Q&A on seasonal flu and H1N1

Posted Nov. 16, 2009, at 12:38 p.m.

In this new series, the Bangor Daily News and infectious disease experts at Eastern Maine Medical Center and the City of Bangor, Health and Community Services Department, will provide answers to the questions you have about H1N1 and seasonal influenza. Each week, we will collect the questions you send us and provide answers to allow you to know what to do and how to protect yourself from influenza.

The following responses were prepared by Donna Dunton, RN, CIC, director of Infection Control, Eastern Maine Medical Center.

How safe is the H1N1 vaccine and how do we know it is safe?

A: Because the H1N1 strain is very similar to the seasonal influenza, the H1N1 vaccine was developed using the very same technology and processes. In addition, the vaccine has undergone intensive study in different age groups.

Experts feel that this vaccine is as safe as the vaccine that is given annually for seasonal flu. When a vaccine such as the H1N1 vaccine is given, the body mounts an immune response (defense) and therefore, some individuals may experience mild flu symptoms. Other people may have injection site reactions such as itching, rash or mild blistering. Most often, these reactions are mild and temporary. Furthermore, there are ongoing studies of the vaccine to further ensure its safety.

Should everyone get an H1N1 flu shot or only people at risk because of age and illness?

A: The H1N1 virus is a novel strain, and it is unlikely that any of us has had any exposure to it. Consequently, the majority of people will have no defense against it if exposed. Therefore, most people should be vaccinated against it. However, because the production of the vaccine has been very slow and certain people are at particularly at risk for complications from influenza, these high-risk groups are the first to receive the vaccine.

People who are categorized as high risk include: the very young whose immune systems are not completely developed, pregnant women, and individuals with coexisting conditions such as heart disease, chronic lung disease, liver disease, kidney disorders and people who have immune deficiencies such as people with cancer and/or HIV/AIDS. These are the people in whom H1N1 flu has been most severe and has caused some deaths. Eventually, when the quantities of the vaccine are sufficient, all people without contraindications should be vaccinated.

Are there people who should not get the vaccine?

A: People who have experienced a severe allergic reaction to a prior dose of influenza vaccine or have had a severe allergy to a vaccine component (such as egg protein) should not be vaccinated. People who have a moderate or severe acute illness should wait until their condition improves.

People who have a chronic condition such as asthma, heart disease, diabetes or kidney disease, or those with immunosuppressed conditions such as HIV/AIDS, and pregnant women should not receive the nasal spray which is a live attenuated virus vaccine (LAIV). Also children under 2 years of age and adults older than 49 years of age should not receive the nasal spray. Patients who have developed Guillain-Barré syndrome within 6 weeks of receiving a previous influenza vaccine should avoid getting the vaccine, either the injection or the nasal spray

What’s the best way to avoid getting the flu?

A:The best way to avoid getting the flu is to practice good hygiene including: washing your hands frequently, and/or using alcohol-based hand gels, coughing and sneezing into a tissue or your sleeve. If you use a tissue, throw it away. Avoid being near people who are sick. Get plenty of rest, eat nutritious foods and drink plenty of fluids (eg, water, fruit/vegetable juices). If you do become sick, stay home and avoid spreading the virus to other people. People are advised to stay home until they have gone 24 hours without a fever and without fever medication.

What are hospitals doing to keep their patients safe from the flu?

A: Eastern Maine Medical Center has a number of policies in place to reduce the risk of transmission of any infectious disease, including influenza. These policies are well-known to staff and compliance with them is mandatory and has been an expectation for many years. In addition, EMMC has taken a number of additional steps to protect its patients and staff from influenza this season. Visitors to the medical center are asked to wash their hands and/or use the hand gel dispensers located throughout the hospital. Visitors to the Pediatric and Obstetrics units are screened for flu symptoms (fever, cough, sore throat).

If an individual has those symptoms, he/she will not be allowed to visit vulnerable patients. Patients who have flu symptoms are asked to use face masks, and staff who are evaluating symptomatic patients also wear masks. The hospital has designated specific areas where patients with flu symptoms can be evaluated without exposing other patients to the virus (seasonal or H1N1). Signs throughout the hospital remind patients and staff about the importance of hand hygiene and respiratory etiquette.

Finally, EMMC is offering vaccine to pregnant women at vaccine clinics at its Healthcare Mall on Union Street. Other high risk groups will be offered vaccine as it becomes available and as recommended by Maine Center for Disease Control and Prevention.

Have a question about H1N1 or seasonal flu? Ask it in the comments section below.

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