Wednesday, December 16, 2009

the FLU

This week I began to see signs, you know those yard signs, at clinics, drug stores and libraries, advertising both seasonal and H1N1 flu vaccines, either free or for 25 dollars and anyone could come in and get it. Even with a substantial recall of a certain batch of a certain company's doses, we still have plenty to go around. (that recall was for potency NOT safety)

I did not see any lines for the vaccine, though there were some in the past months. We now have supply and less demand. Sounds familiar. My fear is that we end up throwing it out. Of course, this is not compelling me to go and get either vaccine.

In a way, I do a disservice to my profession by saying that, but I do not want it. That does not mean you shouldn't get it.

I do have some relevant and trusted information to share with you from Medscape and an infectious disease expert in the US, Dr. John Bartlett.

There are 11 monitoring or surveillance systems in place for the vaccines including the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink. According to these sources, there were very few events reported, with 204 incidents out of 46 million doses. There was a higher rate for both any reaction and serious reaction with the H1N1 vaccine than the seasonal flu vaccine. This could be related to reporting more than actual incidents. There were 13 deaths reported after the vaccine was given, but remember, that does not mean the vaccine caused it. For example, someone died in a car crash.

There are some interesting things to know about anti viral medications. The available antivirals are by brand name, Tamiflu, Relenza and Flumadine. Their efficacy in treating symptoms is associated with the type of flu. It is important to know which flu strain a patient has before prescribing an antiviral. In recent cases where resistance to Tamiflu was found, it was in patients who had been exposed to that medicine in the past, so it may be the right drug to use in persons with swine flu who have not been previously exposed to it. (therefore, don't take it for minor things!)

It is thought that of the 22 million Americans who have been infected with H1N1, 3900 have died and 198 were children. Most of the time it is a bacterial infection that caused the death. This is important. The infection can be treated if identified soon enough.

In an evaluation of some data out of Australia, a clear difference in who was hospitalized because of serious complications with H1N1 than seasonal flu was noted. For example, the median age of those admitted was 43 and of those who died, 53. With regular flu, most deaths occur in the elderly. This may not repeat itself in the US, but it is something to consider.

The second wave of H1N1 has died down, though it is still considered at epidemic levels (affecting many people at the same time). There may or may not be a third wave. We have not yet had an uptake in seasonal flu. Health experts fear that the two strains of flu will occur together and complicate treatment efforts.

It is recommended and strongly encouraged by health agencies that persons get a vaccine for both strains. Only persons who had the H1N1 flu (proved by testing) can skip that vaccine.

Oh, the flu is approaching its 50th week and in this time, 99 percent of the cases that were tested for subtype WERE the swine flu - or more technically 2009 Influenza A (H1N1).

Eat right, exercise, sleep, drink water, wash your hands, cough into your elbow... etc..

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