Most everyone is familiar with the term ‘meningitis.’ We know it refers to an infection in the fluid and linings surrounding the brain and we know it can be deadly. We also know meningitis is potentially contagious. Beyond that, our understanding of meningitis is cloudy. And we generally tend to fear things we don’t understand, especially those things that are contagious and deadly, right? So let’s explore the mystery that is meningitis with the expectation we can turn fear into understanding.
Meningitis does indeed describe an infection of the fluid surrounding the brain and the spinal cord. Many types of bacteria, viruses, and fungi can be responsible for the infection. They all seem to cause a fever with severe headache and stiff neck. Fungal infections are rare and occur most commonly in people with impaired immune systems. Viral infections, while uncomfortable, tend to resolve on their own and without specific treatment. Bacterial causes of meningitis, on the other hand, are a big worry as they can cause major disability and death.
There are three main causes of bacterial meningitis and each will be explained below.
Pneumococcal meningitis is caused by the bacterium Streptococcus pneumoniae, also called ‘The Pneumococcus’. It is the most common cause of meningitis in newborns and in infants. Cases of meningitis due to pneumococcus, at one time quite common, have been drastically reduced through the use of a vaccine called Prevnar given to infants at 2, 4 and 6 months of age. Meningitis caused by S. pneumoniae is rarely contagious.
Hemophilus meningitis is caused by the bacterium Haemophilus infuenzae type b, also known as ‘Hib.’ Prior to the widespread use of Hib vaccine, H. influenzae was the most common cause of meningitis in children up to 5 years of age and used to be the most frequent cause of acquired deafness in children. Although extremely rare now, Hemophilus meningitis is contagious and is a significant risk to un-immunized children.
Meningococcal meningitis is caused by the bacterium Neisseria meningitidis, also referred to as the ‘The Meningococcus’ bacteria. N. meningitidis is a frequent cause of meningitis in infants and the main cause of meningitis in older children and young adults. It is often associated with outbreaks or clusters of meningitis illness in schools, camps, and large gatherings of people. Although meningococcal meningitis is quite rare, occurring at a rate of less than one case per 100,000 people per year, it causes severe disability and often death. The low rate of illness due to meningococcus is surprising, especially considering the fact that at any given time, 5 to 10 percent of the population may carry meningococcus in their nose and throat. Meningococcus is contagious, being spread from person to person by the exchange of saliva.
A vaccine is available for the prevention of disease due to most strains of N. meningitidis. It is routinely recommended for children in the 11-12 year old age range and for entering college students who have not previously been vaccinated. The vaccine is relatively ineffective for children under 2 years of age. The duration of immunity from the meningococcal vaccine, perhaps lasting only 3-5 years, is also fairly low compared to other vaccines.
Meningitis, from any cause, is rare in Whitman County. Unfortunately, in the last four months there have been two cases of illness due to N. meningitidis. Both cases occurred in first year Washington State University students and both were the same Type Y strain. It is unusual to have two cases of meningococcal disease in a year, let alone two cases of the same type over a 4 month period. But even more mysterious is that both students were vaccinated against meningococcal meningitis only three years ago.
The threshold for declaring an outbreak or epidemic of meningococcal illness is three cases occurring in three months in a well defined population like a school or a university. Two cases in four months falls short of meeting this definition, but it is cause for concern nonetheless.
In response to the recent cases of meningococcal disease, WSU has initiated a campaign to make students more aware of the signs and symptoms of meningitis. Students are asked to take steps to limit the transmission of bacteria from person to person through frequent hand washing and avoidance of sharing items like cups, water bottles, eating utensils and smoking materials. WSU officials, in concert with the Whitman County Health Department, are also encouraging students to consider vaccination as an additional measure to reduce the chance of infection. See the WSU Health and Wellness page for more information (http://hws.wsu.ed/default.asp?PageID=4927).
Meningitis may still be a mystery in some respects, but we can protect ourselves by getting the appropriate vaccination at the right time, knowing the signs and symptoms of meningitis, and adopting simple hygienic measures. For more information on meningitis, contact the Whitman County Health Department or visit these excellent web resources:
http://www.cdc.gov/meningitis/index.html
http://www.doh.wa.gov/cfh/immunize/diseases/meningitis/default.htm
http://www.meningitisfoundationofamerica.org/templates/
Showing posts with label Vaccine. Show all posts
Showing posts with label Vaccine. Show all posts
Thursday, January 20, 2011
Tuesday, November 2, 2010
No Ordinary Cough
Pertussis, or Whooping Cough, is making a comeback. All states on the West Coast have seen record setting numbers of cases this past year, with over a dozen deaths occurring in California just this past summer. Whitman County has recorded several cases this year, and counties around Whitman have also seen increased numbers of pertussis.
Pertussis is a bacterial disease that causes severe inflammation and narrowing in the respiratory passages. It usually begins with a runny nose and a mild cough, but after a week or two of fairly mild illness, symptoms get much worse. The cough becomes severe, often occurring in prolonged fits or spasms that make it hard to breathe. A characteristic inspiratory “whoop” may be heard after these coughing spells. The bronchial narrowing and inflammation caused by pertussis may be life threatening in children with small airways, especially those under one year of age.
Pertussis is spread easily between people as it is carried on respiratory droplets created during coughing or sneezing. At the beginning of last century, pertussis was a common illness that caused untold amounts of suffering and death. With the advent of a safe and effective vaccine, pertussis was nearly eliminated as a threat to health.
Infants are immunized for pertussis at two, four, and six months of age as part of the Diphtheria, Tetanus and acellular Pertussis vaccine (DTaP). Even with three shots, immunity is only partial and two more shots are given before school entry to ensure complete coverage. Immunity from DTaP wears off with time however, and a booster shot (Tetanus, diphtheria and acellular pertussis or ‘Tdap’) is needed by age 11 to keep pertussis at bay.
All adults age 18 and over should also get a pertussis booster (Tdap) one time in place of a regular tetanus booster (‘Td’), especially if they work or live with children or infants. That’s because adults can harbor pertussis bacteria in their throat and transmit it to susceptible persons. It doesn’t matter when your last tetanus booster was given; you can receive Tdap now. Ask your doctor or public health office if you are unsure of your immunization status or the immunization status of your family members.
Pregnant women should get a Tdap booster immediately after delivery in order to protect their baby prior to the initiation of the DTaP series. Adult family members of pregnant women should get a Tdap now. Adults over the age of 65 who take care of small children should talk to their medical provider about receiving a Tdap booster too (currently, the Tdap is only FDA licensed for persons under age 65).
For further information on pertussis vaccine, check the CDC website at: http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm
As always, we welcome your comments or questions.
Pertussis is a bacterial disease that causes severe inflammation and narrowing in the respiratory passages. It usually begins with a runny nose and a mild cough, but after a week or two of fairly mild illness, symptoms get much worse. The cough becomes severe, often occurring in prolonged fits or spasms that make it hard to breathe. A characteristic inspiratory “whoop” may be heard after these coughing spells. The bronchial narrowing and inflammation caused by pertussis may be life threatening in children with small airways, especially those under one year of age.
Pertussis is spread easily between people as it is carried on respiratory droplets created during coughing or sneezing. At the beginning of last century, pertussis was a common illness that caused untold amounts of suffering and death. With the advent of a safe and effective vaccine, pertussis was nearly eliminated as a threat to health.
Infants are immunized for pertussis at two, four, and six months of age as part of the Diphtheria, Tetanus and acellular Pertussis vaccine (DTaP). Even with three shots, immunity is only partial and two more shots are given before school entry to ensure complete coverage. Immunity from DTaP wears off with time however, and a booster shot (Tetanus, diphtheria and acellular pertussis or ‘Tdap’) is needed by age 11 to keep pertussis at bay.
All adults age 18 and over should also get a pertussis booster (Tdap) one time in place of a regular tetanus booster (‘Td’), especially if they work or live with children or infants. That’s because adults can harbor pertussis bacteria in their throat and transmit it to susceptible persons. It doesn’t matter when your last tetanus booster was given; you can receive Tdap now. Ask your doctor or public health office if you are unsure of your immunization status or the immunization status of your family members.
Pregnant women should get a Tdap booster immediately after delivery in order to protect their baby prior to the initiation of the DTaP series. Adult family members of pregnant women should get a Tdap now. Adults over the age of 65 who take care of small children should talk to their medical provider about receiving a Tdap booster too (currently, the Tdap is only FDA licensed for persons under age 65).
For further information on pertussis vaccine, check the CDC website at: http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm
As always, we welcome your comments or questions.
Tuesday, January 5, 2010
H1N1: A Pandemic in Review
Some folks say the recent pandemic of H1N1 (“Swine Flu”) influenza was no big deal; just a product of media hype and overzealous public health officials. Others think we dodged a bullet because the H1N1 pandemic was not as bad as it could have been. And others say the H1N1 pandemic was an unmitigated disaster due to pointless school closings, poor governmental communication, overstressed medical care facilities, inexplicable delays in vaccine production and delivery, and many lives lost.
Actually, everybody’s right.
H1N1 arrived in the US in April amidst considerable alarm and panic. A new influenza virus prompted swift action by public health and governmental officials. Schools were closed, travel warnings were issued and flu-fighting medicines were shipped from the federal stockpile to the nation’s public health departments. In Mexico, initial mortality rates from this new flu looked high. Worldwide media went into overdrive covering every flu-related topic they could find.
The pork industry lost hundreds of millions of dollars because the new flu was thoughtlessly called the “Swine Flu.” Personal and business travel to Mexico was eliminated or put on hold. Surgical masks were sold out. Calls were made for quarantines and fever scanners at airports. After a month or so, coinciding with the public school summer recess, the first wave of H1N1 flu ended.
But H1N1 did not go away. It continued along during the summer months at a slow rate, giving CDC epidemiologists time to produce a vaccine and refine H1N1 prevention and treatment guidelines. Review of the first several thousand cases of H1N1 showed it to be no more life-threatening than regular seasonal flu. This was good news. H1N1 was not the “killer” pandemic many scientists had been expecting. But in contrast to seasonal flu, which causes the highest mortality in people over 65, H1N1 was disproportionately affecting children, pregnant women, and adults under 60 with chronic diseases.
Knowing H1N1 flu activity would increase again later in the fall, officials from public health, public schools and hospitals got busy making preparations for flu prevention and treatment, as well as planning for an H1N1 vaccine arriving by mid-October.
What we overlooked is pathogens like H1N1 are on their own time schedule and don’t wait for a vaccine. Universities with late August starts found that school convened with an unwelcome visitor.
Washington State University was one of the hardest hit by H1N1 with the first case identified three days before classes started. By the end of the second week of classes, more than 2000 students had flu-like symptoms.
Thankfully, most people infected with H1N1 had a fairly mild disease. Nevertheless, health care providers were inundated with flu sufferers. Hospitals resorted to triaging patients with mild illness and no risk factors away from their Emergency Rooms so staff could cope, resources could be reserved for those who really needed them, and the spread of infection reduced. Many clinics and urgent care facilities were seriously stressed for several weeks. One wonders what would have happened had H1N1 been a more severe illness.
The speed at which H1N1 spread was truly impressive. WSU's experience demonstrated how explosive a new flu could be in a population where 100 percent were susceptible. Many public schools were caught off guard as H1N1 caused absenteeism rates up to 40 percent, canceling classes as well as athletic contests. In Whitman County, Washington, even rural school districts were impacted following a “Teen Mixer” dance at the County Fair.
By the end of September and into early October, the H1N1 epidemic was on the wane locally. The rest of the state was at least a month behind as H1N1 reached a peak toward the end of October, gradually subsiding to rates similar to what was seen over the summer by the end of November. Since September, 1357 hospitalizations and 71 deaths attributed to H1N1 have been reported in Washington. The hospitalization rate was highest among children 0-4 years of age while the death rate was highest among adults 50-64 years old.
By the time vaccine arrived in any useful quantity, the second wave of H1N1 was nearly over. The delay caused extreme frustration to providers and patients alike. Despite this fact, nearly a million doses of vaccine were distributed statewide. In Whitman County, about 1,000 doses were given at the Public Health Department while an additional 6,000 doses were distributed to hospitals, clinics and pharmacies. Further public interest in receiving the vaccine has essentially evaporated even though we are unsure if H1N1 has a third act waiting for us later this winter.
In retrospect, we were very fortunate. Believe it or not, H1N1 spread much faster and with greater fury than the 1918 influenza pandemic. But H1N1 influenza was a much milder disease than the flu in 1918, at least to those of us who survived it. As such, it served well as a sort of “training pandemic” for public health and other governmental officials. We now know what parts of our influenza pandemic plan work well, which don’t, and what needs improvement. We found out that, even under ideal circumstances (instant recognition, immediate vaccine production, and ideal distribution), we lack the technology to crank out vaccine soon enough and in sufficient quantities to avert a disaster if we truly face a deadly flu.
Beefing up our response plans for the next influenza pandemic is reasonable. However, it is foolish to assume we can prepare for a flu pandemic like the historic 1918 outbreak. Our health care system was taken to the breaking point with H1N1; a relatively mild flu . We don’t have enough beds, enough ventilators, enough anti-viral medicines, or enough doctors and nurses to handle anything like the Great Influenza of 1918. More importantly our society can’t afford to have massive surpluses of highly trained people and materiel on hand “just in case.”
The only way to rationally respond to the next “killer” flu pandemic is to prevent it entirely. Current flu vaccines are produced with the new flu virus strain after it has been identified. We then grow the virus in chicken eggs for vaccine production. As H1N1 showed us, the 1950s era technology is ineffective. Our strain specific vaccines also become less effective if the virus mutates much. Constant genetic changes are the reason we need to get a seasonal flu shot annually to maintain effective immunity.
What if we could develop an effective vaccine that acted on the parts of the flu virus that don’t change or mutate? This could result in a “universal” flu vaccine that prevents illness from strains of influenza circulating now, and new ones that may emerge in the future; even “killer” strains.
The idea of a universal flu vaccine is doable. Some researchers are already testing candidate vaccines and other diseases are being eliminated using the same strategies. Influenza vaccine researchers should be supported, encouraged, and most of all funded with the lion’s share of influenza pandemic planning resources. We can prepare for managing and surviving the next flu pandemic all we want. But a much better strategy is to prevent it from happening so that, in the future, we will ask, what was the flu like back when you were young and we still got it?
Actually, everybody’s right.
H1N1 arrived in the US in April amidst considerable alarm and panic. A new influenza virus prompted swift action by public health and governmental officials. Schools were closed, travel warnings were issued and flu-fighting medicines were shipped from the federal stockpile to the nation’s public health departments. In Mexico, initial mortality rates from this new flu looked high. Worldwide media went into overdrive covering every flu-related topic they could find.
The pork industry lost hundreds of millions of dollars because the new flu was thoughtlessly called the “Swine Flu.” Personal and business travel to Mexico was eliminated or put on hold. Surgical masks were sold out. Calls were made for quarantines and fever scanners at airports. After a month or so, coinciding with the public school summer recess, the first wave of H1N1 flu ended.
But H1N1 did not go away. It continued along during the summer months at a slow rate, giving CDC epidemiologists time to produce a vaccine and refine H1N1 prevention and treatment guidelines. Review of the first several thousand cases of H1N1 showed it to be no more life-threatening than regular seasonal flu. This was good news. H1N1 was not the “killer” pandemic many scientists had been expecting. But in contrast to seasonal flu, which causes the highest mortality in people over 65, H1N1 was disproportionately affecting children, pregnant women, and adults under 60 with chronic diseases.
Knowing H1N1 flu activity would increase again later in the fall, officials from public health, public schools and hospitals got busy making preparations for flu prevention and treatment, as well as planning for an H1N1 vaccine arriving by mid-October.
What we overlooked is pathogens like H1N1 are on their own time schedule and don’t wait for a vaccine. Universities with late August starts found that school convened with an unwelcome visitor.
Washington State University was one of the hardest hit by H1N1 with the first case identified three days before classes started. By the end of the second week of classes, more than 2000 students had flu-like symptoms.
Thankfully, most people infected with H1N1 had a fairly mild disease. Nevertheless, health care providers were inundated with flu sufferers. Hospitals resorted to triaging patients with mild illness and no risk factors away from their Emergency Rooms so staff could cope, resources could be reserved for those who really needed them, and the spread of infection reduced. Many clinics and urgent care facilities were seriously stressed for several weeks. One wonders what would have happened had H1N1 been a more severe illness.
The speed at which H1N1 spread was truly impressive. WSU's experience demonstrated how explosive a new flu could be in a population where 100 percent were susceptible. Many public schools were caught off guard as H1N1 caused absenteeism rates up to 40 percent, canceling classes as well as athletic contests. In Whitman County, Washington, even rural school districts were impacted following a “Teen Mixer” dance at the County Fair.
By the end of September and into early October, the H1N1 epidemic was on the wane locally. The rest of the state was at least a month behind as H1N1 reached a peak toward the end of October, gradually subsiding to rates similar to what was seen over the summer by the end of November. Since September, 1357 hospitalizations and 71 deaths attributed to H1N1 have been reported in Washington. The hospitalization rate was highest among children 0-4 years of age while the death rate was highest among adults 50-64 years old.
By the time vaccine arrived in any useful quantity, the second wave of H1N1 was nearly over. The delay caused extreme frustration to providers and patients alike. Despite this fact, nearly a million doses of vaccine were distributed statewide. In Whitman County, about 1,000 doses were given at the Public Health Department while an additional 6,000 doses were distributed to hospitals, clinics and pharmacies. Further public interest in receiving the vaccine has essentially evaporated even though we are unsure if H1N1 has a third act waiting for us later this winter.
In retrospect, we were very fortunate. Believe it or not, H1N1 spread much faster and with greater fury than the 1918 influenza pandemic. But H1N1 influenza was a much milder disease than the flu in 1918, at least to those of us who survived it. As such, it served well as a sort of “training pandemic” for public health and other governmental officials. We now know what parts of our influenza pandemic plan work well, which don’t, and what needs improvement. We found out that, even under ideal circumstances (instant recognition, immediate vaccine production, and ideal distribution), we lack the technology to crank out vaccine soon enough and in sufficient quantities to avert a disaster if we truly face a deadly flu.
Beefing up our response plans for the next influenza pandemic is reasonable. However, it is foolish to assume we can prepare for a flu pandemic like the historic 1918 outbreak. Our health care system was taken to the breaking point with H1N1; a relatively mild flu . We don’t have enough beds, enough ventilators, enough anti-viral medicines, or enough doctors and nurses to handle anything like the Great Influenza of 1918. More importantly our society can’t afford to have massive surpluses of highly trained people and materiel on hand “just in case.”
The only way to rationally respond to the next “killer” flu pandemic is to prevent it entirely. Current flu vaccines are produced with the new flu virus strain after it has been identified. We then grow the virus in chicken eggs for vaccine production. As H1N1 showed us, the 1950s era technology is ineffective. Our strain specific vaccines also become less effective if the virus mutates much. Constant genetic changes are the reason we need to get a seasonal flu shot annually to maintain effective immunity.
What if we could develop an effective vaccine that acted on the parts of the flu virus that don’t change or mutate? This could result in a “universal” flu vaccine that prevents illness from strains of influenza circulating now, and new ones that may emerge in the future; even “killer” strains.
The idea of a universal flu vaccine is doable. Some researchers are already testing candidate vaccines and other diseases are being eliminated using the same strategies. Influenza vaccine researchers should be supported, encouraged, and most of all funded with the lion’s share of influenza pandemic planning resources. We can prepare for managing and surviving the next flu pandemic all we want. But a much better strategy is to prevent it from happening so that, in the future, we will ask, what was the flu like back when you were young and we still got it?
Monday, December 14, 2009
The Wait is Over
As of Monday, December 14, the Whitman County Health Department now has enough H1N1 vaccine to lift any restrictions on who may receive it. Most other health departments in our area have also lifted restrictions now that vaccine supplies are adequate.
In Whitman County, we will be distributing vaccine to physician offices and pharmacies that are interested in giving the vaccine. Special clinics will be conducted at the offices of the Health Department, and, for WSU faculty and staff, immunization clinics will be held at the WSU Health and Wellness Service clinic on Wednesday, Thursday and Friday from 1-5 pm.
H1N1 vaccine is now available to anyone over the age of 6 months. Vaccination is especially encouraged for anyone with a chronic medical condition, pregnant women, children 6 months to 2 years of age, everyone 65 years of age or older, and parents/care givers of children under 6 months of age.
H1N1 vaccine is available in several formulations. Preservative free injectable vaccine is reserved for young children and pregnant women. The nasal spray formulation is for healthy people age 2 to 49. Injectable vaccine with preservative is best for anyone with chronic health problems and folks age 50 and up.
The safety of the H1N1 vaccine has been excellent, with a rate of reactions/complications less than what we typically see with seasonal influenza vaccine. The most common reaction is soreness at the injection site.
If you are interested in getting the vaccine, this would be a good time to receive it. It takes about 10 days after immunization for immunity to build up. People who are traveling over the holidays should get the vaccine now to ensure protection.
Although it appears we are well past the peak of the H1N1 influenza epidemic around the country, there is a possibility of a resurgence or 'third wave' later in the winter. It is impossible to predict. Get the vaccine now and you won't need to worry about it.
Stay tuned for a more complete review of the H1N1 outbreak in a coming blog post.
Call the Whitman County Health Department (Colfax 509-397-6280, Pullman 509-332-6752, or the Flu Line 877-783-0039) or visit our website (www.WhitmanCounty.org/PublicHealth) for more information.
In Whitman County, we will be distributing vaccine to physician offices and pharmacies that are interested in giving the vaccine. Special clinics will be conducted at the offices of the Health Department, and, for WSU faculty and staff, immunization clinics will be held at the WSU Health and Wellness Service clinic on Wednesday, Thursday and Friday from 1-5 pm.
H1N1 vaccine is now available to anyone over the age of 6 months. Vaccination is especially encouraged for anyone with a chronic medical condition, pregnant women, children 6 months to 2 years of age, everyone 65 years of age or older, and parents/care givers of children under 6 months of age.
H1N1 vaccine is available in several formulations. Preservative free injectable vaccine is reserved for young children and pregnant women. The nasal spray formulation is for healthy people age 2 to 49. Injectable vaccine with preservative is best for anyone with chronic health problems and folks age 50 and up.
The safety of the H1N1 vaccine has been excellent, with a rate of reactions/complications less than what we typically see with seasonal influenza vaccine. The most common reaction is soreness at the injection site.
If you are interested in getting the vaccine, this would be a good time to receive it. It takes about 10 days after immunization for immunity to build up. People who are traveling over the holidays should get the vaccine now to ensure protection.
Although it appears we are well past the peak of the H1N1 influenza epidemic around the country, there is a possibility of a resurgence or 'third wave' later in the winter. It is impossible to predict. Get the vaccine now and you won't need to worry about it.
Stay tuned for a more complete review of the H1N1 outbreak in a coming blog post.
Call the Whitman County Health Department (Colfax 509-397-6280, Pullman 509-332-6752, or the Flu Line 877-783-0039) or visit our website (www.WhitmanCounty.org/PublicHealth) for more information.
Thursday, October 29, 2009
H1N1 Vaccine Purgatory
Unless you have been living under a rock lately, you know that the flow of vaccine to combat H1N1 Influenza has been slow. Extremely slow. Woefully slow. We need the vaccine; not now, but yesterday.
So what happened? Early predictions from the Centers for Disease Control (CDC) were 45 million doses of vaccine by mid-October with 20 million doses a week after that. It is nearly the first of November and vaccine manufactures have delivered less than 20 million doses. The CDC and vaccine manufacturers offered multiple reasons for the shortfall. Most of these relate to problems at the point of production. However, vaccine manufacturers that are based in foreign countries face domestic pressures that can delay the fulfillment of orders from the United States. We will probably never know the true impact of those pressures.
The most likely explanation for the mismatch, though, was the wildly optimistic projection by the CDC. The US is lucky if we get between 90 and 120 million doses of influenza vaccine in a regular flu season. Production of seasonal flu vaccine was already well under way when manufacturers had to slow the assembly line and begin making H1N1 vaccine. I'm not sure how the CDC thought we might get upwards of 100 million doses of each type of vaccine. Now we are faced with a supply of H1N1 vaccine that was certainly less than hoped for, as well as shortages of seasonal flu vaccine in many areas of the county.
Looking for someone to blame for the shortage or just wishing our doctor or public health department had more H1N1 vaccine won't help to protect a single person from H1N1 influenza. Instead, we need to focus on what we can do right now to protect the ourselves and everyone else from H1N1. Here are a few suggestions.
1) Keep doing those things that prevent the spread of H1N1, including:
- Wash your hands frequently
- Avoid touching your eyes, nose or mouth
- Wash high-tough surfaces frequently
- Don't share with others items you put in your mouth
- Cover your cough or sneezes with your sleeve rather than your hands
- Stay home if you are sick with symptoms of the flu
2) Make sure folks that are on the target list for H1N1 vaccination have access to vaccine first. This includes:
- Pregnant women
- Parents and caregivers of children under 6 months old
- Everyone age 6 months to age 24
- Persons age 25 to 64 chronic health conditions
- Health care and emergency service workers
3) Call your health care provider to inquire about vaccine availability. The Public Health Department will place announcements on the radio, newspaper and on-line when vaccine is in stock.
4) Be patient. Eventually, there will be enough vaccine for everyone who wants it.
So what happened? Early predictions from the Centers for Disease Control (CDC) were 45 million doses of vaccine by mid-October with 20 million doses a week after that. It is nearly the first of November and vaccine manufactures have delivered less than 20 million doses. The CDC and vaccine manufacturers offered multiple reasons for the shortfall. Most of these relate to problems at the point of production. However, vaccine manufacturers that are based in foreign countries face domestic pressures that can delay the fulfillment of orders from the United States. We will probably never know the true impact of those pressures.
The most likely explanation for the mismatch, though, was the wildly optimistic projection by the CDC. The US is lucky if we get between 90 and 120 million doses of influenza vaccine in a regular flu season. Production of seasonal flu vaccine was already well under way when manufacturers had to slow the assembly line and begin making H1N1 vaccine. I'm not sure how the CDC thought we might get upwards of 100 million doses of each type of vaccine. Now we are faced with a supply of H1N1 vaccine that was certainly less than hoped for, as well as shortages of seasonal flu vaccine in many areas of the county.
Looking for someone to blame for the shortage or just wishing our doctor or public health department had more H1N1 vaccine won't help to protect a single person from H1N1 influenza. Instead, we need to focus on what we can do right now to protect the ourselves and everyone else from H1N1. Here are a few suggestions.
1) Keep doing those things that prevent the spread of H1N1, including:
- Wash your hands frequently
- Avoid touching your eyes, nose or mouth
- Wash high-tough surfaces frequently
- Don't share with others items you put in your mouth
- Cover your cough or sneezes with your sleeve rather than your hands
- Stay home if you are sick with symptoms of the flu
2) Make sure folks that are on the target list for H1N1 vaccination have access to vaccine first. This includes:
- Pregnant women
- Parents and caregivers of children under 6 months old
- Everyone age 6 months to age 24
- Persons age 25 to 64 chronic health conditions
- Health care and emergency service workers
3) Call your health care provider to inquire about vaccine availability. The Public Health Department will place announcements on the radio, newspaper and on-line when vaccine is in stock.
4) Be patient. Eventually, there will be enough vaccine for everyone who wants it.
Monday, October 5, 2009
H1N1 Vaccine Arriving Soon
The vaccine for 2009 H1N1 Influenza (“swine flu”) may be arriving this week. Folks have a lot of questions. Fortunately, I have answers.
The first doses of H1N1 vaccine to be delivered will be in a special formulation called Live Attenuated Influenza Virus or LAIV. This vaccine has a form of H1N1 virus that has been weakened so that after it is delivered it causes a sub-clinical form of the flu. It is given in a nasal spray and helps build immunity to the flu in the upper respiratory passages; the same place natural flu viruses gain entry. LAIV has been used for seasonal flu vaccine for several years and is marketed under the trade name FluMist.
LAIV is approved by the FDA for use in healthy, non-pregnant individuals between the ages of 2 and 49. This limits its usefulness in protecting people who are high risk for complications from the flu. However, it is an excellent vaccine to use in healthy children, young adults, and especially in health care workers who could accidentally spread H1N1 influenza to the patients they care for.
Initial shipments of vaccine to Whitman County will be very limited. We are scheduled to receive only 500 doses the first week the vaccine begins shipping. Most public health departments in Washington have decided to use the first allotment of vaccine in health care workers and emergency medical personnel. We have elected to do the same. Vaccine left over after health care workers are inoculated will be distributed to clinics in our area as quickly as possible.
An injectable form of H1N1 vaccine will be available later in October. This vaccine is made from a killed, purified H1N1 virus. It will come in several formulations for both children and adults. We do not know at this time how many doses Whitman County will receive. Much of the injectable vaccine will be sent directly to clinics and physicians offices. Our website will have a list of where and when the vaccine is available.
All H1N1 vaccine is paid for by the federal government. Clinics may charge an administrative fee, which insurance plans will cover, but they cannot charge for the vaccine. Folks without insurance can obtain the vaccine for no cost through the public health department. Although early supplies of vaccine will be limited, there should eventually be enough for anyone who wants it.
Target groups for H1N1 vaccination are pregnant women, parents and caregivers of children under six months old, health care workers, all persons age 6 months to 24 years of age, and persons age 25 to 64 with chronic health problems. People 65 and over are not in the initial target group because H1N1 flu rarely affects this age group. Once the vaccine supply is adequate, H1N1 vaccine will be available to everyone.
Some of the vaccine will be delivered in multi-dose vials and will contain a preservative made from mercury called Thimerosal. Multiple scientific studies have shown no worrisome effects due to thimerosal. Nevertheless, some H1N1 vaccine will be available in single-dose vials without thimerosal. The LAIV form of vaccine (nasal spray) is single-dose only, and does not contain any mercury or preservatives.
H1N1 vaccine is being made in the same manner and by the same companies that make seasonal flu vaccine, and it is expected to have a similar safety profile. The only difference between H1N1 vaccine and seasonal flu vaccine is a change in the strain of the flu virus from which the vaccine is made. Also, just like seasonal flu vaccine, H1N1 vaccine will be free of any immune boosting chemicals or adjuvants.
Finally, check the Whitman County website for details of when H1N1 vaccine will be available. Also call the Flu Line at 509-397 -6FLU.
I welcome your questions and comments.
The first doses of H1N1 vaccine to be delivered will be in a special formulation called Live Attenuated Influenza Virus or LAIV. This vaccine has a form of H1N1 virus that has been weakened so that after it is delivered it causes a sub-clinical form of the flu. It is given in a nasal spray and helps build immunity to the flu in the upper respiratory passages; the same place natural flu viruses gain entry. LAIV has been used for seasonal flu vaccine for several years and is marketed under the trade name FluMist.
LAIV is approved by the FDA for use in healthy, non-pregnant individuals between the ages of 2 and 49. This limits its usefulness in protecting people who are high risk for complications from the flu. However, it is an excellent vaccine to use in healthy children, young adults, and especially in health care workers who could accidentally spread H1N1 influenza to the patients they care for.
Initial shipments of vaccine to Whitman County will be very limited. We are scheduled to receive only 500 doses the first week the vaccine begins shipping. Most public health departments in Washington have decided to use the first allotment of vaccine in health care workers and emergency medical personnel. We have elected to do the same. Vaccine left over after health care workers are inoculated will be distributed to clinics in our area as quickly as possible.
An injectable form of H1N1 vaccine will be available later in October. This vaccine is made from a killed, purified H1N1 virus. It will come in several formulations for both children and adults. We do not know at this time how many doses Whitman County will receive. Much of the injectable vaccine will be sent directly to clinics and physicians offices. Our website will have a list of where and when the vaccine is available.
All H1N1 vaccine is paid for by the federal government. Clinics may charge an administrative fee, which insurance plans will cover, but they cannot charge for the vaccine. Folks without insurance can obtain the vaccine for no cost through the public health department. Although early supplies of vaccine will be limited, there should eventually be enough for anyone who wants it.
Target groups for H1N1 vaccination are pregnant women, parents and caregivers of children under six months old, health care workers, all persons age 6 months to 24 years of age, and persons age 25 to 64 with chronic health problems. People 65 and over are not in the initial target group because H1N1 flu rarely affects this age group. Once the vaccine supply is adequate, H1N1 vaccine will be available to everyone.
Some of the vaccine will be delivered in multi-dose vials and will contain a preservative made from mercury called Thimerosal. Multiple scientific studies have shown no worrisome effects due to thimerosal. Nevertheless, some H1N1 vaccine will be available in single-dose vials without thimerosal. The LAIV form of vaccine (nasal spray) is single-dose only, and does not contain any mercury or preservatives.
H1N1 vaccine is being made in the same manner and by the same companies that make seasonal flu vaccine, and it is expected to have a similar safety profile. The only difference between H1N1 vaccine and seasonal flu vaccine is a change in the strain of the flu virus from which the vaccine is made. Also, just like seasonal flu vaccine, H1N1 vaccine will be free of any immune boosting chemicals or adjuvants.
Finally, check the Whitman County website for details of when H1N1 vaccine will be available. Also call the Flu Line at 509-397 -6FLU.
I welcome your questions and comments.
Subscribe to:
Posts (Atom)
