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Vital Signs

Fall 2009

Coping with the Flu


Coping with the FluThe outbreak of novel H1N1 influenza, originally referred to as swine flu, was declared a pandemic by the World Health Organization (WHO), making it the first flu pandemic since 1968. At the time the WHO made its declaration, more than 70 countries had reported cases of novel H1N1; by August that number had doubled. Zachary Rubin, M.D., an infectious disease specialist at UCLA Medical Center, Santa Monica, addresses questions about the implications of pandemic flu and what people can do to protect themselves.

What is meant by pandemic influenza, and why is the novel H1N1 flu classified as such?

A pandemic is a measure of the geographic spread of a disease — it means we have a worldwide epidemic, which is the case now with H1N1. Many people assume it is a measure of severity, but it is not.

How is novel H1N1 virus different from the seasonal flu virus that comes around every year?

They’re both part of the same family of influenza viruses; H1N1 is simply a new strain. And because of the genetic differences, the seasonal flu vaccine doesn’t provide protection against novel H1N1, although a novel H1N1 vaccine is being developed and should become available this fall. When it comes out, the vaccine may require two shots in addition to the vaccine for the usual seasonal flu.

Other than that, there are many similarities. Novel H1N1 appears to be transmitted in the same way as seasonal influenza — mostly through coughing or sneezing. As with seasonal influenza, novel H1N1 flu symptoms include fever, sore throat, cough, headache, muscle aches and, in a significant number of cases, diarrhea and nausea. People over 65 have the highest risk for complications from seasonal influenza infection, but this is not necessarily the case for H1N1. The novel H1N1 virus may be more problematic for younger patients, especially pregnant women.

How does this compare with past influenza pandemics?

Over the last 100 or so years that we’ve been able to study influenza viruses, it seems that every so often a novel virus is transmitted into the human population that tends to wreak havoc, some more than others. In 1976, for example, there was a public health scare over swine flu that resulted in only about 200 cases and one death. But in 1918, an influenza pandemic killed at least 20 million people worldwide. It’s not clear where this one will fall, but it’s already more widespread than the 1976 version.

In terms of the severity of the illnesses, in most cases, people who have been sick have recovered without requiring medical treatment, though there have been hospitalizations and deaths. At this point, it doesn’t look like novel H1N1 will be too severe, but it’s possible it could pick up steam. That’s why there is an urgency to develop a vaccine.

What are the best ways to prevent becoming sick or, for those who have the virus, infecting others?

Basic precautions can keep people from getting sick. Cover your nose and mouth when you cough or sneeze; wash your hands often with soap and water — carrying around alcoholbased hand rubs is particularly effective; avoid close contact with sick people. People with either H1N1 or seasonal flu are advised to stay home for at least 24 hours after the fever ends and to keep away from others as much as possible.

What should people do if they think they have the virus?

Anyone who is otherwise healthy and doesn’t have any underlying immune problems will most likely not need to do anything other than staying home and taking care of themselves just as they would with seasonal influenza. Those who have compromised immunity may be candidates for antiviral drug treatment. In some cases, such as when people with an underlying illness are exposed to the novel H1N1 virus but have not yet developed symptoms, antiviral drug treatment may be given as a preventive measure.

For more details about the N1H1 flu, follow the link at:

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