H1N1 update for 3 November 2009

November 3, 2:23 PMHealth and Happiness ExaminerGabriella Filippi

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H1N1 update for 3 November 2009

Thomas R. Frieden, M.D., M.P.H, Director, Centers for Disease Control and Prevention, held a briefing today regarding the H1N1 virus and vaccine. "The virus continues to be spreading. All of the diagnosed flu is H1N1, no seasonal flu," stated Dr. Frieden. It is important to recognize that even if an individual has a fever or cough they may not have H1N1. Dr. Thomas Frieden stated that the CDC is realizing a steady increase in demand for seasonal flu vaccine -- the highest to date -- yet almost no seasonal flu cases have been seen so far. Those cases seen have been almost all H1N1 influenza.                                                                                                                                                                                                                  For those with asthma who are also sick from the flu, however, the CDC stresses the need to be seen by a health care provider. Dr. Frieden stated that a 10 million mark is set for vaccine shipment for Friday; not nearly as much as they would have liked. Physicians and public health providers are frustrated since vaccine is not available as needed. Patience and persistence is necessary, as supply does continue to improve daily. Some states are sub-prioritizing.

Anti-virals are also important and effective in reducing the severity of flu. Underlying conditions warrant seeking care promptly, which will decrease chances for hospitalization or minimize hospital stay. Once again, individuals are encouraged to stay home when sick, rest, increase fluid intake, wash hands frequently, and cover sneeze and cough. 

Regarding the flu, Dr. Frieden states, "We do not know what will happen. We will continue to monitor, to prevent or reduce likelihood of illness."  

Obesity and H1N1

CDC reports that we (United States) are still in the midst of an epidemic with obesity (aside from H1N1.) Those individuals with a BMI (body mass index) of 40 and above are at risk for flu. Often times diabetes, lung disease, and/or heart disease complicate/compound the obese individual's medical history.                                                                                                                                                                                                                                                                                                                                                            

Proper storage and documentation for H1N1 flu vaccine is critical. It is important to keep vaccine at a specific cold temperature in temperature controlled units. Of 30 million doses to date, there have been only rare cases of mishandling, improper storage, etc.

H1N1 is a young person's disease. The CDC reports continued high levels of hospitalized children under the age of 25. The level of severity is similar to seasonal flu.                                                                                                                                                                                         The U. S. Government has been in contact with the World Health Organization (WHO) to get vaccine available to other parts of world. Specifics of when will be determined in near future. Some of the max activity of the virus is in the temperate areas.  

JAMA papers cite the neurologic complications associated with novel influenza A (H1N1) virus infection in children. The recommendation for patients with respiratory illness and neurologic signs remains to be diagnostic testing for possible etiologic pathogens associated with neurologic disease, including influenza viruses. Health-care providers should also consider a diagnosis of Reye syndrome in patients with viral illness and altered mental status. Salicylates* and salicylate-containing products* should not be administered to children with influenza or other viral infections because of the increased risk for developing Reye syndrome.

Antiviral treatment should be initiated as soon as possible for any hospitalized patient with neurologic symptoms and suspected seasonal influenza or novel influenza A (H1N1) virus infection. Although respiratory specimens should be obtained for appropriate diagnostic testing before administering antiviral agents, clinicians should not wait for the results before beginning treatment. Antiviral medications have been shown to decrease the risk for complications from influenza; however, the effectiveness of antiviral treatment to prevent influenza-associated encephalopathy sequelae is unknown. Clinicians should also send respiratory specimens for appropriate diagnostic testing. Although no vaccination against novel influenza A (H1N1) virus is available currently, CDC recommends that all children aged >6 months receive annual seasonal influenza vaccination to prevent illness and complications from infection with seasonal influenza virus strains.

*Salicylates can be found in food, medication, and cosmetics. Some examples of salicylate-containing substances include:

Foods that contain salicylates and salicylate-containing ingredients:                                                      

• Fruits such as apples, avocados, blueberries, dates, kiwi fruit, peaches, raspberries, figs, grapes, plums, strawberries, cherries, grapefruit, and prunes
• Vegetables such as alfalfa, cauliflower, cucumbers, mushrooms, radishes, broad beans, eggplant, spinach, zucchini, broccoli, and hot peppers
• Some cheeses
• Herbs, spices, and condiments such as dry spices and powders, tomato pastes and sauces, vinegar, and soy sauce, jams, and jellies
• Beverages such as coffee, wine, beer, orange juice, apple cider, regular and herbal tea, rum, and sherry
• Nuts such as pine nuts, peanuts, pistachios, and almonds
• Some candies, such as peppermints, licorice, and mint-flavored gum and breath mints
• Ice cream, gelatin

Products that contain salicylates and salicylate-containing ingredients:

• Fragrances and perfumes 
• Shampoos and conditioners 
• Herbal remedies  
• Cosmetics such as lipsticks, lotions, and skin cleansers 
• Mouthwash and mint-flavored toothpaste                                          
• Shaving cream  
• Sunscreens or tanning lotions  
• Muscle pain creams  
• Alka Seltzer  
• Aspirin 
• Acetylsalicylic acid, Beta-hydroxy acid, Salicylic acid
• Artificial food coloring and flavoring  
• Benzoates      
• Menthol, Mint, Peppermint, Speamint 
• Magnesium salicylate, Phenylethyl salicylate, sodium salicylate

In closing, Dr. Frieden stated that the CDC strives for newer methods of producing vaccine at a more rapid pace. Each year the CDC decides in February what strains to place in vaccine, yet if those strains alter in December, that changes the process for them.

Further reading on the H1N1 virus-- prevention, symptoms, vaccine, treatment:

• H1N1 update for 30 October 2009
• Dr. Udo Erasmus on enymes, probiotics, and health
• H1N1 information

All Health and Happiness Examiner articles, photographs, and artwork © 2009-2010 by Gabriella D. Filippi. Reprints granted with written permission. All rights reserved.