache and diarrhea.  If symptoms become severe, such as worsening headache, chest pain, shortness of breath or a cough that won’t go away, these symptoms should be reported immediately to your doctor. Keep in mind that children can also become dehydrated quickly with persistent vomiting and diarrhea. Children should be given fluids regularly and if they are unable to keep fluids down, consult with your child’s pediatrician immediately. 

The CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that five categories of the general population be given the highest priority in receiving the H1N1 vaccine. Those are: pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency services personnel, persons between the ages of 6 months through 24 years of age and people from ages 25 through 64 years who are considered to be at high risk because of chronic health disorders or compromised immune systems.  While the CDC does not anticipate a shortage of the vaccine, an alternative plan to ration supplies has been announced.

While seasonal flu often poses a significant risk to people over the age of 65, studies have shown that those over 65 are less at risk than those in younger age groups. The CDC recommends that  

It is estimated that those listed as high priority number about 159 million people in the United States.

With the start of the 2009-2010 school year just a few weeks away, school and health officials are readying for what could be widespread infection of students throughout the public school systems and also in private schools, as well.

The CDC recommendations for schools and child care facilities are to see that children and faculty practice good hygiene and identify ill students and staff quickly, with those displaying symptoms to stay at home.  The CDC is not making recommendations for school closures unless a large number of absent students and/or faculty are affecting the school’s ability to function. Local authorities are being given discretion on these considerations.

The CDC is recommending that schools be vigilant in identifying and isolating sick students or faculty members in a separate room prior to being sent home. Those who appear to have the flu should stay at home except to seek medical care for at least 7 days even if symptoms resolve sooner. Symptoms should have resolved completely for 24 hours prior to returning to school. Students should not be placed in alternative childcare facilities while away from school. 

Aspirin or products containing aspirin should not be given to children suspected of having influenza due to the risk of Reye syndrome, a serious disease closely associated with children taking aspirin while feverish.

With concerns of a widespread, large-scale H1N1 viral outbreak among school-aged children, it is possible that state educators and health officials may consider vaccinations at schools to help alleviate rampant spread of infection. Ask your child’s school officials for more information. Vaccines for H1N1 will be available at hospitals, clinics, private providers and other venues. Public health departments will also be supplied.

For more information, visit the US Center For Disease Control and Prevention at www.cdc.gov/h1n1flu as well as find information about the novel H1N1 virus in North Carolina by visiting www.epi.state.nc.us/epi/gcdc/HN1N1flu.html.

Since the outbreak of H1N1 in the United States, most cases of the “swine flu” have been relatively mild with symptoms resolving within a few days. Tamiflu, an anti-viral medication specifically made for influenza has been shown to have some degree of improving symptoms. However, there have been reported cases of H1N1 that worsened with sufferers developing more severe respiratory disease such as pneumonia. People who suspect that they may have the flu (seasonal or H1N1) should consult with their physicians as soon as possible. Early treatment can often shorten the duration of the infection.