School's in, the autumn flu season approaches, the H1N1 influenza virus has been lurking all summer, and America's health officials anxiously prepare for . . . they know not what.
"The only thing certain is uncertainty," says Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention. "This will be a unique season with both H1N1 and seasonal flu virus circulating at the same time.
"Even with our best efforts, there is going to be a lot of illness, severe illness and death."
"This isn't the flu we're used to," noted Kathleen Sebelius, U.S. secretary of Health and Human Services. "We've seen continued transmission in a summer that should not be flu season. It's never gone away."
As flu season approaches, here are some frequently asked questions about H1N1 (also called swine flu), and their answers.
Q: When would this happen?
A: Soon. Schools are in, and children are close together in classrooms again, cooler weather is coming, which increases transmission. Officials speculate H1N1 could peak in mid-October, but say they really don't know.
Q: What about those headlines predicting 90,000 people might die of H1N1 this season?
A: A White House task force put out a report last week talking about 90,000 deaths, 1.8 million hospitalized, 50 percent of the population infected and 50 percent of all the hospital beds in America filled with H1N1 patients.
But officials from the Centers for Disease Control and Prevention immediately started criticizing those numbers. And the White House acknowledged their report was a "planning scenario, not a prediction."
Q: What's being done to fight H1N1 influenza?
A: The government is launching a vaccination campaign, hoping to inoculate at least 195 million people against H1N1 by the end of the year.
Q: Are local governments involved?
A: Yes. Both the Broward and Miami-Dade Health Departments are helping to organize places to get the shots -- maybe school clinics for school children, and, for other people, shopping centers, pharmacies, supermarkets, public health clinics, private doctors' offices, private offices.
Q: When will the H1N1 vaccines arrive?
A: About mid-October. The first batch will be about 45 million shots, with more arriving weekly for the 195 million total. It's a big job, but doctors routinely vaccinate 100 million Americans each year against regular seasonal flu.
Q: Is the H1N1 vaccine safe?
A: Several clinical trials are going on now to check the vaccine's safety, even as it is being manufactured. CDC officials stress that the H1N1 vaccine is very similar to the vaccines against regular seasonal flu that we've been taking routinely for years.
Q: Will there be enough vaccine to go around?
A: Not enough at first to cover everyone who should be immunized, but probably enough to cover all those who come forward to get the shots. By year's end, there should be enough for everyone who wants a swine flu shot.
Q: Who has priority for the first H1N1 flu shots?
A: Priority goes to those most at risk -- pregnant women, people who care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between 6 months through 24 years and people from 25 through 64 at higher risk because of chronic health disorders or weak immune systems. These groups comprise about 159 million people.
Q: Will H1N1 shots be expensive?
A: They shouldn't be. The federal government is paying for the vaccines. Most schools and public health clinics will probably give the shots free. Private doctors, pharmacies, supermarkets and others may charge a small administration fee. Some health insurance plans will cover it, some won't.
Q: Will H1N1 flu shots contain the preservative Thimerosal? I'm worried that it might be associated with autism.
A: Study after study around the world has concluded that Thimerosal is not associated with autism. Still, many parents don't want their children getting shots that contain it, with its mercury content. So some H1N1 flu shots will contain it, others will not. You can ask for the shot without it.
Q: Are there people who should not get swine flu shots?
A: Yes, especially people allergic to eggs, which are used in its manufacture. People with mild allergies can discuss with their doctor whether they could get the shots under close supervision. People with strong allergies should avoid the shots altogether.
Q: Are antivirals like Tamiflu effective in treating swine flu?
A: They are effective -- best if given within 48 hours of flu symptoms, says Dr. Anthony Fiore, of the CDC's Influenza Vaccine Working Group. In high-risk individuals, Tamiflu is sometimes given even before tests come back confirming that it's swine flu. If you're in one of the groups at high risk from swine flu, experts suggest talking to your doctor about it beforehand so you can simply call her or him later if you need it.
Q: Who are the most frequent victims?
A: Young people between 5 and 24, pregnant women and people with asthma, heart trouble, diabetes and other underlying conditions.
In a typical year, 80 young people in that age group die of regular seasonal flu. So far this year, 111 have died, with 42 definitely diagnosed as swine flu victims, says Lyn Finelli, surveillance leader for the CDC's Influenza Division.
Experts believe it's because they haven't lived long enough, haven't gone through enough previous flu seasons to build up immunity.
Also since April, 20 pregnant women have died of H1N1 flu. Pregnant women make up less than 1 percent of the population, but 6 percent of H1N1 flu deaths, the CDC says. They're more at risk because their bodies' immune systems naturally lower their defenses to keep from rejecting the baby they're carrying, a CDC expert said.
And countrywide, more than 70 percent of all H1N1 deaths have been in people with underlying medical conditions.
People 65 and over, very much at risk from regular seasonal flu, appear to be somewhat protected against H1N1 -- apparently because they have lived through half a dozen past flu epidemics and had many flu shots. To see more of The Miami Herald or to subscribe to the newspaper, go to http://www.herald.com. Copyright (c) 2009, The Miami Herald Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
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