Influenza has been in the forefront of medical news recently because of the emergence of a new human pandemic virus called Influenza A (H1N1), commonly known as swine flu. Typically found in pigs, human infections made its first appearance in California and Texas in early 2009 but now have spread worldwide. The World Health Organization raised the pandemic level of H1N1 to indicate this is causing more serious infections and deaths.
The matter really hit home when I went to India for a short trip recently and landed at Kochi International Airport in my hometown. Even before we met the Immigration and Customs officials for passport and visa clearance, we were asked to form a single file. Every one of us was screened for fever by an digital electronic beam thermometer remotely as we passed the entry door. If you did have even a slight fever, you would be quarantined for a few days in a hospital before they let you go.
I was a bit nervous until I safely got out of the airport. If you are traveling outside the country, you will be required to fill a special form attesting that you are not suffering from swine flu symptoms.
Federal health officials say this will be one of the most complicated flu seasons in memory because it involves two flu viruses — the standard seasonal flu and the much-dreaded H1N1 flu.
From 5 to 20 percent of the U.S. population, including residents in long term-care facilities and health care workers, are infected with influenza every year. Annual flu-related hospitalizations range from 200,000 to 400,000, depending on seasonal variations in virulence. And you can expect 40,000 to 60,000 deaths from influenza each year in United States, 90 percent of whom are 65 and older. This year, it could be worse since we have the additional burden of swine flu to contend with. Symptoms of swine flu are the same as the regular flu except that they are more severe. When CNN medical correspondent Dr. Sanjay Gupta came down with the swine flu in Afghanistan recently, he said, "This was the sickest I had ever been."
The modes of transmission for common influenza are well known and they are more or less the same for swine flu. Droplets expelled from the mouth or nose of infected persons is the common mode, so stay away from those who suffer from the illness especially when they start coughing or sneezing. These infectious aerosol droplets can travel more than 10 feet and can stay suspended in the air for some time, especially if the humidity is low, hence the increase in the spread during cold weather. Anything the infected person touches with a virus-contaminated hand — pens, books, keypads, remote control, towels — can easily transmit the virus to others.
Officials predict the swine flu could infect half of the U.S. population. This is a real cause for alarm. The vaccine for H1N1 virus has just arrived and plans for the general public this year will include separate vaccinations for seasonal flu and H1N1. Children, pregnant women, health care workers, adults especially those suffering from other diseases like diabetes and asthma are more susceptible and must be immunized.
I attended a recent teleconference with CDC regarding the H1N1 vaccine safety. The Food and Drug Administration has already approved the use of one dose of H1N1 flu vaccine for persons 10 years and older. Children younger than 10 years most likely will need two doses of the vaccine. Immunization does work despite some controversy about it. Mass vaccination also will protect the unvaccinated from getting the infection.
Physicians are already ordering extra quantities of the vaccine. But there is a possibility that they may run out of the vaccine. Hence, don't wait too long. Get vaccinated by the end of October or early November. It may take up to a month for full immunity to be established.
Also, we need to implement better preventive and safety precautions focusing on practicality. Here is a checklist to follow this flu season:
Wash your hands using soap or alcohol-based hand cleanser after contact with any individual you suspect of being infected. Regularly disinfect the frequently touched surfaces with Lysol.
Wear a sterile mask in crowded places and if you are visiting infected persons. Every single employee in Indian airports that I passed through recently right down to the cleaners and baggage handlers was wearing a mask.
Stay at least 3 feet away from people who exhibit symptoms of cough, sneezing etc., especially in public places or turn your face away and don't breathe in the droplets.
Ann-Gayl Ellis, director of Health Education at the nursing at Hernando County Health department, informed me that they will receive adequate supplies of intranasal mist vaccine and the injectable vaccines by mid October. They have been sending information out to local physicians over the last several weeks, in an effort to stem this crisis. For information please visit the Web site http://www.cdc.gov/h1n1flu/clinicians/.
Dr. M.P. Ravindra Nathan is a Brooksville cardiologist and director of the Hernando Heart Clinic.