“Don’t Let Your Guard Down” Experts Warn

By Ngoc Nguyen

H1N1 virus has no cure, but there is a way to prevent it … get vaccinated! That’s the message health experts around the state are telling the public, even though H1N1 flu cases have peaked.

“It’s much too early to let our guard down,” says Ken August, spokesperson for the California Department of Public Health.  “H1N1 flu cases may be decreasing, but [the virus] is not going away.”

The first two confirmed H1N1 cases in the country were found in California, and now a majority of counties in the state have reported at least one case of H1N1. The virus has hospitalized more than 7,546 Californians and caused nearly 397 deaths, according to the latest state data (http://www.cdph.ca.gov/HealthInfo/discond/Pages/H1N1Home.aspx).

The state estimates that more than 3 million Californians have become ill from the H1N1 flu.

“The vast majority of flu illnesses are of the H1N1 strain. We’re seeing almost none of the seasonal flu strain right now,” said August, who emphasized the importance of getting vaccinated against the strain that is out there the most.

As of early December, California has ordered 7 million doses of H1N1 vaccine. The number of doses ordered so far is enough to vaccinate about 18 percent of the state’s population against H1N1.

Early supply problems hampered mass vaccination efforts, said Jonathan Fielding, M.D., public health officer for Los Angeles County.

“That’s really caused a lot of problems, because expectations were heightened, and we didn’t have enough vaccine to fulfill them and that caused anxiety,” he said. Los Angeles County has received 1.4 million doses, whereas the high-risk group is 5.5 million people, Fielding said.

Pregnant women, children, young adults under age 24 and people of all ages with chronic conditions are at increased risk of infection and complications from the flu.

Health officials emphasized the importance of getting vaccinated against H1N1 flu, especially those in high-risk groups, and they said it is not too late to do so. As it takes up to two weeks after a vaccination for the body to develop immunity, those who want to protect themselves during the holiday season should get immunized in the next two weeks.

The experts say the epidemic has crested for now, but we’re likely to see additional waves. “We’ve already had a second, we could see a third wave,” said Fielding.

The first wave of H1N1 infections occurred in the spring (April-June), with cases dropping off, but never disappearing, during the summer. Infections spiked again in October, after students went back to school.

Takashi Wada, M.D., public health officer for the City of Pasadena, said H1N1 cases could rebound again after the New Year, as people tend to congregate indoors more during the winter and travel over the holidays.

In Santa Clara County, H1N1 hospitalizations and school absenteeism have leveled off, according to Joy Alexiou, spokesperson for the county public health department. But, getting vaccinated is still a good idea, she says, because flu activity is still high.

“Flus are notorious for changing and getting unpredictable,” Alexiou said. “Will there be another wave after the first of this year? We don’t know.” The message: Better to be safe than sorry. Get vaccinated.

Gift of Health is supported by grants from The California Endowment andCalifornia Community Foundation.

This Holiday Season, Get a Flu Shot and Give the Gift of Health to Your Family

When you get a flu shot this holiday season, you’re not only decreasing your own risk of getting sick from H1N1, the swine flu. You’re also giving the gift of health to your family, because when you get vaccinated, you’re also protecting your loved ones.

When you get vaccinated, you help build a wall of protection for those you
live with, work with, and even sit next to on an airplane.

Since April, the Centers for Disease Control reports, 10,000 Americans have died from the swine flu. Another 213,000 people have been sick enough to be hospitalized.

“It’s important to understand that the vaccine’s not only for you, it’s also for those around you,” says the CDC’s Alan Janssen.

Experts call it “the cocooning effect” because when you get a vaccine for flu—seasonal or H1N1 — you in effect are building an immunity wall for those you come in contact with, especially those you’re closest to. You’re not exposing them through yourself to the virus because you’ve immunized yourself.

The opposite is equally true. When you get infected, you can pass the virus on to those you care about most.

This is especially important for parents of newborn babies, who have little if any immunity to influenza for the first 12 months of life. In addition, infants under six months old cannot be vaccinated. To ensure protection for the baby, immediate household contacts (representing its cocoon) must vaccinate themselves against influenza so they won’t transmit the virus to the baby.

The same is true for those in regular contact with elderly family members with compromised immune systems, the CDC’s Janssen says.

While studies show the vaccine for H1N1 is 97 percent effective, older Americans can benefit from the additional protection of having their family members vaccinated.

The upshot, Janssen says, if we all build a cocoon around ourselves and our families, we will be able to keep the swine flu from spreading further.

“We’re trying to decrease the number of folks who can get influenza by having a vaccination,” he said. “That way you’re preventing it from getting into the community.”

Gift of Health is supported by grants from The California Endowment andCalifornia Community Foundation.

A Doctor’s Word: Virus as unpredictable as the weather

Dr. Manoj K. Jain

My 10-year-old son tracks the weather map each day and enjoys the predictability (colder temperatures in the winter) with the unpredictability (50 percent chance of rain). Such is the case for the flu season this year. We have the usual seasonal flu, which peaks in January and February and then nearly goes away in the summer months. And then there is the unpredictability of the H1N1 or swine flu.

The swine flu first occurred in Mexico this past spring and spread to North America. The World Health Organization soon declared it a pandemic. During June and July, it occurred at summer camps, which my children attended, yet luckily none became ill. But when schools began in the south in late August, a surge of cases began to occur. Hospitals had to set up tents in their parking lots as makeshift emergency rooms to triage sick children. The number of people coming into our clinics with flu-like illness was three to four times the usual for that time of year. Nearly all of the cases were suspected to be H1N1.

The H1N1 flu has been unpredictable. Now, according to the Centers for Disease Control and Prevention, the cases of flu-like illness have been decreasing in all parts of the nation.

From early findings, it appears to be very contagious and seems to transmit easily from person to person, unlike the bird flu, but much like the seasonal flu virus.

Additionally, from early findings, it does not appear to be highly virulent among the reported cases in the United States. The virus in most cases causes a mild illness, and most patients recover fully within a week or so, much like the seasonal flu virus and unlike the SARS virus.

It is unclear what will happen when the seasonal flu cases begin to occur in January and February. Will H1N1 cases come back or just go away altogether? Nobody knows, but my son is not worried. Three weeks ago, his school offered the nasal mist vaccine for H1N1. He and all his friends stood in line to be vaccinated. A few weeks earlier, he had his seasonal flu shot.

Studies show that the vaccine for H1N1 is 97 percent effective, and after 22 million doses there are no serious side effects. Also, the rates of flu vaccinations are lower among minority populations. Even though the cases of flu-like illness are decreasing, there is plenty of flu activity to make a non-vaccinated person very sick.

Even as the swine flu epidemic turns into a pandemic, I am reassured for a number of reasons.
First, the pandemic flu preparedness has been unprecedented, with the use of technology and local, state, national and international collaboration. I am on a daily afternoon conference call or webcast at cdc.gov with the Centers for Disease Control and Prevention, and I get routine CDC updates on Twitter.

I tell my son, there is a 50 percent chance of rain– so taking an umbrella–the vaccine–is a good idea.

Dr. Manoj K.Jain is an infectious-disease specialist in Memphis and an adjunct assistant professor at the Rollins School of Public Health at Emory University in Atlanta. He frequently writes health columns for the Washington Post.

Gift of Health is supported by grants from The California Endowment andCalifornia Community Foundation.

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