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Now is time to prepare for H1N1 flu
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Right now, parents in the Coastal Health District are preparing for, or have already started, a new school year and are finding out who their children’s teachers are and seeing the doctor to make sure their kids are healthy and ready to learn.
But if you’re a parent, you need to add one more item to that back-to-school checklist: what to do if someone in your family gets the flu.
This fall — as every fall — we not only have to plan for a new version of seasonal influenza, but in addition, another potentially serious strain, the 2009 H1N1 virus.
We first saw the new H1N1 virus in the U.S. last April, but the Centers for Disease Control and Prevention continue to report higher than normal levels of flu-like illness and actual H1N1 outbreaks in some parts of the country. That’s very unusual at this time of year.
CDC estimates so far we’ve had more than 1 million cases of H1N1 in the United States. Similar to seasonal flu, with H1N1 you’ll get a fever, cough, sore throat, stuffy nose, achiness, headache, chills and fatigue. Sometimes H1N1 causes diarrhea and vomiting. Just like seasonal flu, it can be severe and potentially deadly.  
H1N1 can be dangerous for a person with an underlying medical condition — such as asthma or diabetes — or if you’re pregnant. So far, it’s been most contagious among children and young adults age six months to 24 years. Health care workers, emergency responderss and people caring for infants should be on guard.
Scientists believe this virus could worsen with the arrival of school. But if we prepare for the virus now, it does not have to.
Some of these precautions are simple and personal. Make it a routine to wash your hands often with soap and water. Avoid shaking hands if possible, or wash your hands immediately afterwards or use a hand sanitizer. Cough into your elbow or into a tissue, not in your hands.
Stay home if you’re sick, and start planning now in the event that one of your kids gets the flu. And ask yourself these questions: If you work, have you made arrangements for child care? Have you talked with your employer about what to do in case you need to be out?
Some preparation is community-wide. If you’re an employer, now is the time to plan to meet your objectives with a reduced staff. You do not want an employee who is ill to spread flu in the workplace.
If you’re a medical provider, don’t risk being overloaded and overburdened. An outbreak will not only bring people who have H1N1 into hospitals and doctors’ offices — you’ll also see the “worried well.” Plan now to deal with the influx of patients who could come with an outbreak.
At the national level, scientists at the National Institutes of Health, the CDC, and the Food and Drug Administration are working with vaccine manufacturers to make sure that an H1N1 vaccine is not only safe, but that the virus is not changing in ways that would reduce a vaccine’s impact. They expect to have a vaccine ready this fall.
The CDC recommends that certain groups receive the H1N1 vaccine first. These groups have been identified as being more susceptible to suffering complications from novel H1N1 flu. The targeted groups for early vaccination include:
• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated.
• Household contacts and caregivers for children younger than 6 months because infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity
• All people from 6 months through 24 years of age: Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day cares, which increases the likelihood of disease spread. And young adults 19-24 years because we have seen many cases in these healthy young adults and they often live, work and study in proximity, and they are a frequently mobile population
• Persons aged 25-64 years who have health conditions associated with higher risk of medical complications from influenza.
Also, seasonal flu is a significant cause of illness and hospitalization during winter months. For that reason, individuals should consider getting a seasonal flu shot every year.
If you want more information, please visit www.flu.gov. The site provides guidance to prepare for, prevent, and respond to an outbreak. It includes checklists and fact sheets that will help families and others make sure they are prepared.

Skelton is district health director and Weems is chief medical officer of the Coastal Health District
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