Last updated Friday Oct. 30 @ 2 p.m.
We have been receiving many e-mails in the CP24 newsroom about H1N1 influenza and the H1N1 flu shot. Our Medical Specialist Dr. Karl Kabasele answers some of the most frequently asked questions:
Sections:
Influenza Q & A:
1: What are the symptoms of H1N1 flu, and how will I know when to seek medical attention?
A person infected with H1N1 influenza will almost always have a cough and a fever of greater than 37.8 degrees Celsius (100 degrees Fahrenheit). They will commonly experience fatigue, muscle aches, sore throat, headache, decreased appetite and a runny nose. They will sometimes have diarrhea, nausea and vomiting.
Most people with H1N1 flu will have a moderate illness and will be able to recover at home. However, Toronto Public health recommends that if your symptoms are worsening over time you should see a doctor. For infants and children, if there are signs of breathing problems or dehydration associated with the flu, you should see a doctor. Some signs and symptoms to look for in infants and children include:
• fever in infants less than 3 months
• fever with rash
• fast or troubled breathing
• purple or blue discoloration of the lips or skin
• drinking very little fluid and urinating less than usual
• difficulty waking up or confusion
• irritability - child does not want to be held
• seizures (convulsion/fit) or stiff neck
• flu-like symptoms improve then return with fever and/or worsening cough
• underlying health condition that worsens
• difficulty breathing or shortness of breath
• chest pain
• severe or persistent vomiting
• fever that lasts for more than 2 days
• confusion or difficulty waking up
• flu-like symptoms improve then return with fever and/or worsening cough
• underlying health condition that worsens
If your child has any of these, seek immediate medical attention, either by calling 911 or going to a hospital emergency room.
2. If I get the H1N1 flu, how long will I be contagious?
The Public Health Agency of Canada says that a person with H1N1 flu is contagious from 1 day before the onset of symptoms, to as long as 7 days after symptoms start. However, there is ongoing research to determine if a person with H1N1 flu may be contagious for a longer time. Because of this uncertainty about the contagiousness, we should all practice universal precautions throughout flu season, and that includes frequent hand washing, covering up coughs and sneezes with a tissue or your sleeve, keeping your hands away from your face, cleaning and disinfecting surfaces in common areas, and if you’re feeling unwell, staying home for as long as possible to rest, recover and reduce the spread of the virus. Perhaps the most effective way to protect yourself is to get the H1N1 flu shot, so consider getting one.
3. Don't more people die of the regular seasonal flu every year? Why is this one different?
The seasonal influenza virus causes serious disease every year and may kill up to 8,000 Canadians every year according to estimates by the Public Health Agency of Canada. Overall, the World Health Organization is calling this worldwide H1N1 flu outbreak “moderate”, but we will only know after flu season is over how deadly H1N1 was in relation to the regular seasonal flu. H1N1 influenza is different because it is a new virus, so most people around the world will have no natural immunity to H1N1.
4. How do I look after my child who is sick without getting the flu?
There are simple infection control techniques that you can use at home when caring for a sick person with a flu-like illness. Frequent hand washing by everyone in the home can help to reduce the spread of influenza viruses. Having the sick person wear a mask can help to stop the spread of infectious droplets. A person with influenza may be infectious for about 7 days after symptoms start, so they should be resting away from others in the home. The sick person’s belongings should be kept separately, and surfaces and objects touched by the sick person should be disinfected. To help the sick person feel better and recover, make sure that they are well hydrated, well fed, and well rested. Treat fever as necessary and be alert for complications of the flu, and worsening of chronic health problems.
5. I take public transit and work in an office with multiple people - is washing my hands good enough to protect myself from H1N1 flu?
The H1N1 virus can live on surfaces for up to 2 days, so you can pick up the virus from objects as well as people. In order to lessen your chances of getting or spreading H1N1 influenza, washing your hands frequently or using a hand sanitizer are effective techniques. Keep your hands away from your face and cough or sneeze into a tissue or into your sleeve. In the workplace and at home, keep surfaces in common areas clean and disinfected with a bleach solution or commercial sanitizer. If you’re sick, stay home. And consider getting the H1N1 flu shot – it may be the most effective way to protect yourself.
1. Should I get the shot if I'm healthy?
Public health officials advise that all Canadians consider getting the H1N1 flu shot to decrease their chances of serious illness and death from H1N1 influenza. The Public Health Agency of Canada (PHAC) strongly recommends the vaccine for people at higher risk of complications from H1N1 flu, including people under the age of 65 with ongoing health problems; pregnant women; children between the ages of 6 months and 5 years of age; people who live in isolated or remote communities; and people who care for people at high risk of complications from H1N1 flu. The PHAC also recommends the H1N1 vaccine for all other Canadians who can take it.
2. What is in the H1N1 flu vaccine?
The H1N1 vaccine contains:
- purified pieces of the killed H1N1 flu virus
- a small amount of the preservative, thimerosal
- an adjuvant called AS03 (that makes the vaccine more potent)
The vaccine also contains trace residual amounts of egg proteins, formaldehyde, sodium deoxycholate, and sucrose. Thimerosal contains a small amount of mercury, but it has been determined that there is not enough mercury present to harm a child or adult.
3. What is an adjuvant?
An adjuvant is a substance added to a vaccine to increase its potency. In the case of the H1N1 vaccine, the adjuvant is called AS03. It is an “oil-in-water” adjuvant and contains squalene, (a natural, biodegradable oil), vitamin E oil, and polysorbate 80 (which maintains the stability of the mixture). Squalene occurs naturally in the human body, and the squalene in the H1N1 vaccine comes from sharks. Because it is processed and purified, the squalene in the H1N1 vaccine should not be a problem for people with fish allergies, according to the Ottawa Public Health department.
4. Is it true only kids, elderly and immune compromised people are at risk of the serious complications and death from infection with the H1N1 virus?
Seasonal flu is a serious disease – it kills up to 8,000 Canadians every year, according to the Public Health Agency of Canada. In general, the elderly, very young children and people with chronic medical problems are at the highest risk of severe illness from influenza. On the other hand, the evidence thus far indicates that H1N1 influenza seems to severely affect children and young, healthy adults more often seasonal flu does. Having said that, the majority of people with H1N1 flu in Canada have had mild illnesses and were able to recover at home.
5. Is there a shortage projected for the H1N1 flu shots? Should I wait until the “at-risk” patients get their shots first?
The Canadian government has ordered more than 50 million doses of the H1N1 flu vaccine, so there should be enough for everyone in Canada. Naturally, not everyone can be vaccinated at once, so public health officials have decided to vaccinate those at greatest risk first (see Question #1 for high risk groups) and then offer the vaccine to everyone else. Every community in Canada has its own plan for how it will get the vaccine out to the public, so you should check with your local public health department to find out when and where you can get your shot.
6. Has the H1N1 vaccine been fully tested in Canada? Was it rushed and rolled out prematurely compared to other vaccines?
It seems that because there are ongoing clinical trials on the H1N1 vaccine in Canada, some people mistakenly believe that the vaccine has not been adequately tested.
The process of approving a vaccine in Canada involves the manufacturer providing scientific and clinical evidence that the vaccine’s health benefits outweigh any risks, and that the vaccine is effective. This is in keeping with the provisions of the Food and Drugs Act, and the Food and Drug Regulations. The evidence presented includes research data from around the world.
As part of the evaluation, Health Canada looks at the manufacturer’s ability to produce the vaccine with the necessary quality controls. Health Canada officials inspect the manufacturing facility, and samples of the vaccine are tested in Health Canada’s laboratories
Even after approval of a new vaccine, the evaluation process for vaccines in Canada continues. There are systems in place to monitor vaccine safety and to report any potential adverse events after vaccination. The ongoing clinical trials are part of this system of monitoring the safety of the vaccine.
