The Swine Flu. Novel H1N1. S-OIV. 2009 H1N1 Influenza. Whatever you want to call it, it’s out there and wreaking havoc. Out of season and out of control, swine flu appears determined to stay, at least for a while. No need to panic, however, as most of us, swine or not, will survive. Here is a little Q & A that may help you avoid the virus and take the appropriate action if you pick it up.
1. What is Swine Flu? It is a viral infection caused by a new type of influenza A virus, first detected in April of this year. Because it is new, most people lack immunity to the virus and it has spread worldwide, prompting the World Health Organization (WHO) to declare a “pandemic” state on June 11, 2009. Although it shares some genetic components with influenza viruses known to infect pigs, it is a distinct virus, so it has most recently been referred to as the “2009 H1N1 Influenza A Virus” by the Centers for Disease Control and Prevention (CDC).
2. How do you get it? Similar to most other influenza viruses, 2009 H1N1 typically spreads from person to person via droplets produced during coughing or sneezing. Touching virus contaminated surfaces then touching your nose or mouth may also lead to infection.
3. What are the symptoms? Again, in most cases very similar to seasonal influenza, familiar to most of us. Relatively sudden onset of high fevers, cough, sore throat, body aches, joint pains, chills, and headache are typical symptoms. Nausea, vomiting or diarrhea may also be noted in some cases. In general, the symptoms, though similar to the common cold, tend to be more severe.
4. Oh no! I think I got it. What do I do? An otherwise healthy adult can usually manage the infection at home. Medicine for fever and pain such as acetaminophen or ibuprofen, rest and adequate hydration are recommended. Recovery should occur in 3 to 7 days. For children under 5 years of age and anyone with chronic health problems (see below) it is best to consult a physician for the best course of action.
5. Shouldn’t I go to the doctor and get tested? A rapid test is available at many clinics and hospitals. The ability of such tests to pick up influenza infection is quite variable. Sensitivity (the ability to return a positive result when the patient actually has the disease) may be anywhere from 10% to 70%. Thus the test may be negative even if you have influenza, and such a result should not be relied upon to exclude the possibility of influenza. Rapid tests can only tell if you have influenza A, and cannot distinguish between seasonal influenza A and 2009 H1N1 Influenza A. Final diagnosis of influenza should be made based on the clinical symptoms in addition to any tests results. A negative rapid test result should not be the sole basis of a decision to return to work or school.
6. I’m not getting better. What should I do? Although most healthy people recover without any problems, a small percentage of people will develop more severe symptoms. If you have any of the following “danger signs” (per WHO) please seek medical attention immediately.
DANGER SIGNS:
Shortness of breath / difficulty breathing
Turning blue
Bloody or colored sputum
Chest pains
Changes in alertness/mentation
High fever that persists beyond 3 days
Low blood pressure
7. Do I have to take medication? Again, most healthy people should do fine with over-the-counter medications for the symptoms and do not require antiviral medications (oseltamivir or Tamiflu® and zanamivir or Relenza®). Early use of such drugs is recommended for high risk patients (see below). Previously healthy people who develop severe respiratory symptoms should also consider the use of antivirals. Isolated reports of viral resistance to oseltamivir are emerging. Physicians in Japan are quite liberal in their prescribing of antivirals, but it is unclear if this is the reason behind the relatively low mortality rate thus far.
8. I have other health problems. What do I do? If you fall into one of the “high risk” categories, consultation with a physician is recommended. This would include anyone with chronic lung, heart, kidney, liver, neurologic, muscular, hematological (blood), or metabolic diseases. Persons with asthma, diabetes, or those who have had heart attacks or strokes would fall into this group. In addition, children younger than 5 years, adults older than 65 years, immunosuppressed patients, and pregnant women are considered high risk. Those 19 years and younger who are on long-term aspirin therapy are also at increased risk and should consult a physician.
9. Can I go to work/school? It is recommended that you stay home until you have no fever without the use of medication for at least 24 hours.
10. Isn’t there a vaccine? A vaccine has been developed in several countries including Japan. Availability in Japan is expected to be sometime in October 2009, but due to the limited supply administration will be prioritized and restricted to certain facilities. The average healthy person may have difficulty obtaining the vaccine. Also, there is a possibility that by the time the vaccine is available, peak spread of 2009 H1N1 will have already passed.
11. How ‘bout those masks? Although the CDC does recommend use of a mask when caring for a person with influenza, there is no good evidence that a mask will protect you from infection. If you have the flu, however, a mask may help limit spread of the disease to others. Covering your cough and washing your hands remain the best ways to prevent spread of the disease.
12. How about the seasonal flu? Annual flu season is coming up in Japan and is expected to be no different from previous years. Vaccination for seasonal influenza is recommended for most people as in the past. This is a different vaccine from the vaccine for 2009 H1N1 Influenza and will not protect you from 2009 H1N1. Unfortunately, there may be a shortage of seasonal flu vaccine in Japan due to early conversion of vaccine production to the 2009 H1N1 vaccine. Seasonal influenza vaccine is expected to be available in October.
13. Do I have to stop eating tonkatsu? In terms of “swine flu”, no, since you cannot catch this flu from pigs or from eating pork. Looking at that belly of yours, however, yes.
14. Will Wilbur be OK? Your pet pig, ironically, is not susceptible to “swine flu”, so he should be fine.
15. How are the Nippon Ham Fighters doing? They’re in first place, despite several members contracting “swine flu”. Being the Hams that they are, however, they wasted time, money and precious test kits by testing the entire team, including those with absolutely no symptoms. “Shinjirarenai!”
The situation with 2009 H1N1 Influenza is ever changing, and you are likely to get conflicting advice from a variety of sources. WHO and the CDC are generally reliable sources, though their perspective may not match the local situation in Japan. So keep your eyes and ears open, your mouth covered, wash those hands, and you too shall survive Swine-Oh-Nine.
Dr Kurosu blogs privatley on behalf of GaijinPot. For more health advice please check: http://www.pctclinic.com/
