Lapeer County Health Department

Date: November 19, 2009

RE: H1N1 Influenza Frequently Asked Questions

Q: Where can I get vaccine in Lapeer County?

A: A number of Lapeer County physicians, including our pediatricians, are administering H1N1 vaccine. Lapeer County Health Department is administering vaccine for those high risk groups whose physicians are not administering vaccine. We have vaccinated most of those on our waiting list and have additional clinics scheduled for the week after Thanksgiving. Call (810) 667-0448 to schedule an appointment. Because of the slow production of vaccine, we want to make sure we vaccinate our highest risk residents first. CDC has prohibited the administration of vaccine to residents outside the risk groups (those 65 and older and adults ages 25-64 without other medical conditions) until additional vaccine becomes available.

Q: What’s new with H1N1?

A: Due to increases nationally in the number of cases of pneumonia, the CDC released guidelines this week emphasizing recommendations for pneumococcal vaccination. The CDC recommends a single dose of pneumococcal vaccine for all people 65 years of age and older and for persons 2 through 64 years of age with certain high risk conditions. Children are routinely vaccinated with pneumococcal vaccine and the CDC emphasizes that those ages 19-64 with high risk conditions (asthma and other respiratory disease, cardiovascular disease, diabetes) should receive pneumonia vaccine. More information is available on the CDC website at: http://www.cdc.gov/h1n1flu/vaccination/qa_pneumococcal_disease.htm

Q: Are there cases of H1N1 in Lapeer County?

A: Yes. We continue to receive many reports of positive Influenza A in Lapeer County residents. Since 99% of Influenza A is currently the H1N1 strain, we clearly have many residents with H1N1. We also continue to receive reports of confirmed H1N1 cases. These have been tested in private labs and may not have met the Michigan Department of Community Health’s (MDCH) requirement for hospitalization or severe disease. These confirmed cases have occurred in residents 5-60 years of age.

Q: If the MDCH/CDC is only testing cases that require hospitalization, how do we know whether H1N1 is

in our county?

A: The Michigan Department of Community Health has physicians throughout the state that regularly send in samples of suspected influenza for testing. The state uses this information to monitor the level of flu activity throughout the state and in individual counties. The CDC also uses this information to help determine what flu strains should be included in the seasonal influenza vaccine each year.

Q: Should my child’s school notify me if they learn of a confirmed H1N1 case?

A: We know that there are many cases of H1N1 (Influenza A) right now. You should assume that your child could be exposed to H1N1 at school, at church, at the grocery store, and during other activities your child may participate in. Because of this, it is not necessary for schools to notify parents of every case of possible or confirmed H1N1. If your child is at high risk of complications from the flu you should discuss the recommendation for H1N1 vaccine with your physician.

Q: Why don’t the schools just close until H1N1 is gone?

A: Since the period of transmission can be up to 7-10 days, school would need to be closed for at least 7 days to significantly reduce transmission of the virus. During this time, children will be exposed in other community settings, such as the grocery store or at church or other activities. When those children return to school the cycle would start again, resulting in additional school closures. The national average school closure time has been 2 days. Due to these factors, the CDC, the Michigan Department of Community Health and the Lapeer County Health Department are not encouraging extended school closures. Although many schools in Michigan have been closed for short periods, no Lapeer County schools have been closed. Although we have seen some increased influenza, overall absenteeism continues to remain low at this time. This could change very quickly and we continue to anticipate that school closures of short duration (a day or two) may be necessary if too many students are absent to hold school.

Q: Should I be concerned about exposure to H1N1?

A: For the vast majority of those who are infected, this remains a mild flu illness similar to seasonal flu.

However, this flu is a little different from the usual seasonal flu in that it is affecting young people at a much higher rate than those over the age of 65. People who have certain other health conditions, such as asthma, diabetes, emphysema, kidney disease, etc., pregnant women and small children often have more severe illness from the flu. Due to these factors, the CDC is highly recommending vaccine for these groups.

Q: Should I get vaccine? Should I have my child vaccinated?

A: CDC recommends H1N1 vaccine for the following groups:

1) Pregnant women

2) Household contacts of children less than 6 months of age

3) Health care and EMS workers

4) Children 6 months-24 years of age

5) Non elderly (25-64 year old) population with medical conditions that put them at risk of severe

disease from influenza

Q: What has Lapeer County been doing to make sure those at high risk get vaccine?

A: The amount of vaccine coming to Lapeer County is finally keeping up with the demand for

immunization. The Lapeer County Health Department will continue to offer H1N1 vaccination clinics

through December. Approximately 75% of the doses received in Lapeer County have been distributed to

our 16 physician’s offices for administration to high risk patients. The remainder has been administered

by the Health Department to those on our waiting list.

Q: What are symptoms of H1N1?

A: Symptoms of H1N1 are similar to seasonal flu and may include: fever, cough, sore throat, runny or

stuffy nose, body aches, headache, chills, fatigue and sometimes diarrhea and vomiting.

Q: Should I see my doctor if I have flu-like symptoms?

A: Most people with flu like symptoms do not need to see their physician. Antiviral medication is only

recommended for those with other health conditions that make them more vulnerable to flu

complications, or for severe disease. Stay at home, rest, drink plenty of fluids and take fever reducers

(aspirin is NOT recommended for children).

Q: What if I am at high risk for flu complications?

A: If you have other medical conditions that put you at risk for severe flu (asthma, diabetes, etc.) are

over aged 65 or under age 2 or are pregnant, contact your physician at the first sign of flu symptoms to

discuss recommendations for antiviral medication.

• Know the Emergency Warning Signs of severe flu and seek immediate medical attention:

In Children:

o Fast breathing or trouble breathing

o Bluish skin color

o Not drinking enough fluids

o Not waking up or not interacting

o Being so irritable that the child does not want to be held

o Flu-like symptoms improve but then return with fever and worse cough

o Fever with a rash

In Adults:

o Difficulty breathing or shortness of breath

o Pain or pressure in the chest or abdomen

o Sudden dizziness

o Confusion

o Severe or persistent vomiting

Q: How can I do my part to reduce the spread of flu?

A: You should not return to work or school until at least 24 hours after the fever has subsided. This is likely to be the most effective method of reducing the spread of flu this season. Frequent hand washing has been shown to be one of the most effective methods of reducing the spread of flu.

CDC has a great deal of information on their website, including:

www.cdc.gov/h1n1flu/pdf/2009_h1n1fluandyou.pdf

and