The Chairman of Emergency Medicine at Southampton Hospital on the difference between swine flu and typical flu, who should get a vaccine and why you shouldn’t rush to the ER.
What’s the difference between the H1N1 virus and the typical flu?
Clinically, they are not all that different. Patients have a high fever, muscle pain, classic flu symptoms. A headache and fever — they share that.
There are some differences in who it is affecting, and it has more to do with the fact the younger generation has never been exposed to this before. Usually the flu hits the older population worse. This variation, the H1N1 is hitting the younger generation worse.
What age group?
We’re seeing it in 20 to 40 year olds, with many in their early 20s. A lot of them are college age and are all living in dorms together. This one is concentrated in a lot of colleges. They’re the canary in the coal mine.
How do you determine the difference?
There is not much of a clinical difference; but there are tests specifically for H1N1
The normal flu dies out around February, but this year saw a spike in June. It was almost all swine flu. There’s almost no reason test. We saw a spike again when students went back to school.
The regular flu season starts in November and December and we don’t know if swine will continue into regular season.
Of those who contract H1N1, what is the percentage of those who die?
Extremely low, millions have gotten swine flu in America and very few fatalities. It’s not worse than a typical flu season. You don’t care if you’re 30 in ten million, but it tends to get a lot of media attention.
There is a lot of swine flu that goes undiagnosed. In Mexico, for example, it appeared there were a lot of deaths, and it looked horrible at first until they realized how many people actually had the disease.
And every flu season, a few healthy people will die.
What symptoms should we be looking for that are tell tale H1N1 symptoms?
What symptoms would send us to the emergency room?
It’s still the same, regardless of what flu you’re talking about. You ask, do I need to go to an ER? It will depend on the risk group you fall in. Most people need to stay home and take meds.
The guidelines are almost identical to the average flu. Clearly, if you’re having a problem breathing or experiencing confusion, go to the ER or contact your regular doctor.
A fever and aches don’t necessarily mean you should be going to the emergency room.
Are you at high risk? Have asthma, for example. Then you should. The very young or those with immune deficiencies, too. H1N1 is very typical in most respects.
What are the groups who should be getting the vaccine?
I personally believe everybody should — if you can get it. If for no other reason you don’t want to get the flu,
The very young and pregnant women are getting prioritized, then comes health care workers – because we’re exposed to a lot of sick people.
Is there a contagious shedding from those who receive the nasal mist?
It is a live virus and could cause you to shed the attenuated virus, which could make someone sick. There are some that cannot receive the live virus, those who do not have an intact immune system, for example.
How fast do you have take tamiflu, and how fast do you need to get tamiflu in your system?
CDC changed their recommendations. Only those who are at high risk or seriously sick should take tamiflu. Most patients who have flu will get better on their own. Taking tamiflu will take only about a half day shorter, that’s about it. A lot of doctors have stopped prescribing it.
When will the H1N1 vaccine be available locally?
I believe the hospital’s shipment is due this week. Some pediatricians have gotten theirs already.
At one point all hospital employees were required to get the vaccine, but that was lifted this week. Now no one is required. Once we’ve given our employees and in-house patients, we’ll make the balance available to the public.
A lot more patients are getting vaccinated this year than ever before, but the supply is not as robust as we would have liked.