Novel H1N1 Influenza
General Talking Points
Communications Office · Minnesota Department of Health
Revision of Aug. 7, 2009
Why we are (still) concerned.
- Although novel H1N1 influenza is no longer making front page news, the threat from this new flu virus is not over.
- The virus is still circulating and making people sick – in Minnesota, across the nation and worldwide.
- In the United States, summer camps and similar gathering sites are a special concern right now. Recommendations for preventing the spread of novel H1N1 in summer camp settings are available on the MDH Web site.
- In Minnesota and throughout the United States, almost all of the flu occurring right now is being caused by novel H1N1.
- In the southern hemisphere, where it is “flu season” right now, novel H1N1 is circulating along with seasonal flu.
- There is evidence that – for the time being – novel H1N1 has peaked in Minnesota. But it could be back in the fall.
- Influenza is notoriously difficult to predict. As fall approaches, novel H1N1 could:
- simply go away.
- stay with us, but with no change in the severity of the illness it causes.
- develop the ability to cause more severe illness, possibly even mimicking the severe, life-threatening pandemic of 1918.
- A severe pandemic, like the one that occurred in 1918, could turn out to be the greatest public health emergency that any of us will ever see. The result could be widespread illness, many deaths and extensive social disruption.
- Most scientists currently expect to see a “second wave” of illness in the fall caused by novel H1N1.
- Even if H1N1 does NOT develop the ability to cause more severe illness, it is still dangerous:
- Influenza is always a potentially serious, life-threatening illness – especially for people at high risk of complications. Nationwide, it kills an estimated 36,000 people a year, making it one of our leading causes of death, year in and year out.
- Because novel H1N1 is a completely new virus – one that has never been seen before – it is less likely that people will have any immunity to it.
- Although work is underway on developing a vaccine for H1N1, we do not have one yet. And when we do get a vaccine, there probably won’t be enough for everybody at first.
- In the fall, we could face an influenza threat of historic proportions – with novel H1N1 and up to three different strains of seasonal flu making people sick, all at the same time.
- If we need to cope with widespread illness from both novel H1N1 and seasonal flu in the fall, our health care system could be overwhelmed.
- The groups at highest risk for serious illness from novel H1N1 currently appear to differ from the high-risk groups for seasonal flu:
- Older adults currently appear to be at lower risk than other groups for severe illness from novel H1N1.
- Pregnant women appear to be at increased risk.
§ Compared to the general population, pregnant women are four times as likely to be hospitalized if they develop novel H1N1 influenza.
§ A number of deaths from novel H1N1 have been reported in pregnant women.
- Children, adolescents and young adults appear to be at increased risk.
§ The median age of patients hospitalized with novel H1N1 in Minnesota is 12 years.
- Influenza is unpredictable. We do not know what will happen with H1N1in the fall.
- The groups most at risk of serious illness could change.
- The virus could develop resistance to antiviral drugs.
- The virus could change in ways that would make a vaccine less effective.
- We do not know if the virus will develop the ability to cause more severe illness.
- We need to hope for the best – but prepare for the worst.
Medications and Vaccines
- Antiviral drugs like Tamiflu and Relenza currently appear to be effective in treating novel H1N1 flu.
- These drugs need to be individually prescribed by a physician.
- Antiviral drugs are normally made available through the private sector health care system.
- If shortages of these drugs occur in the private-sector health-care system during a severe pandemic, public stockpiles can be used to fill the gap.
- Enough antivirals for slightly more than one million courses of treatment from state and federal stockpiles are available for use in Minnesota.
- If the regular health-care system is overwhelmed during a severe pandemic, antivirals may be available through specially designated regional “flu centers.”
- Efforts are currently underway to develop a vaccine for novel H1N1 by this fall. CDC is estimating that the vaccine will be available by mid-October (but it could be earlier).
- Estimates vary regarding how much vaccine may be available – and how quickly.
- We will most likely be getting a large initial shipment of novel H1N1 vaccine, followed by several smaller shipments over the next few weeks.
- We are not likely to have enough novel H1N1 vaccine to immunize everyone in Minnesota – at least not right away. Vaccination will initially be recommended for people at highest risk for severe illness.
Protecting yourself against flu: a few simple steps
A few simple, common-sense precautions are still the most important thing you can do to keep from getting the flu – or spreading it to others. That applies to both seasonal flu and novel H1N1.
- Cover your nose and mouth with your sleeve or a tissue when you cough or sneeze.
- Clean your hands frequently and thoroughly – with soap and water or an alcohol-based hand-sanitizer solution.
- Limit your contact with others who may be ill.
- Clean your hands after shaking hands or having other close contact with others and before eating or preparing food, or touching your eyes, nose or mouth.
- Be aware of the symptoms of novel H1N1, which are similar to those for seasonal flu:
- fever
- cough
- sore throat
- runny or stuffy nose
- body aches
- headache
- chills
- fatigue
- In some cases, symptoms of novel H1N1 can also include vomiting and diarrhea – which are not typically symptoms of seasonal flu.
- Stay home from work or school – and generally avoid going out in public – if you are sick with symptoms of the flu.
- If you are an employer, encourage your employees to stay home if they are sick with flu symptoms.
- If you have the symptoms of flu, stay home from work, school or other places where people gather for seven days after flu symptoms appear – or until 24 hours after your symptoms go away – whichever is longer.
- If you are severely ill with the flu, contact your health-care provider, but take steps to avoid exposing others to the flu.
- Call first to see if you need to actually see your provider in person.
- If you do need to see your provider, steps can be taken to avoid exposing other patients to the flu.
Protecting yourself against flu: vaccination
· This year, you may need to get up to three separate doses of flu vaccine – two doses to protect against novel H1N1 and one dose for regular seasonal flu.
· Since as many as four different flu strains may be making people sick this fall, it is more important than ever this year to get vaccinated against “seasonal” flu.
· The seasonal vaccine will not protect against novel H1N1.
· A vaccine for novel H1N1 flu is now being developed and is expected to be available by this coming fall – possibly by mid-October.
· Testing to determine the safety and effectiveness of the novel H1N1 vaccine is currently underway.
· Because no one had ever been exposed to novel H1N1 before this past spring, it may take two doses of vaccine to immunize people fully.
· It is not clear yet whether you will be able to get the seasonal vaccine and one of the two doses of novel H1N vaccine during the same clinic visit.
· Since the seasonal vaccine will likely be available before the novel H1N1 vaccine, you should go ahead and get a seasonal flu shot anyway – and if you are in a high-risk group for severe illness, get your novel H1N1 vaccination later.
· Initial shipments of the seasonal vaccine are already arriving in Minnesota. Check with your health-care provider and be alert for announcements about special flu shot clinics so that you can get vaccinated.
Seasonal Flu Vaccine
· This year’s vaccine is designed to protect against four different strains of seasonal flu.
· Supplies of seasonal flu vaccine should be ample – sufficient to vaccinate anybody who wants it.
· Initial shipments of the seasonal vaccine are already arriving in the state.
· As in past years, seasonal flu vaccination will be available either from your regular health-care provider or through specially scheduled public clinics. Information about public clinics will be posted on the MDH Web site as soon as it is available.
· Information about public clinics may also be available from your local health department.
· The seasonal vaccine is especially recommended for people at high risk of serious complications from the flu. These groups include:
o Children and adolescents from six months to 18 years of age
o Adults age 50 and over
o Women who will be pregnant during flu season
o Health-care workers
o People living in nursing homes or other chronic care facilities
o People who live with or care for children age five or younger (especially those under six months, who cannot be vaccinated against flu)
o Children and adolescents who regularly take aspirin as part of their medical treatment (because they may be at risk of a complication called Reye Syndrome if they get the flu)
o People who are at risk of complications because of an underlying medical condition, including:
§ some kinds of conditions that may interfere with breathing
§ chronic lung disease (except asthma)
§ chronic cardiovascular disease (except hypertension)
§ chronic kidney disease
§ chronic liver disease
§ chronic metabolic conditions, or conditions involving the blood or blood-forming organs (including diabetes)
§ suppressed immune systems (due to medical treatment or infection)
o People who live with or care for people with conditions that place them at high risk of flu complications.
Novel H1N1 Vaccine
· A vaccine for novel H1N1 flu is now in the process of being developed and tested.
· Exact predictions about how much novel H1N1 vaccine we will have – and when it will be available – are difficult to make at this point.
· It is also likely that delivery of the vaccine will be spread over a period of time, with a large initial shipment and smaller additional shipments over the next few weeks.
· CDC currently expects to have enough of the new vaccine to begin vaccinating those at highest risk of serious illness by mid-October.
· Plans for vaccinating people against H1N1 are still being developed.
o The vaccination effort may include both vaccination by regular health-care providers and specially scheduled public clinics.
o Details will be announced as they become available.
· CDC has not formally issued recommendations about who should get the novel H1N1 vaccine. However, the following groups have been recommended to get the vaccine, based on their risk of severe disease:
o Pregnant women
§ Compared to the general population, pregnant women are four times as likely to be hospitalized if they develop novel H1N1 influenza. A number of deaths from novel H1N1 have been reported in pregnant women.
o People who live with or care for children under the age of six.
o Health care workers and emergency personnel
o All children, adolescents and young adults aged six months through 24 years
§ Children and adolescents appear to be at greater risk of serious disease from H1N1 than they are from seasonal flu. The median age of patients hospitalized with novel H1N1 in Minnesota is 19 years.
o People aged 25 to 64 who are at risk of complications because of an underlying medical or immune system condition, including:
§ some kinds of conditions that may interfere with breathing
§ chronic lung disease (except asthma)
§ chronic cardiovascular disease (except hypertension)
§ chronic kidney disease
§ chronic liver disease
§ chronic metabolic conditions or conditions involving the blood or blood-forming organs (including diabetes)
§ suppressed immune systems (due to medical treatment or infection)
o Although people age 65 and older are still a priority group for seasonal flu vaccination, they are not a high priority group for novel H1N1 vaccination. They appear to be at lower risk than other groups for getting novel H1N1 flu.
o The proposed groups for whom novel H1N1 will be recommended include an estimated 159 million people in the U.S.
o If the vaccine is in short supply, the recommendations will be adjusted to focus vaccination efforts on a smaller group of about 40 million people.
o This smaller group will still include pregnant women and people who live with or care for children under six. But it will also focus on a smaller segment of the other groups:
- It still includes health care workers and emergency personnel, but only if they have direct contact with novel H1N1 flu patients.
- It includes all children aged six months through four years, instead of children and adults aged six months through 24 years.
- It includes people with chronic medical conditions or immune system problems who are 5 to 18 years of age, instead of 25 to 64 years of age.