Since this is the time of the season that we are likely to get sick. The following are reader-submitted H1N1 questions with answers supplied by Dr. Alissa Ackelson, infectious diseases director of Infection Control, Genesis HealthCare System
Q: Does UV light kill the H1N1 virus?
A: Ultraviolet light illuminated on surfaces at the proper wavelength can degrade some viruses. However, in order to be effective, the surface of any object has to be readily accessible to the light. This means that the undersurface of the chair, table, doorknob, etc., would not be reached by the light, and therefore, it would not be disinfected. Additionally, ultraviolet light cannot be used on skin. Therefore, there are very few places where the use of ultraviolet light would be practical or useful. Studies have shown influenza virus can survive on surfaces and can infect a person for up to eight hours after being deposited on the surface. Frequent hand washing will help decrease the deposition of virus on the surfaces to help kill the virus picked up on your hands. It also is advisable to try to avoid frequent touching of the eyes and mouth.
Q: Is the H1N1 vaccine FDA safe to get and has anyone who has received it died or gotten sick from either the shot or the mist?
A: As of Nov. 19, 2009, World Health Organization has received vaccine information from 16 of the 43 countries around the world using H1N1 vaccine. They estimate that approximately 80 million doses of pandemic vaccine have been distributed and 65 million people vaccinated. All the data compiled to date indicate that the pandemic vaccine has the same safety profile as seasonal influenza vaccine which has an excellent safety record. To date, no deaths have been attributed to the vaccine despite thorough investigation of the few deaths that have coincidentally occurred. The World Health Organization continues to aggressively monitor for side effects. To date, fewer than 10 suspected cases of Guillain-Barré syndrome have been reported in people have received the vaccine. These numbers are the same as the normal rate of Guillain-Barré formerly seen when no vaccine is available and therefore there has been no increased incidence in the occurrence of Guillain-Barré. Nonetheless, all such cases are being investigated by the World Health Organization.
In comparison, as of Oct. 17, 2009, to CDC estimates there have been more than 22 million cases of H1N1 infection and more than 3,900 deaths associated with this infection. The H1N1 vaccine has received U.S. Food and Drug Administration approval and is recommended by the National Centers for Disease Control as the most effective way to protect against the H1N1 virus. The vaccines are made in the same way as seasonal flu vaccine and are as safe and effective.
Q: Is there mercury in the vaccine? If so, how much and whom might it harm?
A: The 2009 H1N1 influenza vaccines have been manufactured in several formulations. Some will come in multi-dose vials and will contain small amounts of thimerosal, a mercury-based preservative, to prevent the growth of microorganisms that can contaminate the vaccine after the vial is opened and could cause serious illness or death.
Some vaccine manufacturers have produced the 2009 H1N1 influenza vaccine in single-dose units, which do not require the use of thimerosal as a preservative. In addition, the live-attenuated version of the vaccine, which is administered intranasally (through the nose), is produced in single-units and will not contain thimerosal.
Three leading federal agencies — CDC, FDA, and the National Institutes of Health — have reviewed the published research on thimerosal and found it to be a safe product to use in vaccines. If you have any concerns, ask for the vaccine from a single-dose injection.
Q: Some reports have said the regular flu did not hit until October, and those who had the flu prior to that had the H1N1 virus. Is that true?
A: Influenza activity in the United States remains very high this year. So far most of this influenza has been H1 N1 but seasonal influenza A and B strains are also circulating and have been seen in patients in our area. There were some cases of seasonal influenza in the country as early as late July, but 99 percent of type A influenza has been H1N1 and influenza B has been circulating at low levels. There has been very limited availability to test specifically for H1N1 virus especially in non-hospitalized patients. However, if someone had true influenza, most of the time they probably did have H1N1. On the other hand, not everyone with flu-like symptoms had H1N1. Illnesses such as pertussis (whooping cough), severe colds and other viral infections could have similar symptoms as the flu. Just because you had flu-like symptoms, you may not have had H1N1. You still should get the vaccine as soon as it is available to you.
Q: What is the difference between H1N1 (swine flu) and seasonal flu?
A: The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death; approximately 36,000 people dying from complications from seasonal flu in the United States each year. More than 90 percent of deaths and about 60 percent of hospitalization occur in people older than 65.
The best way to prevent seasonal flu is by getting a seasonal flu vaccination each year to protect against that year’s strain of the disease. Some people, such as older people, young children, pregnant women and people with certain health conditions (such as asthma, diabetes or heart disease), are at increased risk for serious complications from seasonal flu illness.
2009 H1N1 (sometimes called “swine flu”) is a new influenza virus first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide in much the same way that regular seasonal influenza viruses spread — through coughs or sneezes by people with influenza or by touching a surface or object with flu viruses on it and then touching your mouth or nose.
While it is essentially a different strain of the influenza virus, the H1N1 virus differs from seasonal flu in the timing of the virus and those identified as at highest risk for complications. H1N1 has occurred nationally since April 2009, not following the same late fall through winter timing pattern as seasonal flu. Illness with 2009 H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred.
In seasonal flu, those considered at “high risk” of serious complications include people 65 years and older, children younger than 5 years old, pregnant women and people of any age with certain chronic medical conditions. The 2009 H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people. At this time, there are relatively fewer cases and deaths reported in people 65 years and older, which is unusual when compared with seasonal flu. Other previously recognized high risk medical conditions from seasonal influenza also appear to be associated with increased risk of complications from 2009 H1N1. These underlying conditions include asthma, diabetes, suppressed immune systems, heart disease, kidney disease, neurocognitive and neuromuscular disorders and pregnancy.
Q: When will people older than 24 who have chronic health conditions, such as asthma or compromised immune systems, be eligible for the H1N1 vaccine? According to the CDC, this was to be a priority group.
A: The CDC’s Advisory Committee on Immunization Practices, a panel made up of medical and public health experts, developed recommendations regarding who should receive the 2009 H1N1 vaccine. These groups include:
Pregnant women
Household contacts and caregivers for children younger than 6 months of age
Health care and emergency medical services personnel
People 6 months through 24 years of age
People aged 25 through 64 years who are at higher risk due to chronic health disorders or compromised immune systems
The ACIP further determined that if there was not an adequate supply of vaccine available, the distribution would be limited to the following groups until more vaccine was available. These priority groups include:
Pregnant women
Household contacts and caregivers for children younger than 6 months of age
Health care and emergency medical services personnel with direct patient contact
Children 6 months through 4 years of age
Children 5 through 18 years of age who have chronic medical conditions
As more vaccine becomes available and the groups listed above are vaccinated, we will continue to see more vaccine available to others in the other risk categories. It is important to continue to monitor updates from the local health departments to learn when free vaccine clinics are available.
