Your Questions About H1N1 Pandemic Flu

Date:
10/29/2009 | 12:00 pm

This is the time of year when we often know family and friends who become sick from the seasonal flu.  This year there is another flu to be concerned about - H1N1 Pandemic Influenza.  With so much in the news about H1N1 flu (also known as swine flu), we know that you have many questions about staying healthy, who should get the H1N1 vaccine and how to prepare your family for this pandemic. 

Join Rosalie Pepe, M.D., of Cooper University Hospital’s Division of Infectious Diseases, as she answers your questions live on CooperHealth.org.  No question is too big or too small; as she’ll help you sort through the rumors and debunk the myths.

Dr. Pepe is board certified in both Internal Medicine and Infectious Disease. She received her medical degree from the Jefferson Medical College in Philadelphia.  She completed her internship, residency and a fellowship at Hahnemann University Hospital.  Her special interests are in infectious disease disorders in adults and immune deficiency conditions.

How is illness from H1N1 diagnosed? Are the symptoms that indicate H1N1 different from symptoms of sesonal flu? Are there blood tests or anything that confirm illness from H1N1? Are the medical treatments for H1N1 and seasonal flu the same or do they differ? Thanks Beatrice from Berlin

10/29/2009 12:03:26 PM

Rosalie Pepe, M.D.: The test that confirms H1N1 illness is called an H1N1 rt PCR.  It is done on a swab from the nose, or washings from the throat, or on respiratory specimenobtained in the hospital.  There is not a blood test to confirm H1N1 at this time.  The symptoms are very similar to seasonal flu, with fever, sore throat, muscle pain, headache very common.  Nasal congestion and GI symptoms like nausea and vomiting are more common early in H1N1 illness.  The serious complications in both usually involve the lung.  Initial treatment with fluids and medicines to lower symptoms are the same for both, but different antiviral medications are used for H1N1 and seasonal flu at this time.

What's the difference between flumist and the vaccine? Can adults get the flumist or just kids? Maryanne from Red Bank

10/29/2009 12:04:50 PM

Rosalie Pepe, M.D.: Flumist is one type of vaccine, it is the vaccine that is given by nasal spray. It has a weakened, live form of the virus.  It works better in children, but adults younger than 50 years old, with no immune system problems and who are not pregnant can get the nasal spray.

After the 1976 swine flu vaccine, several people were diagnosed with Guillain -Barre syndrome. Does anyone know why? Is the 2009 swine flu vaccine prepared differently than the 1976 vaccine? Are there still risks of GBS? Tammy from Philadelphia

10/29/2009 12:07:27 PM

Rosalie Pepe, M.D.: It has never been figured out exactly why Guillain-Barre occurred more often with that vaccine, although it is possible that at the time we were just better at finding and counting all the cases.

The virus this year is a little different than that first swine flu virus, so this vaccine will not be exactly the same as that vaccine.  GBS is considered a possible risk of all vaccines, although it occurs very rarely.

I am a 63 year old woman with adult onset diabetes, and asthma controlled with medication.I use a c-pap machine for my apnea with an oxygen concentrator. I've already had the flu shot. Should I have the H1N1 also? Nancy from Mount Laurel

10/29/2009 12:09:35 PM

Rosalie Pepe, M.D.: Because of your medical conditions, you should plan to receive both vaccines this year. Please look for the availability of the H1N1 vaccine in your area.

Are there things the government and health organizations are not telling us about the H1N1 that would make more of us get the vaccine if we really knew the facts? Do we know all there is to know or is this just hyped-up? If you already have H1N1 do you need the vaccine? Seeing it is already very prevalent in this particular area and the vaccine is not available yet. If we get it, do we still need the shot? Vicky from Berlin

10/29/2009 12:11:16 PM

Rosalie Pepe, M.D.: The way I see the whole situation with H1N1 is that most people will have mild illness, but because the number of people with no immunity is much larger, the numbers of people with severe illness will end up being larger than usual.  The severe cases have been happening in younger people than usual as well.  The vaccine would prevent these severe cases, as well as the milld, from happening. For people that are confirmed cases of H1N1, the vaccine is not necessary.  For people who do not have the diagnosis confirmed should still get the vaccine since they may have been sick with something else.

My daughter is 21 years old and a senior at Rowan University. She says she is not going to get the H1N1 flu shot because she is worried about side effects in the future. I am very worried about her because she is around a very large number of people everyday. Should she get the vaccine and should she be concerned about side effects? Wendy from Mantua

10/29/2009 12:14:59 PM

Rosalie Pepe, M.D.: The vaccine is recommended for all individuals between the ages of 6 months and 24 years.  I would recommend the vaccine since more of the severe cases have happened in younger people, but it is an individual decision.  There have been no unusual side effects seen from this vaccine so far, and monitoring is continuing as more people receive the vaccine.

If my child is sick now with H1N1 virus, do you still recommend getting the vaccine when it is available? Diane from Marlton

10/29/2009 12:18:57 PM

Rosalie Pepe, M.D.: If your child is a confirmed case, that is, a swab test is done and is positive for H1N1, then your child would not need the vaccine.  However, most cases are going to be diagnosed by clinical symptoms, and will not have testing done.  (You can see a discussion about testing in the answer to Beatrice above). These children should still receive the vaccine since they may have been sick  with something else.

Is it true that they may think that the H1N1 vaccine can cause Guillian Barre? Rose from Voorhees

10/29/2009 12:19:52 PM

Rosalie Pepe, M.D.: Guillain-Barre syndrome has occurred rarely after many type of vaccinations.  Please see the answer to Tammy above for more information.

My kids (age 3 and 5) go to Cooper Pediatrics in Voorhees. The office has told us that you will NOT be receiving any H1N1 vaccinations. Why not? They also will not comment on whether it is advisable to vaccinate our children. They comment that it is up to the parents. Holly from Medford

10/29/2009 12:21:01 PM

Rosalie Pepe, M.D.: Most of the doses of vaccine in this area so far have gone to the local health departments, some will be arriving for vaccinating health care workers. Since this vaccine is coming from the federal government, there are some specific administration requirements that may make it difficult for individual offices to obtain. The American Academy of Pediatrics, and our pediatricians, do recommend the vaccine but the decision is up to parents.

If my husband and I are able to be vaccinated with H1N1, could we still be a carrier and pass it to our kids if they have not yet been vaccinated? Holly from Medford

10/29/2009 12:22:25 PM

Rosalie Pepe, M.D.: If you are vaccinated with the shot, you will not receive any live virus and cannot pass any infection to your children.  If you receive the nasal spray, there is a short period of time where you may have weakened, live virus in your nose and throat and a very small chance of passing the vaccine virus on to someone else, and it is very unlikely that person would become symptomatic.

The public has been told that one of the first group to receive the H1N1 vaccine is health care personnel. Have any health care personnel in New Jersey been given the vaccine yet? Valerie from Blackwood

10/29/2009 12:24:12 PM

Rosalie Pepe, M.D.: I am not able to answer for the entire state, since the distribution of the vaccine is generally determined by the state health department.  As more vaccine becomes available, the answer could change on any day. 

I am 81yrs. of age=should i get the vaccine. I am a diabetic but in fairly good health. I do not get many colds=not among people Theesa from Collingswood

10/29/2009 12:25:27 PM

Rosalie Pepe, M.D.: The C.D.C. recommends that ultimately everyone should receive the vaccine.  Because of your age, you would not be in the first groups recommended to get the vaccine because this virus causes illness in people over 65 more rarely,but should plan to get it later.

Has the vaccine been approved by the F.D.A.? If so, what are its side-effects? Joanne from Deptford

10/29/2009 12:28:06 PM

Rosalie Pepe, M.D.: The vaccines prepared by each manufacturer are approved by the FDA before release.  The side effects seen so far have been the same as those described for seasonal flu vaccine.  The injectable vaccine may cause a few days of a low grade fever, and some pain in the arm at the injection site.  The nasal spray can also cause some low grade fever, but also some nasal congestion, and possibly asthma symptoms in patients with asthma.

How are the distribution channels for the H1N1 vaccine being determined? County clinics, schools, private physicians office etc? When can we expect the vaccine to be widely available for ALL the children who need it in the community? Ruth from Collingswood

10/29/2009 12:30:16 PM

Rosalie Pepe, M.D.: The federal government is providing the vaccine as it becomes available through one distributor.  Applications are placed on-line and most of the vaccine is then allotted through counties.  All private offices may not be able to meet some of the requirements for administering the vaccine, so county health departments and schools may deliver more of the vaccine.  The availability is changing very quickly locally and I hope it will be generally available in the next 2 weeks.

Can you receive both the seasonal flu vaccine and the H1N1 vaccine at the same visit or does there need to be a waiting period between receiving the different vaccines? Michelle from Westmont

10/29/2009 12:32:03 PM

Rosalie Pepe, M.D.: If both of the vaccines are being given as the shots, the two can be administered at the same time.  The nasal spray forms have to be separated by several days between doses.

If they're not testing for H1N1 now and you come down with a flu-like illness, how do you know it is swine flu and NOT to get a vax for it? Jerry from Millville

10/29/2009 12:33:48 PM

Rosalie Pepe, M.D.: This is a good question and as I said previously,  there will be no way to know and people who have been sick but have not had a test to confirm H1N1 should get the vaccine. 

Having had a stem cell replacement in 1998, my immune system has been compromised. I'm a diabetic and have asthma. I'm over 60, should I have the H1N1 vaccine? Nancy from Mount Laurel

10/29/2009 12:35:25 PM

Rosalie Pepe, M.D.: You should receive the injectable vaccine when it is available.  If your doctor's office does not have the vaccine, please look for it through a county health department.

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