Before we begin to discuss specifics about the flu, it is imperative that we understand the two different types of flu that we are facing this year. It is a unique year in that we are not only facing common colds as we always do, but we also face the seasonal flu and a new strain called the H1N1 virus, also known as the Swine Flu. There’s been much talk about H1N1 and some of it has caused a feeling of panic in the community. What we will do in this article is touch very briefly on the common cold, go into more detail about seasonal flu and talk a great deal about H1N1. By doing this, we can talk about prevention but also dispel some common misconceptions about both flu viruses.

Seasonal vs. H1NI Flu: Differences

Seasonal flu: Seasonal flu is a virus that has been around before, so there is an ongoing immunity in the community that prevents widespread transmission. These outbreaks occur typically in fall and winter and can affect up to 20 percent of the population in any given year.

H1NI: H1N1 is a strain of a virus that has not been around before. Some call it Swine Flu because in the past it has been found to be carried in pigs. There is no immunity to it so it can spread and affect people quite dramatically. The H1N1 virus has been labeled a pandemic, a flu that spreads rapidly from person to person to create a worldwide epidemic. This strain meets the three characteristics of a pandemic; it is new, it infects people, and it spreads easily from person to person.

Is It Safe to Eat Pork? While the H1N1 got its name “swine flu” because it originally was carried in pigs, there have been questions about the safety of eating pork or products derived from pigs. H1N1 has not been shown to be transmitted to people through eating properly prepared pork, so feel free to continue eating it. As always, cook it thoroughly and practice safe cooking habits. How Is the Flu Spread? Whether it is seasonal flu or the H1N1, transmission is the same. When a person sneezes or coughs, large virus-laden droplets are deposited and transmitted to the upper respiratory tract of a susceptible person by (within about three feet of the droplets). For example, an infected person sneezes and the mucus that comes out of that sneeze lands on a table nearby. A person walking nearby stops at that table and puts their hands down right where the mucus was deposited. They then scratch their eye and the virus is transmitted through their eye to their respiratory system and if they are susceptible, they will suffer flu symptoms. How long does a virus stay on a surface? The answer to that could be anywhere between a few seconds or up to 48 hours.

Difference Between Flu and Colds:
The flu, like the common cold, is a respiratory infection caused by a virus. But the flu differs from the cold in several ways. People who get colds rarely get fevers or headaches and they generally do not suffer from the extreme exhaustion brought on by flu. Colds generally affect the upper respiratory area and do not make you feel like you have been “knocked off your feet.” The flu sure does.

Symptoms of the common cold vs. seasonal flu vs. H1NI:

Sympton	Colds	Seasonal Flu	H1N1
Body aches Fever Dry cough Hacking, wet cough Chills Stuffy and/or runny nose Headache Sore throat Fatigue Vomiting Diarrhea	slight rare no yes - yes rare rare mild - -	yes yes yes - yes yes yes yes severe - -	yes yes yes - - yes yes yes extreme yes yes

As you can see, almost all cases of both types of flues have the same symptoms so it makes it difficult to diagnose one versus the other. They also can share many traits of the common cold. Reported cases of H1N1 have shown that vomiting and diarrhea are more prevalent with this virus. Unfortunately, because the H1N1 is still relatively new, not enough actual case studies are available. Until the seasonal flu starts to really hit its peak in October through February, most cases being diagnosed are actually the H1N1 virus. When you start to experience any of the above symptoms, the best course of action is to seek a medical diagnosis.

Warning Signs in Children That Warrant Emergency Treatment: Fast breathing or trouble breathing Bluish or grayish skin color Not drinking enough liquids (dehydration can occur) Severe or persistent vomiting Not waking up or interacting with others Extreme irritability Flu-like symptoms occur but return again with fever and more coughing

Warning Signs in Adults That Warrant Emergency Treatment: Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Dizziness Confusion Severe or persistent vomiting Flu-like symptoms occur but return again with fever and more coughing

Complications of the flu can include ear infections, sinus infections, bacterial pneumonia, dehydration, congestive heart failure and worsening of chronic conditions. It is imperative to stay tuned in to your body to avoid complications.

How to Prevent Catching and/or Transmitting the Flu:

• If sneezing, cough into your sleeve or tissue. ALWAYS COVER YOUR MOUTH and teach your children the importance of doing the same.
• Wash your hands often with soap and water, especially after sneezing or coughing. Use alcohol-based cleaners whenever necessary.
• Avoid touching your eyes, mouth or nose since germs are spread this way.
• If you find yourself sick with symptoms, stay home for at least 24 hours AFTER your fever is gone. The only exception to this is if you need to seek medical treatment.
• Pay attention to public health advice regarding school closures or other closings due to illness.
• Get a flu vaccine every year and use whatever flu drugs may be available for the H1N1 virus. Please see below for further information.
• Get plenty of sleep, be physically active, drink plenty of fluids and eat a nutritious diet.

Additional Medical Steps That Can be Taken to Avoid the Flu:

Seasonal flu – The main method to avoid getting the flu is to get inoculated with the flu vaccine every year. It’s readily available at clinics or doctors offices most years, but there is a shortage this year due to manufacturing problems. You must get a new vaccine every year because the strain of flu changes. Up until recently, the only method to receive the vaccine was in the form of a shot. New options are now available. Ask your physician about the flu mist. It is a nasal spray flu vaccine and is approved for ages 2-49. However, you should not take the flu mist if you fall into one of the groups listed: You have lung conditions that include asthma or heart conditions You have diabetes or kidney dysfunction You have Guillain-Barre syndrome You are pregnant You have a history of allergy or sensitivity to eggs or any parts of the flu mist You are a child or teen who regularly takes aspirin or aspirin products

Who Should be Vaccinated: While it is recommended that everyone get vaccinated, the following groups are at the top of the priority list and typically are the first to receive the vaccine as it becomes available: Children and adolescents ages six months to 19 years Adults 50 years or older People with chronic lung, heart or kidney problems Diabetics Those with weak immune systems People with anemia Women who will be more than three months pregnant during flu season People in nursing homes Those in close contact with children 0-23 months

H1N1 Vaccinations: There will be a vaccination available in a shot form to combat the H1N1 virus. It is scheduled to be available this Fall , but supplies will be limited . The Wake County Government can be useful in directing you to who and where the vaccination will be available. Go to www.wakegov.com for more information.

Possible Side Effects From Flu Shot Vaccines:
Because the viruses in the flu shot are inactive, you cannot get the flu from a flu shot. You may, however, experience some minor side effects.

• Soreness, redness or swelling at the sight of the injection
• Low grade fever
• Body aches

These effects can last from soon after the shot is given up to two days, but the vast majority of people who receive the flu shot have no serious issues that occur. In some small instances, serious side effects can occur, mostly from severe allergic reactions. If anything other than the above symptoms occur, contact your doctor for further attention.

The flu mist can also carry some possible side effects that differ slightly in children versus adults...

Possible Side Effects in Children From the Flu Mist Runny nose Wheezing Headache Vomiting Muscle aches Fever

Possible Side Effects in Adults From the Flu Mist Runny nose Headache Sore throat Cough

Additional Medicine Available for Prevention:
There are some options available in terms of antiviral medicine. Adults and children who are older than one year can use Tamiflu. Relenza is another medicine and can be used by people five years or older. Both of these medicines help you prevent getting the flu if you take them for at least two weeks during an outbreak of flu in your community. You can also use these if you are in close proximity to someone who has the flu. You may also use these for the two to four week period after taking a shot when your body is getting adjusted to the vaccine.

		Can Wearing a Mask Help Prevent Me From Getting H1N1? There is no definitive proof that facemasks will offer protection against the H1N1virus. One study does show that when a member of a family wears a mask around the infected person, their chance of getting the virus is cut down by sixty to eighty percent. Since the H1N1 virus and the seasonal flu are caused by the deposit of large droplets, a face mask would seem to be a logical barrier to catching the virus because it is designed to combat large droplets. Here are some guidelines as to who might benefit from wearing a mask:
If you must come within six feet of an infected person, wear a facemask. Health care professionals would fall into this category. If you already have the flu, wear a mask if you must go out around other people. If you live in a household where someone has contracted the flu, wear a mask when going near other people. The reason for this is that you may already be infected but have no symptoms.

What To Do If You Get the Flu:
If, after taking precautions, you still find you have the flu, take the following steps:

• Stay home for AT LEAST 24 hours after your fever has ended. If you are having to reduce your fever through Ibuprofen or Acetaminophen, that does not qualify as fever free.
• Avoid close contact with others, especially those more susceptible to the virus such as older people, pregnant women, infants, children and people with compromised immune systems.
• Wear a facemask when sharing areas with other household members to help prevent the spread of the virus.
• Get plenty of rest.
• Drink plenty of clear fluids...water, broth, electrolyte and sports beverages. This will help avoid dehydration.
• Cover your mouth when sneezing or coughing...cough or sneeze into the crook of your elbow to avoid spreading the virus to your hands.
• Wash hands with soap and water frequently. If no soap or water is available, use an alcohol-based hand solution often.
• Speak to your doctor about medications that may be available to help you.

Your best defense against the flu is making sure you watch for warning signs and take steps to protect yourself and your family from catching the flu. Talk with your physician and get as much information as you can to arm yourself against a possible outbreak. Most of all, don’t panic. There are many steps you can take to ensure a safe and healthy fall and winter.

Knowledge is key to combating any sickness. For further information on both seasonal flu and the H1N1, visit the following links:

Wake County specific information: http://www.wakegov.com

Centers for Disease Control: Links available to different topics relating to the flu and the H1N1 virus:
http://www.cdc.gov

Swine Flu updates: http://www.health.harvard.edu

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