School H1N1 Virus Info

This 25th October, 2009

Salaam Alaikum

Swine Flu (H1N1) Update #2

The H1N1 (Swine Flu) virus has been active throughout the summer months in N. America but at a low level. However, as expected, the activity has increased in the past month and the severity of the illness has also increased. This is the time for the common seasonal flu activity as well and this is also the FLUSHOT season.

CONTAGION
• All influenza viruses spread from person to person in respiratory droplets of coughs and sneezes.
• These viruses are also acquired by touching contaminated objects – door handles or someone’s hands- and then touching your face. (The virus can stay alive up to 3 days on the surface of objects if left alone)
• An infected person is contagious 1 day before symptoms appear until 1 day after fever has disappeared.
• Symptoms generally appear 1-4 days after getting infected.

PREVENTION
• Practice good hand hygiene all the time. Wash hands with soap and warm running water for at least 15 seconds. Alcohol-based hand sanitizers are also effective where soap and water is not available. Avoid touching eyes, mouth and nose with unwashed hands.
• Avoid crowds and stay at least 6 feet from people who are coughing and sneezing. Parents should plan to do their grocery shopping at 7:00 am.
• Practice respiratory etiquette. It is important to cover your mouth and nose with a tissue when you cough or sneeze. If a tissue is not available, cough in your sleeve or elbow, not into your hands.
• Stay at home if you develop symptoms of a cold and return to school after you have been without fever for at least 24 hours.

INFLUENZA VS COMMON COLD
• Children with the common cold normally have nasal congestion, cough and low grade fever. On the other hand, children who catch the influenza virus usually develop a high fever of sudden onset, cough and mild nasal congestion. Older children and adults may complain of severe headache, muscle ache and sore throat. The symptoms of influenza are usually severe enough to make one stay in bed for a few days. Those with chronic medical conditions often need to be hospitalized. Please note that influenza virus is different from the common “stomach flu virus”.
• Seek emergency medical attention for children with signs of respiratory distress. This includes rapid breathing, blue lips, excessive sleeping, irritability esp. when held and seizures.

HIGH RISK PATIENTS
• Unlike the seasonal influenza virus that normally affects elderly patients more severely, the H1N1 virus tends to have a liking for younger people. At highest risk are pregnant women, children under 18 years of age and people under age 65 with any chronic medical conditions. From Aug.30th to October 22, 2009 there have been 53 pediatric deaths in the U.S. caused by H1N1 virus- more than 80% of these were in the age group 5-17. This is significantly higher than the 40-50 deaths that normally occur every year from the seasonal influenza virus. The total number of death from H1N1 in N. America was 947 up to Oct.22nd.

THE FLUSHOT
• Vaccination is the best protection we have against influenza. This year we have 2 different vaccines. One against the H1N1 virus and the second one provides protection against the seasonal influenza viruses. Both should be taken for full protection. Health Canada and the CDC have stated that both can be given safely at the same time (of course at 2 separate sites). Children under age 10 years will need 2 vaccinations 4 weeks apart. Since infants under 6 months of age cannot get the flu shot, all household members and caretakers of such infants should be fully-immunized. Anyone allergic to eggs should not receive the flu shot.

There have been a few negative statements on the internet regarding the safety of the H1N1 vaccine. All the published articles in respected medical journals have not identified any cause for concern. In fact, the adjuvant used in the current H1N1 vaccine has been used in Europe since 1997 with more than 40 million doses administered. The Hospital for Sick Children Infectious Disease Department and Health Canada fully support the safety of the vaccine. Finally, the vaccine is not derived from pigs.

For further info you can visit the Ontario Ministry of Health Website at www.health.gov.on.ca and the Centre for Disease control at www.cdc.gov

Prepared by;
Dr. Hyder Fazal, Pediatrician
Lecturer ,University of Toronto