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Health & Medicine

2009-11-01 15:55:00

H1N1 - series

: What are the symptoms of H1N1 swine flu? Answer: The symptoms of H1N1 are like regular flu symptoms and include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu have had diarrhea and vomiting. Nearly everyone with flu has at least two of these symptoms. But these symptoms can also be caused by many other conditions. That means that you and your doctor can’t know, just based on your symptoms, if you’ve got swine flu. Health care professionals may offer a rapid flu test, although a negative result doesn’t necessarily mean you don’t have the flu. Like seasonal flu, pandemic swine flu can cause neurologic symptoms in children. These events are rare, but, as cases associated with seasonal flu have shown, they can be very severe and often fatal. Symptoms include seizures or changes in mental status (confusion or sudden cognitive or behavioral changes). It’s not clear why these symptoms occur, although they may be caused by Reye’s syndrome. Reye’s syndrome usually occurs in children with a viral illness who have taken aspirin…something that should always be avoided. Only lab tests can definitively show whether you’ve got swine flu. State health departments can do these tests. But given the large volume of samples coming in to state labs, these tests are being reserved for patients with severe flu symptoms. Currently, doctors are reserving antiviral drugs for people with or at risk of severe influenza. Question: Who is at the biggest risk for H1N1? Answer: Most U.S. cases of H1N1 swine flu have been in children and young adults. It’s not clear why, and it’s not clear whether this will change. But certain groups are at particularly high risk of severe disease or bad outcomes if they get the flu: • Pregnant women are six times more likely to have severe flu disease than women who are not pregnant. • Young children, especially those under 2 years of age • People with cardiovascular conditions (except high blood pressure) • People with liver problems • People with kidney problems • People with blood disorders, including sickle cell disease • People with neurologic disorders • People with neuromuscular disorders • People with metabolic disorders, including diabetes • People with immune suppression, including HIV infection and medications that suppress the immune system, such as cancer chemotherapy or anti-rejection drugs for transplants • Residents of a nursing home or other chronic-care facility • Elderly people are at high risk of severe flu disease…if they get it. Relatively few swine flu cases have been seen in people over age 65. People in these groups should seek medical care as soon as they get flu symptoms. A striking number of adults who developed severe swine flu complications have been morbidly obese. However, obesity itself does not seem to be the issue. The vast majority of extremely obese people suffer respiratory problems and/or diabetes, which seem to be the underlying reason for their severe flu complications. Question: I think I have swine flu, what shou

Answer: Swine flu, also known as 2009 H1N1 influenza, is a human disease. People get the disease from other people, not from pigs. The disease originally was nicknamed swine flu because the virus that causes the disease came to humans from pigs. The virus contains genes from swine, bird, and human flu viruses. Scientists are still arguing about what the virus should be called, but most people know it as the H1N1 swine flu virus. The swine flu viruses that spread among pigs aren’t the same as human flu viruses. Swine flu doesn’t often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs. But the current “swine flu” outbreak is different. It’s caused by a new swine flu virus that has changed in ways that allow it to spread from person to person…and it’s happening among people who haven’t had any contact with pigs. That makes it a human flu virus. To distinguish it both from flu viruses that infect mainly pigs and from the seasonal influenza A H1N1 viruses that have been in circulation for many years, the CDC calls the virus “2009 H1N1 virus.” Many people have at least partial immunity to seasonal H1N1 viruses because they’ve been infected with or vaccinated against this flu bug. These viruses “drift” genetically, which is why the flu vaccine has to be tweaked from time to time. But the H1N1 swine flu is not the usual “drift variant” of H1N1. It’s come to humans from a different line of evolution. That means very few people have any natural immunity to H1N1 swine flu. The normal seasonal flu shot offers no protection against this new virus. Some people who may have had seasonal H1N1 flu before 1957 might have a little bit of protective immunity against the new virus. That’s because seasonal H1N1 flu strains that circulated before 1957 (and which were replaced by the 1957 pandemic flu bug) were genetically closer to the 2009 H1N1 swine flu. This protection, if it truly exists, is not complete. While relatively few elderly people have had H1N1 swine flu, many of those who did get the disease became severely ill. Question: What are the symptoms of H1N1 swine flu? Answer: The symptoms of H1N1 are like regular flu symptoms and include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu have had diarrhea and vomiting. Nearly everyone with flu has at least two of these symptoms. But these symptoms can also be caused by many other conditions. That means that you and your doctor can’t know, just based on your symptoms, if you’ve got swine flu. Health care professionals may offer a rapid flu test, although a negative result doesn’t necessarily mean you don’t have the flu. Like seasonal flu, pandemic swine flu can cause neurologic symptoms in children. These events are rare, but, as cases associated with seasonal flu have shown, they can be very severe and often fatal. Symptoms include seizures or changes in mental status (confusion or sudden cognitive or behavioral changes). It’s not clear why these symptoms occur, although they may be caused by Reye’s syndrome. Reye’s syndrome usually occurs in children with a viral illness who have taken aspirin…something that should always be avoided. Only lab tests can definitively show whether you’ve got swine flu. State health departments can do these tests. But given the large volume of samples coming in to state labs, these tests are being reserved for patients with severe flu symptoms. Currently, doctors are reserving antiviral drugs for people with or at risk of severe influenza. Question: Who is at the biggest risk for H1N1? Answer: Most U.S. cases of H1N1 swine flu have been in children and young adults. It’s not clear why, and it’s not clear whether this will change. But certain groups are at particularly high risk of severe disease or bad outcomes if they get the flu: • Pregnant women are six times more likely to have severe flu disease than women who are not pregnant. • Young children, especially those under 2 years of age • People with cardiovascular conditions (except high blood pressure) • People with liver problems • People with kidney problems • People with blood disorders, including sickle cell disease • People with neurologic disorders • People with neuromuscular disorders • People with metabolic disorders, including diabetes • People with immune suppression, including HIV infection and medications that suppress the immune system, such as cancer chemotherapy or anti-rejection drugs for transplants • Residents of a nursing home or other chronic-care facility • Elderly people are at high risk of severe flu disease…if they get it. Relatively few swine flu cases have been seen in people over age 65. People in these groups should seek medical care as soon as they get flu symptoms. A striking number of adults who developed severe swine flu complications have been morbidly obese. However, obesity itself does not seem to be the issue. The vast majority of extremely obese people suffer respiratory problems and/or diabetes, which seem to be the underlying reason for their severe flu complications. Question: I think I have swine flu, what should I do? When should I see my doctor? Answer: If you have flu symptoms, stay home, and when you cough or sneeze, cover your mouth and nose with a tissue. Afterward, throw the tissue in the trash and wash your hands. That will help prevent your flu from spreading. If you can do it comfortably, wear a surgical mask if you must be around others. If you have only mild flu symptoms, you do not need medical attention unless your illness gets worse. But if you are in one of the groups at high risk of severe disease, contact your doctor at the first sign of flu-like illness. In such cases, the CDC recommends that people call or email their doctor before rushing to an emergency room. But there are emergency warning signs. Children should be given urgent medical attention if they: • Have fast breathing or trouble breathing • Have bluish or gray skin color • Are not drinking enough fluid • Are not waking up or not interacting • Have severe or persistent vomiting • Are so irritable that the child does not want to be held • Have flu-like symptoms that improve but then return with fever and a worse cough • Have fever with a rash • Have a fever and then have a seizure or sudden mental or behavioral change. Adults should seek urgent medical attention if they have: • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting • Flu-like symptoms that improve, but then come back with worsening fever or cough Keep in mind that your doctor will not be able to determine whether you have H1N1 swine flu, but he or she may take a sample from you and send it to a state health department lab for testing to see if it’s swine flu. If your doctor suspects swine flu, he or she would be able to write you a prescription for Tamiflu or Relenza. These antiviral medications aren’t a question of life or death for the vast majority of people. Most U.S. swine flu patients have made a full recovery without antiviral drugs.