Winter 2009 Volume 12 Number 2
A Tale of Two Influenzas: Hype or Horror?
It was the best of times. It was the worst oftimes. In public health, unfortunately, you have to take the good with the bad. The H1N1 strain of influenza is no different.
It has been the worst of times because for the first time in decades there was a new virus, a novel virus, appearing in the world. It was an infection for which very few people appeared to have immunity. A brand new infection whose potential to cause pain, suffering or even death was unknown.
But since the spring we have learned more about this novel influenza we call H1N1. It has not been the big danger that had been feared. In fact it seems it is no more dangerous then the seasonal flu we see year after year.
And the vaccine that has been developed to give people protection where there was none before seems to work. So this is a primer on influenza, giving you some background on a virus that seems magnified in the press and reviled in the streets.
What is influenza? The term flu is thrown around with reckless abandon, used to describe all sorts of maladies from mild coughs and sniffles to stomach viruses that cause vomiting and diarrhea. Real flu is a completely different illness characterized by the sudden appearance of fever, sore throat, body aches, headache, fatigue and a persistent dry cough and runny nose.
Why is it called the H1N1? Every germ has a family and influenza is no different. Influenza belongs to the virus family Orthomyxoviridae that affects birds and mammals. Each school year, we are likely to run into one or both of the two main types of influenza viruses: types A and B. Influenza A causes the most serious disease.
Every influenza virus has two markers on it that help it punch through our body’s cells and help the virus infect our bodies. These proteins are labeled H and N. The H and the N are then further sub-typed depending on the strain. The swine flu has subtype H1N1. These are the parts of influenza virus that change from year to year that allow the virus to attack and infect in new ways.
Why so much fear about another influenza virus? The reason that initially there was so much fear when H1N1 was discovered was because it was the exact same subtype that caused the Spanish Flu in 1918 that killed millions. That killer bug was so long ago that no one has immunity to it anymore. Fortunately, this new flu does not seem to be as virulent as that flu. Every year, 5 to 20 percent of the American population get the seasonal flu while about 36,000 to 40,000 Americans die from it and around 200,000 are hospitalized.
The difference with H1N1 is that it attacks the very young to a more severe degree compared with seasonal flu that is more dangerous for the elderly.
How does influenza infect the body? The influenza virus enters through respiratory surfaces—the lining of the nose, bronchi and lungs. Once coming in contact with the cells on those surfaces, the virus blends into the cell. Once there, the virus replicates and makes new copies of itself. These copies are then released to infect other cells. Sometimes these copies aren’t exact copies of the original. They may be just different enough to still be infectious yet avoid the natural protection that has
built up in the body from past illness or vaccination. These changed viral particles may become the dominant infectious flu viruses. So to keep up, people need to be vaccinated each year.
Our body does not sit idle in the face of this threat of invading viruses. Our bodies release chemicals to fight off the swarming viruses. Unfortunately these same chemicals cause inflammation in our bodies—fever, joint aches and cough among others.
It is thought that the reason that H1N1 seems to affect young children more is because their bodies overreact when mounting an immune counterattack causing a greater degree of inflammation.
Should I have my children vaccinated? Absolutely. The primary reason to get your kids vaccinated is—it works. It is the best way to protect them from the discomfort of flu symptoms. It will lessen missed days of school as well as missed workdays for parents. It will give protection for children who are too young to have built up any type of protection to this new virus. And it may provide some protection against the virus as it mutates into new strains.
Is the vaccine dangerous because it’s so new? Vaccines are manufactured under the highest standards of safety. The H1N1 vaccine is made by the process as the seasonal vaccine and should have a similar safety profile. Makers of influenza vaccine work closely with the Food and Drug Administration (FDA) each year to make sure the vaccine is made in the safest way possible, and its safety is monitored closely after the vaccine is released.
If my child gets influenza, when do I have to worry?
- If you see fast breathing or trouble breathing.
- If you note bluish skin color.
- If your child is not drinking enough fluids.
- If your child is not waking up or notinteracting.
- If your child is so irritable that he or she does not want to be held.
- If flu-like symptoms improve but then return with fever and worse cough.
- If you note a fever with a rash.
Call the clinic with any of these symptoms.
What can I do to protect myself? First, you and your children over six months of age should get vaccinated yearly. Good hygiene also goes a long way in keeping the influenza from spreading:
- Cover your nose and mouth with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your upper sleeve.
- Wash your hands often with soap and water for at least 20 seconds. Alcohol-based hand cleaners are also effective.
- Avoid touching your eyes, nose or mouth since germs spread this way.
- Avoid close contact with sick people.
- If you are sick with a flu-like illness, stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities.
- While sick, limit contact with others to keep from infecting them.
How can I get up-to-date information? If you have any influenz
a questions, check this web site for the most up-to-date information. Click on the influenza button. While you are there you can sign up for PIP’s email newsletter. We will contact you by email with new flu and vaccine availability information.
PIP also has a flu hotline that can be reached at 763-488-4098. The Minnesota Department of Health
along with other associated organizations has a hot line: Minnesota FluLine 1-866-259-4655.
You can also visit the Centers for Disease Control web site at www.cdc.gov/flu