H1N1 Influenza: Who's Afraid of the Big Bad Wolf?
You're waiting in line at the grocery store. The person ahead of you keeps coughing, that deep cough that sounds like it comes from the bottom of her lungs. She's wearing sweats, and looks a little pale, like she doesn't feel well. You look around. Everyone else is just standing in line, but you feel a little panicky. Could you get the swine flu from this person? What will happen then?
Well, the answer is yes, you could possibly get the swine flu (we'll call it H1N1 from here on out) from this person, but it's not that likely, and you do have ways to protect yourself. So why are some people, and apparently the CDC, so worried about H1N1?
H1N1 is what's called a novel virus. As far as we know, this exact strain is completely new. So no one is immune to it already. Well, that may not be strictly true. Scientists have observed since the beginning of the H1N1 epidemic that people over 64 have a much lower attack rate of H1N1 than do younger people (http:/www.cdc.gov/h1n1flu/65andolder.htm) The implication? People over 64 have been exposed to a similar strain of influenza, perhaps in the distant past. Blood tests on immunity in people over 64 support this conclusion (http://www.cdc.gov/h1n1flu/65andolder.htm). In any case, for the majority of people, this is a brand new flu.
H1N1 has a high transmission rate. It seems to be more communicable than most seasonal flu. That's another concern. H1N1 has also been deadly, especially to very young children, pregnant women, and those with underlying respiratory or metabolic diseases (such as diabetes). (http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm; http://www.cdc.gov/h1n1flu/highrisk.htm)
The main reason the CDC has gotten so concerned about H1N1 is that it has reached pandemic stage, and it did so in the Northern Hemisphere's summer-not the usual influenza pattern. Pandemic stage means there has been human-to-human transmission on an ongoing basis in more than two countries in different regions of the globe (http://www.cdc.gov/h1n1flu/background.htm). The spread of H1N1 in the summer months suggests that it may not slow down even when next summer hits. Those two factors mean an awful lot of people around the world may get H1N1 and some may die.
OK. Let's step back and take a deep breath. First of all, if you're not pregnant, under the age of two, or with underlying health problems, you are not at much risk of dying from H1N1. For most people H1N1 is no more to be feared than any other seasonal flu, which most folks don't get very worked up about. It should be noted that every year thousands of people die from seasonal influenza. Why doesn't that make the news? Most of those people are elderly, many in nursing homes. With H1N1, young people have died. That makes the news. Secondly, if you are in one of the above groups, vaccine is now available and it appears to be both safe and effective. Thirdly, if you're in one of the above groups and you do get sick, or if you're not but for some reason you get severely ill, antiviral medications such as Tamiflu are effective against H1N1. The death rate in the U.S. from H1N1 has been 877 confirmed deaths from August 30 to November 7, 2009 (http://www.cdc.gov/flu/weekly/index.htm#MS).
Who else should get vaccinated against H1N1? People who care for infants under the age of 6 months, because infants that age are at high risk of complications and cannot receive the vaccine; everyone from 6 months to age 24, because they have the highest attack rate; health care workers (who are notoriously bad about getting flu shots and about going to work when they are sick (http://www.cdc.gov/h1n1flu/vaccination/vaccine_keyfa cts.htm) and close contacts of people with severe respiratory illness or immune disorders or people on chemotherapy, so that they don't give H1N1 to these people. It is not recommended for people over the age of 64 to get the vaccine at this time, because they appear to have high immunity and we need the vaccine for high risk groups.
Other ways to stay healthy are: avoid people who are coughing and/or have a fever, like that person in the grocery store checkout line, wash your hands or use an alcohol-based hand cleanser after being near other people or touching commonly used surfaces like doorknobs, computer keyboards, phones, etc., avoid touching your face, get extra rest, stay well hydrated and eat nutritious foods.
What if you get sick? Guidelines on this are widely available from local health departments, doctor's offices, and the CDC (http://www.cdc.gov/flu/whattodo.htm), but to sum it up, if you're in one of the high risk groups, get an appointment with your doctor. If you become severely ill with difficult or rapid breathing, mental confusion, severe vomiting or diarrhea, go to the emergency room. If neither of the above applies, stay home, drink lots of fluids, take Advil or Tylenol for fever and aches and pains, and wait it out like you would any flu. DO NOT go out in public (except to go to the doctor, perhaps) until it has been 24 hours after your last temperature over 100.5, without Tylenol or Advil, or for seven days after you became sick, whichever is longer. Schools and workplaces should not be giving you any trouble about this.
So, H1N1, although it has some scary aspects, should not be something to strike fear into your heart. Arm yourself with knowledge, get the vaccine if you are eligible, and take care of yourself and those you love with good old-fashioned common sense, and you should get through this pandemic with nothing to worry about.