A Sure Bet: Few Things Stay the Same Week to Week Relative to H1N1 Outbreak

Widespread Disease Present Throughout the Southeast

When the Center for Disease Control in Atlanta tracks the spread of flu, each state gets categorized as no, sporadic, local, regional, or widespread disease. Reports on spread of disease are issued weekly throughout the entire year. The entire southeast is now undergoing widespread H1N1 outbreaks with the level of influenza nationally now equal to the peak of flu cases that occurred last winter and it is rising sharply. Absenteeism in some of our schools locally this past week reached 50% in some classrooms. These numbers are what are typically seen during the peak of any severe flu season.

Slow the Spread!!

Our efforts now are to continue to slow the spread by early recognition and containment. Continue to preach prevention to your children and if they do become ill with an influenza type illness, keep them at home and try your best to minimize exposing anyone else. If we can slow the spread then we can minimize the potential effect it may have on the overall health care system. Hospitals will be able to better care for the patients if the disease spreads slowly. Of course the biggest effect of slowing the spread is the potential of the vaccine arriving and what it will accomplish in preventing spread. Of course no vaccine is effective unless we are able to immunize as many people as possible. Make plans now to have your entire family immunized! Nothing confirmed though there has been lots of speculation released in the news this past week on anticipated arrival dates. The best news is the effectiveness of the vaccine and the possible need for only one dose at least in the adult population. Still no word on how many will be needed in the children and what ages that may apply to but rest assure those recommendations will be confirmed before the vaccine is released. We are preparing for arrival if we are lucky before our October 14th shot clinic but check this site frequently for most recent updates.

Changes in Recommendations In Use of Antiviral Medications

Use of antivirals for treatment following onset of symptoms is still reserved for high risk individuals.

Routine use of antivirals for the prevention of disease following a known exposure in otherwise healthy non-high risk individuals is now no longer recommended. See previous postings on this blog to review who in our patient population is considered at high risk.

There are now two approaches to prevention in those considered high risk following a known exposure. Preventive dosing with Tamiflu is still an option but the CDC has now offered an alternative to prevention. Option B is early recognition and early treatment with Tamiflu if symptoms develop following an exposure. The choice is up to the clinician managing the care of the patient. Part of that option is obtaining a prescription for the treatment dose of Tamiflu and having it available to start at the onset of a suspected flu like illness. This should only be started under the direction of your physician. This approach makes sense in that this would minimize the use of Tamiflu and therefore help prevent the virus from developing resistance to the drug much like so many antibiotics have become ineffective with certain bacteria due to repetitive exposure.