1)             What is influenza?  This is a virus that every winter season causes fever and coughs and so it is called seasonal influenza.

2)             What is different about 2009 H1N1 influenza?  This virus is a new strain caused by mixing several influenza genes together (a mutation) so few, if anyone, has immunity from exposure in previous years.  This means anyone exposed to the virus will likely become infected.

3)             What kind of symptoms can 2009 H1N1 cause?  All the symptoms are similar to the usual winter influenza so high fever, muscle aches, headache, sore throat, and cough are most common.

4)              Is this flu worse than usual flu?  So far, this appears to be a mild version of influenza except in rare cases.

5)             What should I do if I've been exposed to the flu?  Not all people who are exposed to the flu will get the illness, but be careful to not spread germs all season as much as possible.  Wash hands frequently and do not share food or drinks with others.  Remember that you can spread illness before you show signs of being sick.  If you do show symptoms of being sick, it is very important to use good hygiene and avoid others.  It is recommended to treat symptoms (see our H1N1 page or our Seasonal Flu page).  Stay home to prevent further spread of the illness.  Also be sure to use good hand washing and separating food, toothbrushes and other items that can spread the disease.  Wipe down phones, keyboards, door knobs, toys, and all other surfaces routinely.  If symptoms include difficulty breathing, dehydration, or are concerning, please be seen immediately in our office if appropriate, or at a pediatric urgent care facility or emergency department.  If your child is high risk (see the pages linked above), make an appointment to be seen.

6)             Should I get tested if I think I have H1N1?  Probably not.  Testing is recommended in patients with certain high risk underlying conditions like heart, lung disease or immune problems since complications from influenza are more common in this group.  It is also recommended in patients ill enough to be hospitalized.  We cannot test anyone for H1N1.  If a patient is admitted to the hospital, they might be tested.

7)              If I get 2009 H1N1, should my doctor prescribe routine antibiotics, like amoxicillin?  This is a viral illness and antibiotics only help with certain bacterial infection.

8)              Is there a medicine that fights viruses like influenza?  There are three antiviral medications for influenza and two appear to be effective for the 2009 H1N1 so far.  A serious concern is that if these medicines are overused, then resistance will develop and no treatment will be available for even the sickest patients.

9)             Does treatment help?  Treatment shortens the course of disease by about a day in most patients, but does not lessen symptoms.  It appears most helpful in patients who are most severely ill (hospitalized) or with compromised immune systems.  Our office does not recommend Tamiflu for most people.

10)         Who should get treatment if they have flu?  Current recommendations are that only certain patients should get treated with these medicines.  Treatment is recommended for high risk patients and for preventative treatment for high risk household contacts.  As always, immunization may be the best way to prevent influenza.  2009 H1N1 vaccines are currently being tested and may be available by fall.  Children should still get the routine seasonal influenza vaccine too.  Prophylactic tamiflu (ie take the medicine because you were exposed) is no longer recommended except for the very sick person.

11)         Are there complications of 2009 H1N1?  Like every influenza virus, bacterial complications like ear infection and pneumonia can follow 2009 H1N1 influenza.  Most patients with 2009 H1N1 improve without treatment in two to three days.  If your child has influenza symptoms and does not improve or starts getting worse by day four, SEE YOUR PEDIATRICIAN.

12)         Is the H1N1 vaccine safe?  The H1N1 vaccine has already been shown to be safe.  The tests that are currently being done on children is to test correct dosing needed and timing of the H1N1 vaccine with other vaccines.  It is very similar to the seasonal flu vaccine, which has been used for years in children.  Our office is not one of the test centers.  For more vaccine information, click here.

13)         When and where can I get the H1N1 vaccine?   Our office will not be giving the vaccine.  The Johnson County Health Department is giving it through schools and daycares, some urgent care centers, and some physician offices.  Each county is doing it differently, so if you are in another county, you will have to contact your health department (or look on their website).

14)         Should everyone with symptoms of the flu be seen?  No.  The CDC recommends staying home for most people with flu like symptoms.  Going to the doctor is not required because only people hospitalized will be tested and prescription treatment is not recommended except for high risk people.  Most people can stay home and treat symptoms, as described on our H1N1 and Seasonal Flu pages.  Coming to the doctor's office might simply spread the infection to more people.  For most people the flu self resolves.  If you are a high risk person (congenital heart disease, uncontrolled asthma, diabetic, immune compromised) then you should be seen.  If you are having difficulty breathing, dehydrated, or have other concerns, you should be seen.

15)          How do we get our children vaccinated against the Seasonal and H1N1 influenza viruses?  Our office will post our vaccine clinics on our News page.  When we learn about H1N1 vaccine, it will also be posted.  Check our News page often for updates!

16)         Can breastfeeding mothers continue to breastfeed with the flu?  The influenza virus is not transmitted by breast milk.  Breast milk will contain antibodies that the mother makes to fight the virus, which might help the baby fight the virus if the baby becomes infected.  Mothers who may be infected should wash their hands before breastfeeding.  They should use a clean burp cloth and consider wearing a face mask when holding the baby.  The CDC offers guidance on breastfeeding with swine flu, click here for details.

17)          How long should I wait between flu shot (or nasal spray) doses?  This question needs to be answered in two parts:

·         The first year anyone under 9-10 years old has a flu shot, a booster is needed at least 28 days later (but more than 28 days is ok).  This applies to both the seasonal flu (9 years and under) and the H1N1 flu (10 years and under).  Over those ages, people only need one shot per season for that strain of influenza.  All infants need 4 total flu shots this year to be fully protected (2 seasonal + 2 H1N1), and children under 10 years who have had the seasonal shot before still need 3 this year to be fully protected (1 seasonal + 2 H1N1).  For this reason, it is important to start flu shots as soon as possible...it might take 4 months to be fully immunized!

·         Each year after the first set of 2 vaccines, a single flu booster for that variety of flu (seasonal or H1N1) is needed during the flu season.  It is not necessary for it to be a full year...if you had a seasonal flu shot in January 2009, it is ok to get it September 2009 for the next season.  You will still need the H1N1 flu shot this season to be fully protected (and those under 10 years need two H1N1's...see above).

18)      Can Seasonal Flu Vaccine and Monovalent 2009 H1N1 Vaccine be given together?

• Yes for all possibilities, EXCEPT never give 2 intranasal LAIV vaccine doses at same visit.
  
• Intervals between flu doses: 
• 3-4 weeks for SAME flu vaccine
• Anytime between DIFFERENT inactivated flu vaccines (shots)
• 4 weeks between DIFFERENT intranasal flu vaccines (nose sprays)

19) Are there any other ways to prevent Swine Flu?  (Disclaimer:  Sorry, guys...I just can't pass up the opportunity to post this ~ Dr Stuppy.)  Please click here to see the answer.