Questions and Answers About H1N1
Q. Since H1N1 infections are much less widespread right now, do I still need to get a shot?
A. This is actually a two-part question. The first part of your question concerns whether there is reason to believe that there will be a new widespread outbreak or “third wave” of H1N1 infection before the end of this flu season. There is reason to believe there will be.
Scientists have observed that colds and H1N1 tend to peak at different points in the colds and flu season. Type A influenza such as H1N1 is more transmissible when temperatures and humidity are slightly higher, but the rhinoviruses that cause colds are more transmissible when temperatures and humidity are lower. Many experts predict there will be a lull in new cases of H1N1 in the coldest weeks of the winter and a resurgence in early spring.
The second part of your question is whether you should get a shot for H1N1. Virologists in the employ of the vaccine manufacturers offer the opinion, not surprisingly, that the more flu shots you get, the sooner you will be protected against the flu. In one study, a single dose of vaccine generated an immune response that protected against influenza in 5 weeks, while two doses taken at the same time generated protection in 7 days.
That doesn’t mean you should try to get two H1N1 immunizations. Just be aware that you will have to rely on other protective measures for up to a month after you get your injections.
Q. What besides a flu shot protects you against the flu?
A. Wash your hands. An Australian study found that alcohol-based hand washing solutions are highly effective against H1N1, but simple soap and water followed by drying under an air blower is even better. (Shared cloth towels can serve as a reservoir for the virus.) Without any washing, the H1N1 virus stays on the hands at least an hour after contact.
It also helps to clean house. H1N1 persists up to 24 hours on hard surfaces in the home, particularly when room temperature is below 68° F (20° C). Temperatures above 86° F (30° C) kill the virus, but most people find them uncomfortable for indoor living. Surfaces should be cleaned with an alcohol-based disinfectant or with a detergent; simply wiping them only moves the virus around.
Q. Should I try to stock up on Tamiflu (oseltamivir)?
A. No. Chances are that your doctor will not prescribe it, either. There is a concern that if too many people use Tamiflu, the virus will become resistant to it. Tamiflu works best if taken within 48 hours of the first symptoms, although it is still effective as long as 7 days after the onset of symptoms. Because of the concern that the virus may become resistant, Tamiflu is only recommended when the person infected with the flu is very young, very old, suffers a chronic health condition, is a first responder or medical worker, or is recently back from or about to travel to Mexico.
Q. What about Relenza (zanamivir)?
A. There is less concern that H1N1 will build up resistance to Relenza, but since it is taken by an inhaler, you have to be able to breathe it in for it to be useful for you. There is also a shorter window of efficacy. It has to be taken in the first 5 days after the onset of symptoms rather than the first 7.
Q. How long are you infectious after you get H1N1?
A. Generally, people with H1N1 remain infectious to others for seven days after the beginning of symptoms or until symptoms subside, whichever is later.
Q. What can I do to protect my family from infection if I get the flu?
A. Stay in your room with the door closed, and try to recirculate the air in your room through a high efficiency particulate air (HEPA) filter. Wear a mask when you go outside your room, and make sure any glasses, dishes, cups, or utensils you use are thoroughly washed in soapy warm water and rinsed before they are used by others. Make sure other members of your household wash their hands with soap and water or use hand sanitizer immediately after coming in contact with your respiratory secretions.
Q. What about herbs, vitamins, minerals, supplements, and special foods for the flu?
A. There is good reason to believe that vitamin D may be the missing nutrient in flu protection. Flu strikes during winter, when the skin’s production of vitamin is lowest. A study recruiting women in Africa found that taking 2000 IU a day “abolished” reports of both colds and flu. In one study of people over age 65, deficiencies of not just vitamin D but also vitamins B-6, B-12, and C, and folic acid, and zinc were associated with worse symptoms of flu.
The most specific nutritional supplement that may fight H1N1, however, is echinacea. In November 2009, German scientists published research showing that this herb extract stopped replication of the virus under laboratory conditions, without inducing resistance to the treatment.
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Tags: H1N1, H1N1 shots, HEPA filter, Influenza, Oseltamivir, Q & A, Relenza, Rhinoviruses, Tamiflu, Zanamivir
