Swine flu expected to reappear this fall

by Dr. David Shinstrom

A Presidential advisory group of the nation’s leading scientists and engineers released a new report on Aug. 24 assessing the Obama Administration’s preparations for this fall’s expected resurgence of 2009 influenza A (H1N1) flu (swine flu). They outlined key steps officials can take in the coming weeks and months to minimize the disease’s impact on the nation. The swine flu is different from the usual seasonal flu.

The report concludes that the 2009-H1N1 flu is not likely to resemble the deadly flu pandemic of 1918-19. But in contrast to the benign version of swine flu that emerged in 1976, the report says the current strain “poses a serious health threat” to the nation. The issue is not that the virus is more deadly than other flu strains, but rather that it is likely to infect more people than usual because it is a new strain against which few people have immunity. This could mean that doctors’ offices and hospitals may get filled to capacity.

With schools back in session in the next few weeks the expectation is that there will be an increase in the number of cases since, unlike previous flu seasons, this swine flu has persisted through the summer months. In the United States a total of 7,983 hospitalizations and 522 deaths associated with 2009 influenza A (H1N1) virus have been reported to CDC.

Symptoms of the flu include fever, lethargy, lack of appetite, sore throat and coughing. Steps to reduce the risk of infection are the same as for any viral illness: frequent hand washing, covering your nose and mouth when you cough or sneeze, and avoiding close contact with sick people. If you think you may have the flu, either swine flu or seasonal flu which have the same symptoms, wear a mask to reduce the risk of transmission and limit your exposure to others in the community.

A vaccine against 2009 influenza A (H1N1) is in the testing stage but is unlikely to be available before mid-October and the number of vaccines will quite limited. CDC has issued guidelines targeting high risk persons who should have priority receiving this vaccine. These include pregnant women, persons who live with or provide care for infants aged under six months (e.g., parents, siblings, and daycare providers), health-care and emergency medical services personnel, persons aged six months to 24 years, and persons aged 25 to 64 years who have medical conditions that put them at higher risk for influenza-related complications. As noted above, the swine flu virus is different from the annual seasonal flu. Flu vaccine for seasonal flu will be readily available by the beginning of October.

There are medications that are at times used to treat the flu. Oseltamivir (Tamiflu) is a pill taken twice a day for five days. There has been increasing resistance by the swine flu to this medication. Zanamivir (Relenza) is given by inhalation. Thus far there has been no resistance to this medication but there is a concern that with increased use, resistance may develop.

For more information visit the CDC site at www.flu.gov.

Dr. David Shinstrom is a physician at Orcas Family Health Center in Eastsound.