Flu scare spreads, as H1N1 and seasonal variations strike area hard

With Tennessee now being one of 11 states experiencing a widespread flu outbreak, the disease -- and the vaccines -- are growing concerns.

"We're not in the peak time for seasonal flu," said Janet McAllister, with the South Central Regional Health Department in Tennessee. She said seasonal flu outbreaks usually start up in late October and early November and peak in January. "So most of the cases we're seeing now are thought to be the H1N1 'swine flu' virus."

Dr. Samuel Sells, however, says he has already seen several cases of seasonal flu.

"There was only one I felt was swine flu," he said. "We haven't had any confirmation back yet. But I have seen several other types -- A flu and B flu -- already.

"I've never seen a flu season like this in the 30 years I've been practicing medicine," said Sells. "It's sort of scary."

Variations

According to the Center for Disease Control web site, "There are three types of influenza viruses: A, B and C. Human influenza A and B viruses cause seasonal epidemics of disease almost every winter in the United States. The emergence of a new and very different influenza virus to infect people can cause an influenza pandemic. Influenza type C infections cause a mild respiratory illness and are not thought to cause epidemics."

The H1N1 virus, commonly called swine flu, is a type A virus, the site stated.

Early flu

There is an additional factor in the widespread status that is because of the early emergence of an influenza outbreak. Seasonal flu vaccines are not usually ready for mass distribution until late September and early October. This year, the outbreak arrived before the vaccines.

"I put my order in a month ago and I should be getting it in by Wednesday," said Sells.

Some places already have vaccines and are offering flu shots for seasonal flu, he said, but those vaccines are usually for those 18 years and older.

"We get the vaccines for 6 months and up," he said. "I think they send out the 18 and older vaccines first."

At Walgreens, flu shots are available for those 9 years old and up and cost $24.95.

The Bedford County Health Department is also currently offering seasonal flu vaccine.

Deadly disease

"Seasonal flu is a preventable illness that can be serious and even deadly," said McAllister. "Each year 5 to 20 percent of the country's population gets seasonal flu. Nationwide, more than 200,000 people are hospitalized each year with complications from seasonal flu and more than 36,000 die from the illness. In Tennessee, an estimated 700 people die from seasonal flu each year."

The vaccine is particularly recommended for the elderly, young children and people with certain health conditions such as asthma, diabetes or heart disease since they are at high risk for complications from seasonal flu.

The cost of the flu shot is $25 for adults, ages 19 and older, and $13.70 for children. The Health Department will bill Medicare and other third party payers as appropriate.

To make an appointment for vaccination or ask questions about flu vaccine, call the Bedford County Health Department at (931) 684-3426.

H1N1 vaccine

The H1N1 vaccine is also not available yet.

"We're expecting it in October," said McAllister. "As soon as we get that, we'll really push the information out there."

The original date for the H1N1 vaccine was late October or early November, but Sells said he's heard that the release date has been pushed up to the first part of October.

The Bedford County Health Department will also offer H1N1 vaccine when it becomes available. This vaccine is now being manufactured and tested in a manner similar to that of seasonal flu vaccine. Both McAllister and sells stressed that the seasonal flu will not prevent the H1N1 virus.

"You have to have both shots," said Sells. "But the good thing is, you only have to have one of the swine flu shots. At first, it looked like you would have to have two, but it seems to be working, so they're saying it's only one shot."

With the flu showing up before the vaccine, Dr. Sells urges education and prevention.

"The main thing is good hygiene," he said. "Good hand washing, avoiding exposure. If you're ill, stay home and don't spread it. Don't cough on people -- I see a lot of that."

Who's first?

Who should get a seasonal flu shot?

According to the CDC, people who should get vaccinated each year are:

* Children aged 6 months up to their 19th birthday

* Pregnant women

* People 50 years of age and older

* People of any age with certain 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 for complications from flu, including:

-- Health care workers

-- Household contacts of persons at high risk for complications from the flu

-- Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

If a person has a history of Guillain-Barré syndrome, they should not get the shot, and those under 2, over 49, or pregnant women should not get the nasal spray vaccine.

The CDC priority list for the H1N1 vaccine is similar.

* Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;

* Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by "cocooning" them from the virus;

* Health care and emergency medical services personnel because infections among health care workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce health care system capacity;

* All people from 6 months through 24 years of age

-- Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and

-- Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,

* Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

Warning signs

You should contact your health care provider under these circumstances:

In children, emergency warning signs that need urgent medical attention include:

* Fast breathing or trouble breathing

* Bluish or gray skin color

* Not drinking enough fluids

* Severe or persistent vomiting

* Not waking up or not interacting

* Being so irritable that the child does not want to be held

* Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

* Difficulty breathing or shortness of breath

* Pain or pressure in the chest or abdomen

* Sudden dizziness

* Confusion

* Severe or persistent vomiting

* Flu-like symptoms improve but then return with fever and worse cough

Symptoms

The symptoms of 2009 H1N1 flu virus in people include: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue, and in some cases diarrhea and vomiting. Severe illnesses and death have occurred.

In seasonal flu, certain people are at "high risk" of serious complications. This includes people 65 years and older, children younger than 5 years old, pregnant women, and people of any age with certain chronic medical conditions. About 70 percent of people who have been hospitalized with this 2009 H1N1 virus have had one or more medical conditions previously recognized as placing people at "high risk" of serious seasonal flu-related complications. This includes pregnancy, diabetes, heart disease, asthma and kidney disease.

One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of 2009 H1N1-related complications thus far. CDC laboratory studies have shown that no children and very few adults younger than 60 years old have existing antibody to 2009 H1N1 flu virus; however, about one-third of adults older than 60 may have antibodies against this virus. It is unknown how much, if any, protection may be afforded against 2009 H1N1 flu by any existing antibody.

Source -- Center for Disease Control