Globally, teenagers and young adults continue to account for the majority of cases, with rates of hospitalization highest in very young children.
As of 8 November 2009, worldwide more than 206 countries and overseas territories or communities have reported more than 500,000 laboratory confirmed cases of pandemic influenza H1N1 2009, including over 6250 deaths
WHAT ARE ANTIVIRAL DRUGS?
Antiviral drugs are medicines that act directly on viruses to stop them from multiplying.
ARE ANTIVIRAL DRUGS USED FOR TREATMENT OF PANDEMIC (H1N1) 2009 INFECTION?
Yes, two antiviral drugs are being used to treat pandemic (H1N1) 2009 infection. These are TAMIFLU and RELENZA
WHAT IS THE GENERAL GUIDANCE ON THE USE OF ANTIVIRAL DRUGS?
Early treatment, preferably within 48 hours after the first sign of symptoms, appears associated with better clinical outcome.
ARE ANTIVIRAL DRUGS SUITABLE FOR EVERYONE?
Antivirals should only be used when prescribed by a qualified health care provider, as they will be able to assess each situation and make the appropriate decisions on care.
All patients (including pregnant women) and all age groups (including young children and infants) should be treated with TAMIFLU in the event of severe or deteriorating illness. Treatment with either TAMIFLU or RELENZA should also be offered to all patients in at-risk groups in the event of illness, even if mild or uncomplicated.
WHAT IS MEANT BY AT-RISK GROUPS?
Individuals that have been identified as “at-risk” of more complicated or severe illness associated with infection by influenza virus include:
1) Pregnant women (particularly in the later stages of pregnancy);
2) Infants and children (<5 years);
3) Patients with chronic health conditions, such as cardiovascular, respiratory or liver disease, or diabetes;
4) Patients with immunosuppression related to treatment for transplant surgery, cancer, or due to other diseases.
The elderly (>65) appear less susceptible to infection by pandemic H1N1 influenza virus, but are assumed to be at higher risk of more severe or complicated illness if infected.
IS IT NECESSARY TO WAIT FOR A LABORATORY RESULT BEFORE STARTING ANTIVIRAL DRUG TREATMENT?
No, if antiviral drug treatment is indicated by the clinical presentation, then treatment should start as soon as possible. If there is a delay, treatment may be less effective.
SHOULD INDIVIDUALS KEEP A PERSONAL STOCKPILE OF ANTIVIRAL DRUGS?
It is not recommended that individuals stockpile TAMIFLU.
SHOULD INDIVIDUALS TAKE ANTIVIRAL DRUGS FOR THE PREVENTION OF PANDEMIC (H1N1) 2009 INFECTIONS?
It is not recommended to use of antiviral drugs for prevention. For people who have had exposure to an infected person and are at a higher risk of developing severe or complicated illness, an alternative option is close monitoring for symptoms, followed by prompt early antiviral treatment should symptoms develop.
WHAT ABOUT THE VACCINE?
Influenza vaccines are one of the most effective ways to protect people from contracting illness during influenza epidemics and pandemics. The pandemic influenza is a new virus, and virtually everyone is susceptible to infection from it. These vaccines will boost immunity against the new influenza, and help ensure public health as the pandemic evolves.
ARE PANDEMIC VACCINES SAFE?
Outcomes of studies completed to date suggest that pandemic vaccines are as safe as seasonal influenza vaccines. Side effects seen so far are similar to those observed with seasonal influenza vaccines.
WHAT ABOUT SAFETY FOR PREGNANT WOMEN?
To date, studies do not show harmful effects from the pandemic influenza vaccine with respect to pregnancy, fertility, or a developing embryo or fetus, birthing or post-natal development. In view of the elevated risk for severe illness for pregnant women infected by the new influenza, in clinical studies, pregnant women are a group that should be vaccinated against infection, as supplies allow.
Recent studies show that infected pregnant women have a 10 times higher chance to require hospitalization in intensive care units than infected persons in the general population, and 7% to 10% of hospitalized cases are women in their second or third trimester of pregnancy. The benefits of vaccination far outweigh the risks.
Additional studies on pregnant women following immunization are continuing.
WHAT ABOUT MY CHILD'S SAFETY FROM A REACTION?
The most frequent vaccine reactions in children following influenza immunization are similar to those seen after other childhood immunizations (such as soreness at the injection site, or fever). A child's health care provider or vaccinator can advise on the most appropriate methods for relief of the symptoms. If there are concerns about a child's safety from a reaction, consult a health care provider as soon as possible.
Please note that a child may suffer from a condition not related to immunization, which coincidentally developed after vaccination.
WHAT ARE THE EXPECTED SIDE EFFECTS OF THE NEW VACCINES?
Some side effects can be associated with influenza vaccination. How often they result depends on the type of vaccine, how it is administered, and the age of the vaccine recipient. There are two main types of vaccines: one is manufactured with inactivated viruses, the other uses live viruses.
Inactivated vaccines, administered by injection, commonly cause local reactions such as soreness, swelling and redness at the injection site, and less often can cause fever, muscle- or joint- aches or headache. These symptoms are generally mild, do not need medical attention, and last 1 to 2 days. Fever, aches and headaches can occur more frequently in children compared to elderly people.
Rarely, such influenza vaccines can cause allergic reactions such as hives, rapid swelling of deeper skin layers and tissues, asthma or a severe multisystem allergic reaction due to hypersensitivity to certain vaccine components.
Live vaccines are given via a nasal spray, and can commonly cause runny nose, nasal congestion, cough, and can less frequently cause sore throat, low grade fever, irritability and head- and muscle- aches. Wheezing and vomiting episodes have been described in children receiving live influenza vaccines.
HAVE THEIR BEEN ANY REPORTS OF SERIOUS REACTIONS, OR ADVERSE EVENTS, TO PANDEMIC VACCINES?
As of late October, there is no indication at this stage that unusual adverse events are being observed after immunization, according to clinical trials and adverse event monitoring during deployment of vaccines in early introducer countries. The need for continued vigilance and regular evaluation by health authorities is ongoing.
CAN INFLUENZA VACCINATION CAUSE GUILLAIN BARRÉ SYNDROME?
Guillain Barré syndrome (GBS) is a rapidly developing, immune-mediated disorder of the peripheral nervous system that results in muscular weakness. Most people recover completely but some have chronic weakness. It can develop following a variety of infections, including influenza. In people who have been immunized with available vaccines, the frequency of GBS usually is the same as in unvaccinated people.
Extensive studies and data analysis of influenza vaccines have only found a well established causal association with the 1976 vaccine that contained an H1N1 swine-influenza-like virus. No other clear association has been found with either seasonal or other pandemic influenza vaccines.
HOW CAN A REPEAT OF THE 1976 SWINE FLU VACCINE COMPLICATIONS (GUILLAIN-BARRÉ SYNDROME) EXPERIENCED IN THE UNITED STATES OF AMERICA BE AVOIDED?
During the 1976 influenza vaccination campaign, about 10 persons per million vaccinated persons developed GBS.
The reason why GBS developed in association with that specific vaccine has never been firmly established. The potential for the development of a similar risk with future vaccines can never be totally excluded. However, pandemic influenza vaccines are manufactured according to established standards, and are similar to recent well-studied influenza vaccines that have shown no association with GBS. Surveillance after vaccines have been sold (post-marketing surveillance) is being conducted to look for potential developments of serious adverse events. Safety monitoring systems are an integral part of strategies for the implementation of the new pandemic influenza vaccines.
MOST FAMOUS 7 QUESTIONS ABOUT SWINE FLU
Scared of getting sick with the flu—or just sick of all the swine-flu hullabaloo? It’s easy to feel a little of both after months of H1N1 headlines dominating the news. To preserve your sanity as well as your health, it helps to sort the facts from the fables that have circulated about the world’s first pandemic flu in more than 40 years. Here are seven of the most common myths health experts are trying to dispel.
1- I AM HEALTHY, I DO NOT NEED TO WORRY
It’s true that most people infected with the new H1N1 virus have recovered fully without medical treatment. But this virus continues to show disturbing differences from run-of-the-mill flu viruses. First, it didn’t disappear over the summer. Historically, such persistence is a warning sign that a colossal fall and winter wave is in store. Second, this virus has caused more severe illness in those under 25 than in those over 65 years of age (the population that typically suffers some of the most serious cases of seasonal flu). That’s an indication that being in good health doesn’t assure protection against, yet it limits the possibility of serious—even deadly—complications.
For these reasons, the U.S. Centers for Disease Control and Prevention (CDC) continues to urge everyone to protect themselves by practicing good health hygiene and getting immunized when the H1N1 vaccine becomes available.
2- IT IS INEVITTABLE, BETTER TO GET IT OVER WITH
Heard of swine flu parties? Yep, they’re gatherings centered on deliberately catching H1N1 influenza from someone with a relatively mild case. Some people have concluded that this is a smart way to protect against a more severe infection caught down the line. Others may see catching swine flu as inevitable and simply want to control when they get it.
Both are wrong-headed approaches, according to the CDC. First, there’s no way to predict the course of anyone’s infection. The same flu virus that causes mild illness in one person can cause severe illness and dangerous complications in another. Second, there is no predicting how the H1N1 virus will mutate in the months ahead. Yes, it could become more dangerous. But it could also become less so.
3- I AM IMMUNE BECAUSE I’VE HAD IT
This is, in fact, true, but only if you were truly infected with H1N1. The problem is that few people are tested to identify the virus strain that made them sick. Your infection may have been an “ordinary,” or seasonal, flu. Even bad colds are often mistaken for flu. So even if you’ve been sick with a flu-like illness, the CDC recommends you still take steps to protect yourself.
4- VACCINE GUARANTEES PROTECTION
The H1N1 vaccine should reduce your risk of becoming infected. But no flu vaccine guarantees protection. Historically, even the best seasonal flu shots have provided only 70 to 90 percent protection, according to the CDC. The good news is that even if you still get the flu, you’ll have a lower risk for complications. Also early studies are showing H1N1 vaccines to be more effective than conventional flu shots, since it is more specifically targeted—with greater than 90 percent protection against this strain of the virus.
To reduce that final 10 percent of risk, continue practicing good infection-control habits. You know the drill: Wash hands often, avoid infected persons when you can, and be sure to get enough rest and drink plenty of fluids.
5- THE VACCINE CAN GIVE YOU THE FLU
This is the same misconception that has long dogged seasonal flu vaccines. In part, it may stem from the fact that some people are already coming down with the flu when they get vaccinated. Others may mistake a bad cold (a different virus) as a consequence of their flu shot.
In fact, the H1N1 vaccine—like all flu vaccinations—is prepared from bits of weakened or destroyed viruses. They can’t cause flu. But a vaccine can spark a slight fever and feelings of achiness, a sign that your immune system is responding to it.
6- ANTIBIOTICS CAN HELP
Fortunately, doctors today know better than to prescribe antibiotics for viral infections such as the flu. Antibiotics target bacteria, not viruses. Unfortunately, confusion tempts some people to dip into stashes of old antibiotics.
Don’t do it, the experts concur. Not only are antibiotics ineffective against the flu, they can have unwanted side effects. What’s more, their overuse can breed drug-resistant bacteria in your body and the environment.
7- IF I FEEL OKAY, I AM NOT INFECTIOUS
People with the flu usually don’t know it for the first 24 hours. During that time, they can spread the contagion. In addition, they remain infectious for around 24 hours after their temperature returns to normal without fever-reducing medicine. What’s more, a lucky few never develop fever or severe symptoms and, so, may not realize they’re infected and infectious.
This means that everyone needs to be practicing good hygiene (cleansing hands frequently and sneezing into a tissue or upper sleeve) even when they feel fine. And don’t rush yourself or family members back to work or school too soon.
This was a quick review of the answers we submitted for the questions we received from you on (Doctor on Phone) service. This service has been initiated by Bupa Arabia since one year to activate its unique role as a leader in healthcare when it made available the toll free number (800 440 4040) and dedicated an assorted team of its specialized doctors in different specialties to answer your medical queries.