Weekly Flu Facts

	Update on H1N1 vaccine availability Due to a Federal reallocation of H1N1 flu vaccine, Massachusetts will be receiving a significant amount of H1N1 flu vaccine in early January. This will result in Southcoast receiving a larger than expected supply to be distributed throughout our hospitals and physician affiliates. Commercial pharmacies such as CVS, Walgreens, Rite Aid and Target will also receive supplies for public distribution. The following was issued by the Massachusetts Department of Public Health on December 23: New Options for Getting H1N1 Vaccine We're excited to announce that residents will have an additional option to vaccinate themselves and their families in the coming days. The federal government has announced that large chain pharmacies will soon be able to begin offering H1N1 vaccine to all residents. Currently, the national chains which are participating are CVS, Publix, Rite Aid, Supervalu, Target, and Walgreens. This list may grow as other large pharmacy chains express interest in participating. By working with these additional partners, we hope to increase the overall availability of vaccine in the state, especially since these pharmacies will be open throughout the holiday season and serving large numbers of customers. It's important to note that these additional doses do not come from vaccine quantities allocated to Massachusetts by the CDC. We continue to receive ever-larger amounts of our allotted vaccine which are going out to clinicians, hospitals, and local health departments for use at large scale flu clinics. Those public clinics will continue to be planned to begin in January. As these chain pharmacies begin to receive H1N1 vaccine at their individual store locations, these sites will be listed at www.mass.gov/flu, by clicking on "Find A Flu Clinic." For additional information, you can read a letter from DPH Commissioner John Auerbach to local public health departments about this federal partnership with chain pharmacies to distribute H1N1 vaccine.
	Voluntary recall for H1N1 pediatric vaccines Four lots of Sanofi Pasteur H1N1 pediatric vaccines in pre-filled syringes for children ages six to 35 months, were found to have a lower than required potency level. The CDC and the FDA issued a voluntary recall identifying the specific lot numbers and stating the following about the recall: There are no safety concerns or harmful effects for children who were vaccinated. There is no need to re-vaccinate children who received the shot from this lot. The recalled vaccine poses no harmful effects, just a potential for a reduction in the anticipated immune response. Children nine years old and younger who have only received one dose of the H1N1 vaccine still need to receive a second dose of 2009 H1N1 vaccine approximately one month after the first vaccination.
	Beware of e-mails for "State Vaccination Program." The U.S. Centers for Disease Control & Prevention has received numerous reports of fraudulent e-mails (phishing) referencing a CDC-sponsored "State Vaccination Program." The messages request that users must create a personal H1N1 (Swine) Flu Vaccination Profiles on the CDC's Website. The message then states that anyone that has reached the age of 18 has to have his/her personal Vaccination Profile on the CDC site. The CDC has NOT implemented a state vaccination program requiring registration on its Website. Users that click on the e-mail are at risk of having malicious code installed on their computers. CDC reminds users to take the following steps to reduce the risk of being a victim of a phishing attack: Do not follow unsolicited links and do not open or respond to unsolicited e-mail messages. Use caution when visiting un-trusted Websites. Use caution when entering personal information online.
	Update on vaccine supply. Massachusetts has now received more than 1.2 million H1N1 vaccine doses. As we move into December, the state expects that there will continue to be regular shipments with significant amounts of vaccine. Check our Flu Clinics page for links to upcoming local clinics.
	Get the H1N1 vaccine, even if you think you had the flu. It's better to be safe than sorry. The symptoms of influenza (flu-like illnesses) are similar to those caused by many other viruses. Current testing (rapid flu test) for H1N1 is not accurate enough to confirm the specific flu strain (Flu Fact #10). Therefore, even if you believe you had the 2009 H1N1 virus, it is still recommended, and not harmful, to receive the vaccine.
	Are you able to administer both the seasonal and H1N1 flu vaccine at the same visit? With the exception of the live attenuated influenza vaccines (nasal sprays), you can in most cases. We can administer: Both the inactivated seasonal and the inactivated H1N1 influenza vaccines at the same visit (using separate syringes and sites) or at any time before or after each other. The inactivated seasonal and live H1N1 influenza vaccines together or at any time before or after each other. The live seasonal and inactivated H1N1 influenza vaccines together or at any time before or after each other. Administering both the live attenuated seasonal and the live attenuated H1N1 influenza vaccines at the same visit is NOT recommended because of concerns about competition between vaccine viruses. If you have only live vaccines for both seasonal and H1N1 influenza available, you should separate the doses of the two live vaccines by at least 4 weeks.
	What are "high risk" medical conditions for complications from the flu? Medical conditions that confer a higher risk for influenza-related complications include: Chronic pulmonary diseases (including asthma). Cardiovascular diseases (except hypertension). Renal conditions. Hepatic neurologic/ neuromuscular conditions that can cause breathing or swallowing problems (including cerebral palsy). Hematologic metabolic disorders (including diabetes mellitus) and immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus).
	Does pandemic H1N1 vaccine contain thimerosal? Vaccine will come in multiple formulations, some of which will be multi-dose vials and contain thimerosal. It is so low that it should not be a concern. Overwhelming evidence, including an Institute of Medicine review, indicates that thimerosal has not been associated with any adverse effects. The type of flu vaccine that is sprayed into your nose (nasal spray) does not contain thimerosal or other preservatives. Institute of Medicine Report: Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders
	Will H1N1 influenza vaccine ever be available for healthy people age 25 years and older (who are not in targeted groups)? Once public health authorities at the local level determine that the H1N1 influenza vaccine demand for the five target groups has been met, providers will be notified that they can administer the vaccine to healthy people ages 25 through 64 years. Once demand for H1N1 influenza vaccine among younger age groups is met, vaccination should be expanded to all people age 65 and older. Five target groups: Pregnant women. Household contacts and caregivers of all infants under 6 months of age. Health care workers. Persons age 6 months to 24 years. Persons with chronic medical conditions between the age of 25 to 64 years — conditions such as heart disease, lung disease, asthma, diabetes or persons with weakened immune systems.
	Southcoast is not recommending a rapid flu test if H1N1 (Swine) flu is suspected. The seasonal flu is not currently circulating. If it is the flu, it is H1N1. Rapid tests can have low sensitivity for H1N1 flu. These tests should not be used to rule out the presence of H1N1. If a rapid test is positive for influenza A, the patient can be presumed to have H1N1. In a number of cases, if a rapid test is negative, the patient may still have H1N1. Health care providers are advised to manage and monitor symptoms rather than rely on a test that may not be accurate. Remember, whether it is H1N1 (swine) flu or seasonal flu, the treatment is the same. News: H1N1 testing not recommended by health officials
	H1N1 nasal mist age limitations. In order to receive the H1N1 nasal mist vaccine, persons must be less than 50 years of age and in generally good health. The age limitation is due to clinical data that showed reduced immunity in persons age 50 and over.ÊH1N1 nasal mist vaccine provides better immunity in the younger population, and is a safe option for healthy people 2 to 49 years of age who are not pregnant.
	Some viruses and bacteria can live 2 hours or longer on surfaces. Primarily cold and flu viruses spread from person-to-person. They also spread by touching contaminated surfaces or objects. Flu viruses tend to survive longer outside the body than cold viruses. Depending on the surface and the virus, a virus can last a few seconds to a few days. The CDC states that the human influenza viruses generally can survive on surfaces such as doorknobs, desks, computer keyboards and phones between 2 and 8 hours, in some cases as long as 48 hours. It is also generally believed that viruses survive for longer periods on nonporous surfaces (plastic, metal or wood) than porous surfaces (fabric or paper). The best way to stop germs: washing hands frequently with soap and water or alcohol-based hand sanitizer and wiping down surfaces with soap and water or a disinfectant wipe. CDC: Preventing Seasonal Flu Mayo Clinic: Flu germs: How long can they live outside the body?
	When should you keep your child home from school. At this time, state and local public health officials recommend that students can — and should — continue to go to school, as long as they are not sick and do not have flu symptoms. Flu-like symptoms include: fever over 100.4 degrees F or 38 degrees C with cough and/or sore throat. In addition, symptoms of H1N1 flu include: runny nose, stuffy nose, headache, body aches, feeling very tired and sometimes vomiting or diarrhea.
	Southcoast's new visitor policy effective October 26, 2009. Southcoast Hospitals Group has updated its visitors policy to limit visitor access to maternity and pediatric units at the three hospitals to protect the patients most at-risk. No visitors will be allowed under the age of 18, including siblings, in the maternity and/or pediatric areas. We are also asking that no individuals with cold or flu symptoms visit the hospital. Patients and people entering the hospital with cold or flu symptoms are asked to wear surgical masks that will be provided by hospital staff. Reminder, practice safe hygiene by washing hands and/or using the antibacterial dispensers located throughout public areas and patient floors. This policy will stay in effect until further notice. News Release: Southcoast Hospitals updates hospital visitor policy for flu season; maternity and pediatric units only those over 18, including siblings
	If you have, ASTHMA or you SMOKE: Mass. DPH recommends that you get the pneumococcal vaccine to help prevent pneumonia this flu season. This is because you are more likely to have serious complications if you get the flu. Also recommended is the Seasonal Flu and H1N1 Flu vaccines. The pneumococcal vaccine is FREE through employee health if you meet the criteria.
	H1N1 (Swine) flu is a pandemic influenza. H1N1 is of great concern because it's a new virus that just appeared last spring. Because this is a new virus, most members of the community do not have immunity to it. It is considered a pandemic, because it has spread on a worldwide scale and continues to infect large populations.
	Disease is bad. Vaccines are good. There are far less complications from flu vaccination than from the flu itself. Swine flu has infected more than 20,000 Massachusetts children and adults since the virus first appeared five months ago. Eleven deaths in Massachusetts have been blamed on swine flu. DPH projects in the coming weeks and months Massachusetts will begin seeing more widespread cases similar to what the South is experiencing now.
	Dial 2-1-1 in Massachusetts for general information on H1N1 (Swine) flu and seasonal flu. Mass 211 offers free access to health and human services information with a dedicated line answered by a resource specialist for questions about H1N1 and seasonal flu. Share this information with your family and friends. Massachusetts 2-1-1. Get Connected. Get Answers.
	The H1N1 (Swine) flu shot is safe. Federal health experts agree that the H1N1 (Swine) flu shot should be as safe as the shot for the seasonal flu. CDC expects that any side effects following vaccination with the 2009 H1N1 influenza vaccine would be rare. If side effects occur, they will likely be similar to those experienced following seasonal influenza vaccine. Remember, many millions of doses of seasonal vaccine have been distributed every year for many years with a well-established safety record.

Flu Facts

Every year, flu kills 36,000 Americans and causes over 114,000 hospitalizations.

Prevention:

• Take advantage of a flu shot. Be sure to get the shot every year because flu viruses are constantly changing and new vaccines are needed to protect against the different flu viruses.
• Frequently wash hands and encourage your family to wash hands. Hand-washing is the single most important means of preventing the spread of illness.
• Avoid crowded, public places during flu season, since the illness is primarily spread through the air.
• A person can spread the flu virus starting one day before he or she feels sick and continuing up to three to seven days after they develop symptoms. A child can continue to spread the virus for longer than seven days.

Symptoms: The flu is different from a cold. Symptoms may include:

• Sudden onset of a high fever.
• Headache.
• Muscle aches.
• Dry cough.
• Extreme fatigue.
• Children may also experience gastrointestinal symptoms.

Treatment:

Since the flu is a virus, antibiotics are not useful in treating the disease. There are several anti-viral medications that can reduce symptoms and duration of the flu. These are available only by prescription through your doctor.

Treatment for flu symptoms include:

• Acetaminophen or ibuprofen for fever and aches.
• Bed rest.
• Plenty of fluids to prevent dehydration.
• NEVER give aspirin to a children or teenagers who have flu-like symptoms. Giving aspirin in these cases can cause a rare but serious illness called Reye syndrome.

Most people who get the flu will recover in one to two weeks. However, a certain number develop complications that include secondary bacterial infections such as sinus and ear infections and pneumonia.

These complications are more common among very young children, the elderly and those with chronic illnesses.