Novel H1N1 or swine flu; Get the Facts to Protect Yourself.

November 25, 8:45 PMPortland Science News ExaminerHalley DeLay

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This year the medical science on everyone’s lips is swine flu, known to scientists as novel H1N1. The place to start when learning about what novel H1N1 is begins however, with the seasonal flu.

Seasonal Flu

Influenza, commonly known as the flu is a contagious respiratory illness caused by the influenza virus. This virus spreads mainly from person to person via coughing or sneezing. The flu can also be spread by touching something with the virus then touching the nose or mouth. Most health adults may be able to infect others beginning one day before symptoms develop and up to five to seven days after becoming sick.

The symptoms of the seasonal flu include a fever (which often runs high), headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, muscle aches and stomach problems. The people who are most at risk for serious side effects from the seasonal flu are older people, young children, pregnant women and people with certain health conditions. These side effects include; Bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

The CDC estimates that about 36,000 people die each year of the seasonal flu. Most of these deaths are in the elderly population. On average each year 5-20 percent of the population gets the flu. On average 200,000 people are hospitalized from complications related to the flu. This is a potentially serious infection and requires medical care as soon as possible to avoid the potential side effects.  

Novel H1N1

The novel H1N1 virus is still an influenza A virus like the seasonal flu virus. H1N1 erupted in the summer as opposed to the typical winter flu season. The virus first appeared in Mexico and then quickly spread into America and over the world. H1N1 has the same method of spreading as the seasonal flu and shows many of the same symptoms.

Unlike the seasonal flu virus, H1N1 has affected mainly those who are under 65 and healthy. This is a direct diversion from the normal flu. It appears that 1/3 of the people over the age of 60 already have the antibodies against the virus. This does not help protect them from the serious side effects if they do get the virus however.

Thus far there have been 4,314 novel H1N1 deaths in the United States and 11918 worldwide (as of Nov. 28, 2009). There have been 61 deaths and 524 diagnosed infections in Oregon. The most infected states according to the CDC are Wisconsin, Texas and Illinois. The most infected countries are Argentina, South Korea, and Germany.               

The Vaccine

The “flu shot” is an inactivated vaccine, which contains a killed virus, that is given with a needle. This shot is for use in people 6 months of age and older. The other option is a nasal spray which is made with live attenuated (weakened) flu virus that does not cause the flu. This spray is for use in people 2-49 years that are healthy and not pregnant. About two weeks after vaccination the antibodies develop that protect the body against infection.

The following people should get vaccinated:

-         Children aged 6months to their 19^th birthday

-         Pregnant women

-         People fifty years of age and older

-         People with chronic medical conditions

-         People who live in nursing homes and other long term care facilities

-         People who live with or care for those at high risk (health care workers etc.)

As of late many people have been worried about various components of vaccines, primarily Thimerosol and Squalene.

Thimerosol is a mercury containing organic compound that is widely used as a preservative in vaccines. This compound has been removed from nearly all vaccines for children 6 and under although it is still in the inactivated flu vaccine. There is a preservative free flu vaccine option for use in infants, children and pregnant women. Thimerosol has 1 microgram or less of mercury per dose, this is not an unsafe level according to the CDC. In fact you get a lot more mercury from fish than you can from any vaccines.

 To start off with, the American version of the vaccine does not contain squalene. Squalene is what is called an adjuvant, these are used to get your immune system to recognize and react to antigens that would not normally respond on their own. This at times makes it so that less antigen needs to be used. Squalene is however being used in much of Europe where it is used as an adjuvant to the flu vaccine.

One of the rare neurological side effects that are correlated to vaccines is Guillain-Berre Syndrome (GBS). For information about GBS Dr. Steven Novella, a neurologist for Yale has this to say about the disorder:

“GBS is an autoimmune neurological disorder. It is a monophasic (one time process that gets worse then gets better) post-infectious illness. Essentially, an infection with a virus or bacteria triggers the immune system to have a second inflammatory response against myelin proteins. Myelin is the insulation around nerves – the inflammation inhibits nerve conduction, damages the myelin, and when severe can damage the underlying nerve fiber itself. This results in weakness, numbness, and autonomic dysfunction. The weakness, when very severe, can inhibit breathing resulting in the need for mechanical ventilation. Right now the greatest risk from the disease is the autonomic dysfunction which can cause a severe drop in blood pressure, among other symptoms.

If recognized early and treated properly, most patients with GBS have a short illness – days to weeks – and recover nearly fully. However, severe or untreated cases can result in permanent paralysis and there is a 3-4% death rate. (Although I have treated many cases, I have never seen a death from GBS – not even close. I suspect these cases result from a significant delay in treatment or improper treatment.)” Dr. Novella

GBS can not only be triggered by the vaccine but also by the flu or other infections. Anything that can stimulate an immune response can trigger GBS. This is a rare side effect however, with the risk being about 1 in a million people getting the syndrome.

Availability of the vaccine

There is a very limited quantity of the H1N1 vaccine and because of this those that are considered high risk are being targeted for the first wave of the vaccine. These people are health care workers, children, pregnant women, and high-risk individuals. More vaccines are expected to arrive so that others can get the vaccine as well. For locations to get your H1N1 vaccine in Oregon go here.

For more information about the flu Head to the Oregon Flu site and CDC Flu site. Also the science-based medicine blog has a lot of good information about not only the flu but other medical concerns. Dr. Novella and his co-writers are very knowledagble about many fields are are a wonderful resource.