Update 01-16-10

We receive many questions regarding flu vaccine and swine flu vaccine, and would like to clear up often confusing or conflicting information. We recommend regular seasonal influenza (flu) vaccine annually for all children from 6 months through 18 years of age, as well as older patients attending college or living in dormitories. As of January 2010, we are still scheduling injectable and nasal versions of the seasonal flu vaccine. Children less than six months of age are too young to get either flu or swine flu vaccine, so we recommend that all household members be vaccinated in order to protect the infant.

The swine flu, or H1N1 strain of influenza, has been circulating in our area since June of '09, and after dropping off in the summer is came back at epidemic rates in late October. As of mid December, the H1N1 strain has really dropped off, but is still in our community at a low level, and is the only currently circulating strain of flu in our area. Therefore, we are still considering all children who exhibit classic symptoms of the flu to have H1N1. This strain is distinct from the regular circulating influenza (flu) strain, in that it has picked up some new genes from a strain which infects pigs. These new genes may make the strain capable of causing more severe illness in humans. So far this has not really been the case: while people infected with swine flu certainly get very sick and some have died, the illness is not qualitatively that different from regular human strains. The biggest concern of health officials is that this H1N1 strain will again combine with the circulating annual influenza strain and produce a "super germ" which is much more highly contagious and/or causes greater sickness and higher rates of death than either of the strains from which it came. Such a situation could lead to a "pandemic": a worldwide severe influenza infection. The feeling of health officials is that by vaccinating as many people as possible against both regular influenza and H1N1, or swine flu, we will not only prevent individuals from getting sick with either strain, we will prevent the spread of either strain to other people, and thus reduce the chances of producing a strong recombinant "super germ".

As of January 2010, the vaccine for H1N1 swine flu is now available in both injectable (no live virus) and nasal mist (live virus) forms, although it has been in quite short supply this fall. This lack of availability is tied to the fact that the H1N1 virus has been very difficult to grow in culture, the critical step in producing vaccine. And because vaccine manufacturers are still trying to make enough H1N1 vaccine for high risk groups, it has impacted production and availability of the regular seasonal flu vaccine. Call the Chester County Health Department now to schedule your H1N1 influenza vaccine! 610-344-5353. Keep trying until you get through! The CDC recommends that pregnant women, all children from 6 months through adults 24 years old, and those with certain high risk medical conditions receive the vaccine. Because cases of swine flu are still circulating through many parts of the community, we are recommending that anyone in these risk groups receive the swine flu vaccine. Time, staffing, and logistic constraints prevent All Star Pediatrics from offering swine flu vaccine at our office, but vaccination sites are being coordinated by the Chester County Health Department. See the excellent links below for more information and to sign up to be on the information distribution list from the county. Please note that children less than nine years old may need to receive two doses of vaccine.

The symptoms of regular influenza (flu) and H1N1 (swine) flu are the same: fever, cough, cold symptoms, muscle aches and pains, headache, etc. You just feel terrible! Children and adults get really sick-much more sick than a regular head cold-and often don't want to get out of bed, or just prefer to lay around and rest. Diagnosis of the flu and swine flu is generally made on the basis of the patient's symptoms, and testing is not usually necessary. Treatment involves use of fever reducers like acetaminophen or ibuprofen and plenty of fluids. There are antiviral medications (Tamiflu, Relenza) available for those who may be medically more vulnerable or have serious underlying disease, but these may only reduce symptoms a little bit, or shorten the illness by a day. The best treatment is to drink plenty of fluids, use fever reducers, and rest! Do not go out in public, including back to school, back to work, or to extracurricular activities. We try not to bring flu patients in to the office unless the illness seems more severe than the usual course, or there might be some complication, like pneumonia or dehydration. If you think your child has symptoms of the flu or the swine flu and the simple steps above are not helping, please call our office to further discuss their care.

The best treatment for influenza is not getting it in the first place! Make sure you and your children are vaccinated. Prevention simply involves avoiding excessive contact with people whenever possible, frequent hand washing, not sharing cups or utensils with anyone, and keeping your distance from someone who is coughing, sneezing or displaying cold symptoms or a fever. Think twice about attending family functions over the holidays if you or anyone in your family is sick, and be sure to ask others attending these functions if they are sick as well! This is exactly the sort of close contact that spreads influenza. If you suspect that you may have the flu, please stay home and do everything you can to prevent spreading the illness to others!


Flu.gov
Centers for Disease Control & Prevention
Chester County Health Department
H1N1 in PA (PA Dept of Health)