IMPORTANT INFORMATION ABOUT INFLUENZA AND FLU VACCINES

This year’s flu season will be unusual in the fact that we are dealing with a novel (new) strain of influenza, H1N1. The following information is regarding the regular seasonal flu vaccine, which does not include H1N1 coverage. More specific information about H1N1 can be found after this section. Please also see the links contained at the end of this article for important information.

What is the "flu", anyway?   

Influenza, or the “flu,” is a group of contagious respiratory viral strains capable of producing mild to severe illness in children and adults. In the United States, annual epidemics of seasonal influenza occur typically during the late fall through early spring. Influenza viruses can cause disease among persons in any age group, but rates of infection are highest among children. Rates of serious illness and death are highest among persons aged 65 years and older, children aged <2 years, and persons of any age who have medical conditions that place them at increased risk for complications from influenza.

Annual influenza vaccination is the most effective method for preventing influenza virus infection and its complications. Influenza vaccine can be administered to any person aged >6 months who does not have contraindications to vaccination to reduce the likelihood of becoming ill with influenza or of transmitting influenza to others.

Symptoms of flu include:
	fever (usually high)
	extreme tiredness
	dry cough
	sore throat
	runny or stuffy nose
	muscle aches
	stomach symptoms, such as nausea, vomiting, and diarrhea, also can occur but are more common in children than adults

complications of the flu

Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

how flu spreads

Flu viruses are thought to spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes, people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. Children will often shed the virus for longer periods of time. That means that you or your child may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

Who should get a flu vaccine?

The U.S. Centers for Disease Control, the American Academy of Pediatrics, and the providers at Treehouse Pediatrics recommend that all children ages 6 months to 19 years receive an annual flu vaccine. In particular, emphasis is placed on children in the following categories:

People who:
	Are aged 6 months to 5 years of age;
	Have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematological or metabolic disorders (including diabetes mellitus);
	Are immunosuppressed (including immunosuppression caused by medications or by human immunodeficiency virus);
	Are receiving long-term aspirin therapy and therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
	Are residents of long-term care facilities; and
	Will be pregnant during the influenza season.

Flu vaccine is available in two forms: trivalent inactivated flu vaccine (given as an injection) OR live attenuated flu vaccine (given as a nasal spray – FluMist).

Who can get the FluMist?

People who:
	Children ages 2 and up (24 months or older)
	Children who do not have a history RAD, do not have asthma or are not allergic to eggs
	After being dosed the child will not be around any one who is immune-compromised (i.e. on chemotherapy, etc)
	Are receiving long-term aspirin therapy and therefore might be at risk for experiencing Reye syndrome after influenza virus infection;
	The child has not received a live vaccine (MMR or Varicella) within 6 weeks of their flu mist appointments.

When should my child get a flu vaccine?

The best time is in the early fall (Mid September-November).

When is it too late to get a flu vaccine?

Flu season peaks anywhere from December to March, so children can still be immunized into December, January and later, if supply is still available.

Will my child get influenza from the flu vaccine?

Neither the injected vaccine nor the nasal spray can give your child influenza. Children receiving the FluMist will often have upper respiratory symptoms (congestion, runny nose) similar to a cold for 3-4 days after receiving FluMist.

Who should not get a flu vaccine?

Children who are allergic to eggs should not receive a flu shot.

Will the flu vaccine contain any Thimerosal?

No, since the vaccine is “preservative free”, it does not contain any Thimerosal.

If your child will be receiving the flu vaccine this year, please click on the below links for important information regarding each individual vaccine. We will presume you have reviewed this information prior to your child receiving the vaccine.
	FluMist:
	http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flulive.pdf
	Flu Injection:
	http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flu.pdf

Information Regarding Novel H1N1 Influenza

Is novel H1N1 virus contagious?

CDC has determined that novel H1N1 virus is contagious and is spreading from human to human.

What if I need a Prescription Refill?

When you need a refill for a medication, please contact your pharmacy first. If the pharmacy is unable to refill the prescription, please call our office and leave a message with one of our staff members. A physician will review the medical record and determine if a refill of the medication can be authorized or if an office visit is required.

How does novel H1N1 virus spread?

Spread of novel H1N1 virus is thought to occur in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose.

What are the signs and symptoms of this virus in people?
The symptoms of novel H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting.

What are the plans for developing novel H1N1 vaccine?
Vaccines are the most powerful public health tool for control of influenza, and the U.S. government is working closely with manufacturers to take steps in the process to manufacture a novel H1N1 vaccine. Working together with scientists in the public and private sector, CDC has isolated the new H1N1 virus and modified the virus so that it can be used to make hundreds of millions of doses of vaccine. Vaccine manufacturers are now using these materials to begin vaccine production. Making vaccine is a multi-step process which takes several months to complete. Candidate vaccines are currently in human trials and will not likely be available until mid-October or November. At this time, it is presumed that vaccine will be approved for children 6 months and older, and that two doses will be required to confer immunity.

Will the “regular” seasonal flu vaccine also protect against the novel H1N1 flu?
The seasonal flu vaccine is not expected to protect against the novel H1N1 flu.

Who will be recommended as priority groups to receive the novel H1N1 vaccine?
CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that certain groups of the population receive the novel H1N1 vaccine when it first becomes available. These key populations include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.

Where will the vaccine be available?
Every state is developing a vaccine delivery plan. Vaccine will be available in a combination of settings such as vaccination clinics organized by local health departments, healthcare provider offices, schools, and other private settings, such as pharmacies and workplaces. It is unknown at this time whether we will receive H1N1 vaccine to give to patients, and if that happens, when that will be.

Are there other ways to prevent the spread of illness?

Take everyday actions to stay healthy:
	Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
	Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
	Avoid touching your eyes, nose or mouth. Germs spread that way.
	Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Treehouse Pediatrics will be monitoring this year’s recommendations closely, and we will be communicating those with you via email as they become available. Please make sure that we have an up-to-date email address on file for you.