What is Flu?

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. The best way to prevent the flu is to get a flu vaccine each fall.

Every year in the United States, on average:

5% to 20% of the population gets the flu;
more than 200,000 people are hospitalized from flu complications; and
Approximately 36,000 people die yearly from flu.

Some people are at high risk for serious flu complications, such as older people, young children, and people with certain health conditions, including pregnancy.

Symptoms & Complications of Flu

Symptoms of flu include:

fever (usually high),
headache,
extreme tiredness,
dry cough,
sore throat,
runny or stuffy nose, and
muscle aches.
Gastro-intestinal symptoms, such as nausea, vomiting, and diarrhea, are much more common among children than adults.

Some of the complications caused by flu include bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Children may get sinus problems and ear infections.

How Flu Spreads

The flu spreads in respiratory droplets caused by coughing and sneezing. It usually spreads from person to person, though occasionally a person may become infected by touching something with virus on it and then touching their mouth or nose.

People may be able to infect others beginning 1 day before getting symptoms and up to 7 days after getting sick. That means that you can give someone the flu before you know you’re sick as well as while you are sick. This is why some schools require a person to remain home for seven days when Flu is suspected, even after they are feeling better.

Preventing the Flu

The single best way to prevent the flu is to get a flu vaccine each fall. There also are certain good health habits that can help prevent the flu. In addition, antiviral medications may be used to prevent the flu.

Avoid close contact.
Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
Stay home when you are sick.
If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
Cover your mouth and nose.
Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
Clean your hands.
Washing your hands often will help protect you from germs.
Avoid touching your eyes, nose or mouth.
Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Flu Vaccine

Each year several strains of influenza circulate simultaneously. Type A strains tend to cause more respiratory symptoms( such as cough and runny nose) while Type B tends to cause more gastrointestinal symptoms( such as vomiting and diarrhea) however many strains cause both. Every year the CDC decides what strains will be in the influenza vaccines. They pick two Type A strains and one Type B strain. The strains are picked in February and production of the vaccine starts at that time. Influenza vaccine is incubated in chicken egg yolks and takes several months to produce.

This year the Novel H1N1 strain (AKA Swine Flu) became known in May. At that point the influenza vaccine was already in production. Instead of stopping production of the vaccine which had been incubating for months and starting from scratch with a vaccine that substituted the novel H1N1 strain for one of the other Type A Flu strains, it was decided that they would complete the vaccine already in progress and call it “Seasonal Influenza Vaccine”. Additionally, they would produce a second vaccine which would contain only the one Type A strain (H1N1). Had this strain become prevalent earlier in the season or had the process to produce the vaccine been shorter, the H1N1 strain would have been part of the seasonal Vaccine.

A separate Novel H1N1 Vaccine (Swine Flu Shot) was produced by the same manufactures using the same technique that was used for decades in the production of yearly influenza vaccines. Since the manufacturing technique and manufacturers were the same there is no reason to suspect that the safety or side effects would be any different.

There are two types of vaccines (both contain the same strains):

The "flu shot" -- an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions. Vaccine is available as:

o Ages six months to 35 months of age receive 0.25 ml in a pre-filled preservative free syringe

o Preservative free single dose 0.5 ml vials (children over three). We use this type for children between three and six, or when requested.

o Multi-dose bottles containing trace amounts of preservative (we use for people over the age of six, unless the preservative free is requested)

The nasal-spray flu vaccine (Flu MIST) -- a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). LAIV is approved for use in healthy people 2 years to 49 years of age who are not pregnant. This does not contain preservative. It is not recommended for people with asthma.

Both types will also be available for the Seasonal vaccine and the Novel H1N1 vaccine.

For both types of Seasonal Influenza Vaccine children under 9 years of age require two doses (on month apart) if they have not been previously vaccinated.

For the Novel H1N1 Vaccine all children under 10 should receive two doses (at least three weeks apart).

The seasonal influenza and the H1N1 vaccine can be given at the same visit but does not have to be at the same visit.

About two weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.

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Who Should Get Vaccinated?

Seasonal Influenza Vaccine

all children aged 6months –18 years of age;
adults aged 50 years and older;
persons aged 18-50 years with underlying chronic medical conditions or weaken immune system;
all women who will be pregnant during the influenza season;
residents of nursing homes and long-term care facilities;
children aged 6 months–18 years on chronic aspirin therapy;
health-care workers involved in direct patient care; and
out-of-home caregivers and household contacts of children aged <5 years of age or >50 years of age.
People who live in dormitories, correctional facilities, or under other crowded conditions, to prevent outbreaks

Please note that here has been a change in the recommendations over the last several years. Up until about seven years ago influenza vaccine was only given to children with chronic medical conditions or weakened immune systems. The recommendation was expanded to include health children ages 6 mo- 23 months and their household contacts and care givers. This was later expanded to 6 mo to 35 mo and their household contacts and caregivers. The 2008-2009 flu season was the first year that the recommendation was expanded to 6 mo to 18 years of age. The recommendation was changed in order to reduce the total number of influenza deaths. Although children very rarely die or have complications of the flu, they are the reservoirs of the illness and spread it to others that can become very ill or die.

H1N1 (Swine) Vaccine

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) make recommendations for use of vaccine against novel influenza A (H1N1)

pregnant women,
people who live with or care for children younger than 6 months of age,
health care and emergency medical services personnel,
persons between the ages of 6 months through 24 years of age, and
people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

The groups listed above total approximately 159 million people in the United States

The committee does not expect that there will be a shortage of novel H1N1 vaccine, but availability and demand can be unpredictable. There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others:

pregnant women,
people who live with or care 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, and
children 5 through 18 years of age who have chronic medical conditions.

The committee recognized the need to assess supply and demand issues at the local level. The committee further recommended that once the demand for vaccine for these prioritized groups has been met at the local level, programs and providers should begin vaccinating everyone from ages 25 through 64 years. Current studies indicate the risk for infection among persons age 65 or older is less than the risk for younger age groups. Therefore, as vaccine supply and demand for vaccine among younger age groups is being met, programs and providers should offer vaccination to people over the age of 65.

The committee also stressed that people over the age of 65 receive the seasonal vaccine as soon as it is available. Even if novel H1N1 vaccine is initially only available in limited quantities, supply and availability will continue, so the committee stressed that programs and providers continue to vaccinate un-immunized patients and not keep vaccine in reserve for later administration of the second dose.

The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine. It is intended to be used alongside seasonal flu vaccine to protect people. Seasonal flu and novel H1N1 vaccines may be administered on the same day.

For more information visit www.CDC.gov

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