There are many different types (strains) of flu. Each year scientists figure out the 3 main strains of flu going around and make a vaccine that will help prevent people from getting those 3 strains – this becomes the seasonal flu vaccine. Since H1N1 (swine) flu is a newer strain of flu, scientist had to make another vaccine to prevent this flu. They were not able to mix it in with the regular seasonal flu vaccine this year so to be protected from both the H1N1 (swine) and seasonal flu you will need two different vaccines.

H1N1 (swine) acts differently than most seasonal flu! It targets the young.

The most vulnerable population has been those under the age of 24 yrs. 70% of hospitalizations are those under the age of 24 yrs with an underlying health condition. Average age of death is 37 yrs.

Underlying health condition = asthma, diabetes, heart or lung conditions or other chronic illnesses.

Signs and symptoms of H1N1 flu– sudden onset and usually last 5-7 days.

• Fever – 93% of cases of H1N1 have had fever (> 100.0) as a symptom and fever has correlated to more rapid transmission of the virus. If staff or participants have a fever then they need to stay home until they are fever free for 24 hrs.
• Sore Throat
• Cough
• Nasal congestion
• headache
• body aches and fatigue
• 25% of cases have reported nausea or diarrhea. These are not typical symptoms of the flu.

You are contagious 1 day before you have symptoms. Stay home if you have a fever and do not return to work/school until you are fever free for 24 hrs without use of Tylenol or ibuprofen.

What to do if I have symptoms of H1N1?

• Stay home and limit contact with other people to prevent spreading the disease.
• Call your health care provider especially if you are pregnant or have an underlying health condition. Do not just show up at the emergency room (unless you have warning signs) or your doctor's office. Please call first and they will let you know what special care you may need and if you need to report to the doctor. They are not routinely testing everyone with symptoms.
• Stay home for at least 24 hrs after the fever has resolved.
• Get plenty of rest
• Drink clear liquids (water, broth, sport drinks, electrolyte beverages for children)
• Cover coughs and sneezes
• Wash hands with soap & water or use hand sanitizers
• Be watchful for warning signs or symptoms

When to seek emergency care? (warning signs or symptoms)

• Difficulty breathing, shortness of breath or chest pain
• Purple or blue discoloration of lips
• Severe vomiting or unable to keep liquids down
• Signs of dehydration: dizziness, decrease in urination, in infants look for lack of tears.
• Seizures, feel confused or less responsive than normal
• Flu-like symptoms worsen over time

Prevention – good respiratory etiquette

• WASH HANDS, SNEEZE and COUGH INTO TISSUE OR ARM, USE HAND SANITIZER (60% alcohol based products are effective) That cloud you just sneezed or coughed out hangs in the air about 30 seconds – just enough time for someone to walk right into it! Virus will live for hours on surfaces.
• Do not touch your face – eyes, nose and mouths are portals for infections.
• Reduce stress.
• Eat and rest well.
• Let fresh air into home and work spaces.

Get vaccinated against seasonal flu and H1N1 virus. You can get both at the same time unless you are getting both in nasal spray form. Seasonal Flu vaccine is now available.

H1N1 Vaccine schedule:
Ages 6 months – 9 yrs: 2 doses separated by 3 weeks is recommended.
Ages 10yrs and above: 1 dose is recommended

Vaccines will come in injection and nasal spray form for both adults and children. Egg allergies or illness can make you ineligible for the vaccine. Children with asthma or pregnant women should not use the nasal spray form of vaccination.

Where can I get the H1N1 vaccine?
As of right now, the H1N1 is not available until sometime in October. Your health care provider will have the vaccine. The Milwaukee Health Department (MHD) will also be administering the vaccine. Vaccinations will be free but they may charge your insurance if possible. The MHD will be holding H1N1 vaccination clinics at 3 sites (schools) located around the city. They have not disclosed the sites yet but as soon as they do, we will let you know.




Q. What is the difference between the seasonal flu vaccine and the H1N1 (swine) vaccine?
A. The seasonal flu vaccine contains the vaccine for the 3 major strains of flu in circulation this year. Every year a new seasonal flu vaccine is made based on what scientists have found to be the 3 prevalent strains of flu for the season. This is why you can still get the flu even though you have been vaccinated – you can pick up a strain not included in the vaccine.

The vaccine for H1N1 vaccine could not be manufactured in time to be included in this year’s seasonal flu vaccine so it is a separate vaccination.

To get protection from both the seasonal flu strains and H1N1 (swine) you will need 2 different vaccines this year.

Q. How is the vaccine made and was it subjected to the same clinical trials as the seasonal flu vaccine?
A. All flu vaccine is made from versions of the flu viruses that are injected into chicken eggs where it multiplies. Therefore, those with egg allergies are recommended not to receive the vaccines.

Every year, the seasonal flu vaccine is not subjected to rigorous testing since small only small modifications are made. But the H1N1 vaccine did go through clinical trials. Additionally, since H1N1 is a pandemic, many other countries have developed vaccine and have used it. We are able to gather data about the vaccine from their use. So far no serious adverse affects have been demonstrated.

Q. How is the H1N1 vaccine administered?
A. It will be available in nasal spray (FluMist) and injection for both children and adults. Children 9yrs and younger will need 2 doses of the vaccine separated by 3 weeks. People 10yrs and older will only need one.

You are able to get both the seasonal flu and H1N1 vaccine at the same time unless you are receiving both by nasal spray. Nasal spray vaccines need to be separated by at least 2 weeks.

Q. Can everyone receive the nasal spray form?
A. The nasal spray does contain some of the live virus (but weakened so will not actually cause the flu). When the vaccine is sprayed into the nose, the weakened virus multiplies in the cooler nasal passages which then cause the proper immune response to build immunity.

Because it needs the nasal passages and is made form weakened virus, the FluMist is not recommended for those with asthma, underlying medical conditions or pregnant.

Q. What is considered an underlying medical condition?
A. Pregnancy, chronic lung, heart and kidney diseases – this includes asthma, diabetes, sickle cell, but not hypertension and immuno-compromised individuals like those who are HIV positive or going through chemotherapy.

Q. How long after I receive the vaccine will I have immunity?
A. Immunity should occur about 8 days after vaccination.

Q. What about mercury in the vaccines?
A. Thimerosal contains a trace amount of mercury and is a preservative added to multi dose vials of vaccine. Its purpose is to prevent bacterial growth from repeated exposure from needle contact. Single dose vials and all nasal spray doses do not contain thimerosal. All vaccines given to children are thimerosal free.

For more information:
City of Milwaukee Health Department
www.milwaukee.gov/flu
Centers for Disease Control
www.flu.gov or call 1-800-CDC-INFO