As H1N1 spreads across N.J., here are some ways to thwart it

Sunday, November 01, 2009
STAR-LEDGER STAFF

Swine flu activity in New Jersey moved from regional to widespread this past week, meaning the H1N1 flu is present in a majority of counties throughout the state.

The swine flu may not be in every county, but most counties are seeing elevated levels, according to the state health officials. New Jersey is one of 47 states where exposure to the virus is being viewed as widespread, however, this does not mean the virus has become more virulent.

As this strain spreads more questions arise not only about the swine flu but the vaccine and when it will be available.

Q: What are the symptoms of the swine flu?

A: They are the same as seasonal flu: fever, cough, sore throat, body aches, headaches, chills and fatigue. Some people have reported diarrhea and vomiting. Most people who develop the swine flu are sick for two weeks or less. But in a small number of cases, people -- children and women under 49 in particular -- have become seriously ill. Some have succumbed to bacterial pneumonia and respiratory failure.

Q: Who should be vaccinated?

A: The U.S. Centers for Disease Control and Prevention says pregnant women and all people from 6 months through 24 years of age are in the highest-priority group for vaccination, as well as people ages 25 to 64 years with medical conditions such as asthma and diabetes. Health care and emergency personnel also should be among the first in line to get the vaccine. Unlike the seasonal flu, senior citizens are considered a low risk.

Q: Who should not be vaccinated?

A: There are some people who should not get any flu vaccine without first consulting a doctor, according to the CDC. These include: those who have a severe allergy to chicken eggs, those who have had a severe reaction to a flu vaccination, those who developed Guillain-Barré syndrome within six weeks of getting an influenza vaccine previously, children younger than 6 months of age and people who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Q: Do I need to get separate shots for the seasonal and swine flu?

A: Yes. The swine flu vaccine will not protect people from seasonal flu, and vice versa.

Q: Do I have to get a swine flu shot?

A: No, it is not mandatory. People can protect themselves by washing their hands frequently or using antibacterial gel, especially after using tissues and after coughing or sneezing into hands. Avoid touching your eyes, nose and mouth.

Q: How can I find out when the vaccine will be available?

A: Call your physician or the local health department (find your health department at http://nj.gov/health/lh/directory/lhdselectcounty.shtml). Supplies are limited because production is slower than predicted, but U.S. Health and Human Services Secretary Kathleen Sebelius has said there will be enough vaccine for everyone who wants it.

Q: How long am I contagious if I have the swine flu?

A: Infected adults are considered contagious for up to seven days following the onset of illness. Young children may be contagious longer.

Q: How long should I stay home from work or school after getting sick?

A: Stay home for at least 24 hours after the fever is gone without the use of a fever-reducing medicine.

Q: How many people have died from the swine flu?

A: About 1,000 people nationwide have died since the first outbreak in the spring, including 19 from New Jersey.

Q: The president just declared a state of emergency because of the H1N1 virus. What does this mean?

A: The declaration makes it easier for the federal government to deploy money, medical professionals and other resources where they are needed. It is not an indication the virus has become more widespread or virulent.

Q: Is New Jersey getting its fair share of the vaccine?

A: The CDC allocates vaccine to states based on population. As of Thursday, 610,200 doses of vaccine have been shipped to 1,021 providers in New Jersey, such as individual doctors and county health departments. More vaccine is being shipped to health care providers around the state each day, according to Donna Leusner, spokeswoman for the state Department of Health and Senior Services.

However, it is being delivered to states at a slower pace than initially projected due to manufacturing issues beyond the control of states. The federal government has assured New Jersey that ultimately, there will be enough vaccine for everyone who wants it. Public health officials are urging patience.

Q. How is the vaccine distributed in the state?

A: The federal government is shipping vaccine directly to county and local health departments, hospitals, private physicians, pharmacies, community health centers, schools and universities. Approximately 3,300 providers registered with the state to have vaccine shipped directly to them, Leusner said. In addition, schools, private physicians and other health care providers may request vaccine from their county or local health department. Some local health departments are working with local schools on vaccination plans.

Q: Is the state taking any action to ensure that the vaccine only goes to those at risk, for H1N1?

A: All of the health care providers who registered with the state to have vaccine shipped to them during the initial stages -- when supplies are limited -- signed a provider agreement in which they agreed to administer the vaccine according to the CDC-recommended target groups. Essex County distributed its first 2,000 doses to the county's 21 towns -- not including Newark, which has its own program -- and targeted police, fire and emergency responders. They will target those at-risk when more vaccine arrives. In Middlesex County, patients are being screened by phone for appointments at twice-weekly clinics booked through December for 10,300 available H1N1 doses.

Q. Will I have to stand in long lines to get the vaccine?

A: In Jackson, 1,000 people were turned away from a flu clinic last week after 1,500 doses were used up. More vaccine is arriving in the state each day and, as a result, more clinics at local and county health departments are being scheduled all the time. The state Department of Health and Senior Services has a FindAFlu Shot Locator on its website (www.nj.gov/health), where you can enter the name of your county and find out where a public health clinic is being scheduled near you. Chain pharmacies may also be offering vaccine. Many of the clinics being scheduled at local and county health departments are by appointment so you may want to call ahead. You can also contact your physician to see if the office has ordered or received vaccine.

Q: Is it true taking Tamiflu is a good preventive measure against the virus?

A: Antiviral medications like Tamiflu are recommended for high-risk groups like pregnant women, young children and people with respiratory illness and underlying medical conditions. If you are in a high-risk group and have been exposed to the flu, you should talk to your physician about receiving preventive medication. Antiviral medications like Tamifu are not necessary for the vast majority of individuals who get a mild case of the flu and recover quickly without medical treatment, according to Peter Wenger, associate professor at the University of Medicine and Dentistry of New Jersey.

Q: At what point will schools close if large number of students are sick with the flu? Who makes that decision?

A: Local school districts make the decision in conjunction with local health officials, according to Rich Vespucci, spokesman of the state Department of Education.

Q: How different is this strain of flu from the 1918-19 flu pandemic, which killed between 20 million and 40 million worldwide?

A: The "Spanish flu" strain is believed to have been a particularly virulent strain, a stronger one than the H1N1. But pneumonia and other infections are what killed many back then, and today we have much better treatments for those illnesses. Antibiotics, for example, were not available during World War 1, according to Wenger. Other factors contributing to flu deaths during World War I were the unusually large concentrations of people where the virus spread, such as refugee camps and soldiers' training camps. The ability of local health groups to help patients was compromised by the war.