September 12, 2009

H1N1 Influenza—Swine Flu Update

When the H1N1 flu came to my office in April and May of 2009, I had been hearing a lot about it, but with few credible statistics. In a few weeks, I saw maybe a dozen kids and parents with the right symptoms to make the diagnosis. One or two actually had confirmed diagnoses with laboratory testing. I have a tiny practice, so that seemed like a lot at the time.

Perhaps it's obvious that everybody in Washington is expecting worse to come. The mini-epidemic last spring was relatively removed from typical winter conditions in most of the country, so if it returns in mid-winter, as the flu usually does, it might be worse.

In the winter, kids generally spend more time indoors with other kids, often playing actively or in close proximity to each other in school. That's a good way to spread germs. Even at home, that closeness favors the spread of contagious diseases. In the winter, the air is drier and our respiratory secretions are thicker and stickier. That, too, is kind of like flypaper for diseases.

There is another hand to this. So far, I haven't really read much about this particular influenza being more virulent than the regular influenza that comes around every season. That's not terribly reassuring in my line of work, since the regular old flu can be a serious problem for newborns, as well as for kids with a breathing condition like asthma. That's the good news.

The reason, I think, that there's so much worry is that it seems that nearly everybody who's exposed to this H1N1 flu gets sick. Think of what that could mean—you and your whole family all sick at once, your neighbors and friends sick, the pharmacist, and so on. It's not a pretty picture.

The nice folks at the CDC have said there will be a H1N1 vaccine available, probably in October or so. I don't know what the final recommendations will be for who will be the first priority of people to get it. At the moment, it’s recommended for all children and young adults, all pregnant women, and people with other risk factors. I'll get it if I can. There's a regular seasonal flu shot too—it's available now. It's worth a shot.

Note to my patients and their parents: if you want your child to have flu shots this season, please let me know ASAP. I might still be able to order them.

The Centers for Disease Control (CDC) is one branch of the government that works superbly. They are the most authoritative source on this planet for all news of epidemics and new diseases. There is no physician or expert who knows more than they do. All the major news organizations get their information from them, and you should too. The H1N1 Flu page is where you can find the best and most up-to-date information. It's updated at least once every couple of days. Don't be sold on something from the alarmist salesperson at the alternative-medicine pharmacy. Trust yourself and get the straight story from the CDC. They have no hidden agenda and aren't trying to sell you anything.

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