This year’s influenza season is unique in that there are additional strains circulating, with unclear medical implications for the US population. I interviewed Dr. Joseph Stubbs, president of the American College of Physicians, to get the inside scoop on what to expect this year with the H1N1 and seasonal flu strains. You may listen to the podcast or read a shortened version of the interview below.
Dr. Val: Why are younger people and pregnant women more susceptible to H1N1 flu?
Dr. Stubbs: What we think is going on with younger people is that some of the genetic material of the H1N1 flu virus was part of the seasonal flu before the 1960’s. Older individuals may have an enhanced immune response to the novel H1N1 virus because their bodies can recognize it and fight it more effectively. Since younger people have never been exposed to this virus before, they’re more susceptible to it.
As far as pregnant women go, we’re not exactly sure why they’re at higher risk for complications from the H1N1 flu, but it’s possible that their susceptibility is related to changes in the immune system associated with carrying a baby. The immune system has to tolerate and accept the growing fetus – which happens to make it less effective at fighting off viruses.
Dr. Val: What’s the latest on the timing of vaccine availability? Do you think we’ll get it in time to head off an epidemic?
Dr. Stubbs: HHS Secretary Sebelius recently announced that the FDA has approved the novel H1N1 flu vaccine, and it appears that it will be effective with one shot. They’re hoping to make it available within the first 2 weeks of October, which is ahead of schedule. However, we still don’t know how much of the vaccine will be available, and how hard we’ll have to ration it. We hope that this will ward off a major pandemic. But here in Georgia, we’ve already been seeing a large number of cases.
Dr. Val: Should physicians prioritize their patients and give the vaccine to the at-risk groups first?
Dr. Stubbs: Right now we are planning to ration the vaccine initially to those who are at risk, which includes: healthcare providers, pregnant women, people who provide care for infants who are less than 6 months old, children 6 months to 24 years of age, and those ages 25-64 who have chronic illnesses that might cause them to have a more severe case of the flu. If we have enough supply then we’ll also vaccinate healthy adults and seniors. But seniors should make sure they get the seasonal flu vaccine this year.
Dr. Val: How does the H1N1 flu differ from the usual seasonal flu?
Dr. Stubbs: The seasonal flu vaccine continues to kill 30,000 of our citizens every year. The people who most need the seasonal flu vaccine are individuals over age 65, immunocompromised, and young infants. We expect the seasonal flu vaccine to be widely available and we recommend that almost everyone get that as soon as possible.
Dr. Val: Is the novel H1N1 flu virus related to the deadly Spanish flu of 1918 in any way?
Dr. Stubbs: They do share some genetic features, but not all.
Dr. Val: Are you concerned about the H1N1 flu virus mutating?
Dr. Stubbs: We certainly are, though we’re concerned about that with any virus. We’re most concerned about the flu becoming resistant to the anti-viral medicines that we have now like Tamiflu – which we use for people with serious cases of the flu.
Dr. Val: How do people know if they have a “serious” case of the flu?
Dr. Stubbs: If someone is experiencing severe shortness of breath within the first 48 hours of getting the flu, or if they have a severe headache and are not acting themselves or if they have uncontrollable diarrhea or vomiting, that requires medical attention.
Dr. Val: What’s the most important thing for Americans to know about the H1N1 flu?
Dr. Stubbs: The most important thing is not to panic. People should not crowd the ERs just because they think they might have the H1N1 flu – they should only go if their illness is severe as I described before. They should wash their hands frequently, and if anyone gets sick, stay home so you don’t spread it to others. The vast majority of people will get better within a few days.