The CDC’s weekly flu surveillance report shows the US death toll due to novel H1N1 flu has risen to 436, up from 353 a week ago. Flu activity continued its decline last week but still remained above normal for this time of year. Four states and Puerto Rico reported widespread flu activity, the same number as the week before. More than 98 percent of all sub-typed flu viruses were the novel H1N1. The CDC said 6,506 hospitalizations related to the virus have been reported.
The vaccine for H1N1 clinical trials started this week but it will be several weeks before the data can be summarized. The CDC has announced that state health departments will decide which providers will administer the H1N1 vaccine this fall. McKesson Corp., based in San Francisco will distribute the vaccine to about 90,000 sites designated by state health departments and the state HD will select the providers to administer the vaccine. The CDC further stated that the shipments are likely to begin about mid-October and will probably require two doses two or three weeks apart for each person. Requests from large employers who want vaccine for their workers may be considered but the initial target groups for immunization will be pregnant women, close contacts of babies under 6 months of age, healthcare and emergency medical workers, young people from ages 6 months through 24 years and non-elderly adults with chronic health conditions. Experts continue to predict that the activity of the novel H1N1 influenza will increase significantly when the fall season arrives. Many also fear that combination with the seasonal flu may increase the severity of the illness as well. CDC recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]), or signs of a fever without the use of fever-reducing medications.
A word on antiviral medications like Tamiflu…..At this point there has been no clear evidence that the H1N1 virus has developed any resistance to these medications. There is some evidence, however, that they may not be as efficatious in children and there may be some significant side effects in children as well.
Reportable studies on the effectiveness of Tamiflu in hospitalized patients have not been done so it’s value in very sick persons is not established. It is my professional opinion that if your physician will prescribe Tamiflu for you and your family, you should avail yourself of the opportunity. But, if you have Tamiflu in your medicine cabinet you should not administer the medication to yourself or your family until you consult with your physician.
It is clear that healthy adults over age 24 will not have priority on the H1N1 vaccine. It is unknown at this time when or if adequate H1N1 vaccine will be available for this age group. Assuming the vaccine will be produced and distributed by mid-October as planned you should take advantage of this by encouraging family members and friends who qualify to take the vaccine. The more members of your community who have been immunized (reducing the population that the virus can attack) the less exposure you will have to infected persons.
• You can reduce the exposure to non-eligible persons in a household (and thusly your own exposure) by promoting families in your community to take advantage of the H1N1 vaccine for:
• pregnant women
• parents of babies under 6 months of age
• children and young adults in the home over age 6 and under age 24
• Non-elderly adults with chronic conditions like asthma, cancer, etc.
• Encourage persons with influenza-like illness to stay home and not go to work
• Continue to stress the importance of personal hygiene (hand washing, etc.)
It appears there will adequate seasonal flu vaccine for all persons and you should see that you and your family receive the vaccine when it is available in your community. There may be some modicum of immunity conferred by the seasonal vaccine against the H1N1 virus….regardless; it may protect you from our seasonal flu bug.
[Dr. Prater, of Big Canoe, researches and tracks flu activity. He publishes a regular newsletter on the virus.]
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