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Influenza season 2009: Why this year is different and what you should know
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Photograph captures a sneeze in progress.
There is no doubt that the news is providing extensive coverage of the flu season of 2009. Yet each year we have a flu outbreak that causes over 200 thousand hospitalizations and claims approximately 36 thousand lives, all without much media hype. So what’s different this year? Why are there two vaccines instead of one? Who is at risk? and Why should we be reminded of “the basics”?
The difference this year is that every year we have what we call a seasonal flu outbreak. However, this year we also have a “new” Influenza A (H1N1) virus outbreak. This type of Influenza A virus has never circulated among humans before. The implication of this is that people that would normally have some immunity to the usual seasonal virus will not have immunity to this new virus. Therefore, more people could potentially become infected and become ill during this flu season. In fact, reports are already starting to come in from various states having higher than normal flu associated emergency room visits. To address the risk inherent with the new virus (H1N1), the US Government has purchased 250 million doses of the H1N1 vaccine in order to ensure that anyone who wishes to take it can do so. Nonetheless, given the size of the order, the actual shipments and availability may vary from region to region. Shipments, as of this writing (October 2009) amount to 4% of the total order or 11 million doses, although the government expects approximately 50 million doses by mid November and 150 million by December. From those shipped so far, 503 thousand doses have come to Florida.
Seasonal influenza viruses have variations each year. This is why there is a different vaccine available every flu season. For each season, scientists try to match the vaccine to the viruses most likely to cause the flu in a given year. As a result, some years the match is better than others, which translates to the effectiveness of the vaccine. The process is cyclical annual vaccine orders are placed to ensure availability for the usual “at risk” population. The seasonal flu cycle and associated process has not changed. It is going on at the same time as the Influenza A (H1N1) is being addressed. This new virus is affecting somewhat different demographic groups from the traditional seasonal flu. Thus, there is a different vaccine produced to fight it.
The usual seasonal influenza vaccine is recommended mostly for children 6 months to 18 years and anyone 50 years of age or older. However, the Influenza A (H1N1) vaccine is recommended for a much larger group including pregnant women, people who live with or care for children less than 6 months of age, healthcare and emergency medical personnel, persons between 6 months and 24 years old. In addition, each vaccine is also recommended for persons with high risk due to chronic illness or condition. A more specific list is available from the Centers for Disease Control and Prevention.
As with any new vaccine or threat of illness, there is a fair amount of controversy, both from the scientific community as well as the public. The commentary so far includes some who question the need for both vaccines and the associated media hype. Some worry we will see the combined effect of the annual seasonal flu plus the H1N1 flu, while others think the later will take the place of the first. Some are concerned with possible complications or reactions, while others predict a flu season of pandemic proportions that could cause over 1.8 million hospitalizations urging all eligible people to take the vaccine. How it will all play out, is hard to say. Everyone should keep informed and consult with their primary health care provider about their specific situation or concerns. Whatever your position on this issue, what is certain in all cases is that there is much to be gained by going “back to basics”. We can all help control the spread of disease by practicing good health habits this year and in any other year.
In the end, these are viruses that infect the nose, throat and lungs. They are transmitted from person to person when an infected person coughs or sneezes, through contact with salivary droplets and nasal secretions. In keeping with the adage “a picture is worth a thousand words” here is a photograph that captures a typical sneeze in progress. It reveals the extent of salivary droplets expelled during a sneeze potentially sending virus particles throughout a wide area.
Therefore, basic precaution calls for the following:
- Cover your mouth and nose when you sneeze or cough – preferably use tissue or if not available, use the inner side of your elbow, wash your hands (or use hand sanitizer) after you do so.
- Clean your hands often (both with and without the flu) – this can reduce the opportunity for infection to yourself and others.
- Avoid touching your eyes, nose or mouth with uncleaned hands – these areas have moist surfaces that can be entry points for viral infection.
- Stay home when you are sick to prevent infecting others and check with your physician as needed.
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