Southwest Family Physicians 

Flu Season 2009-10 Information.

We have plenty doses of the H1N1 Vaccination.

We will be giving these shots to the following priority groups (in accordance with CDC guidelines):

• All children between the ages of 6 mos and 5 yrs
• Adults caring for children 6 mos and younger
• Patients between 5 and 64yrs old, who have a chronic illnesse (ie-diabetes, asthma, chronic respiratory disease, immunosupressant disease).

Please keep checking with the clinic for the latest information

The Flu season is now upon us and On June 11, 2009, the World health Orgnaization (WHO) declared that a global pandemic of H1N1 (swine) flu is underway. At Southwest Family Physicians we have developed guidelines based on the lastest information from the CDC, the Oregon Department of Health, and the healthcare systems in the area to help you stay your healthiest and get the best treatment for the flu.

What is H1N1 Swine Flu?

Swine Flu (H1N1) is a viral infection that causes a fever (>100*F or >37.8*C)), coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue and sometims vomiting and diarrhea. It is a new virus in the United States. Older adults are not as affected and 1/3 of those over 60 who have been tested have antibodies to the virus. Most people recover without complications and 70% of those hospitalized had one or more medical conditions that placed them at high risk. The seasonal flu (Influenza A) causes the same symptoms except vomiting and diarrhea.  If you don’t have a fever, you don’t have Swine Flu.

Cause:

Swine Flu is caused by the H1N1 virus. After exposure (close contact), 20% of people come down with respiratory symptoms within 1-7 days, most likely 1-4 days. You can be contagious for 24  hours before you have symptoms. It is spread by exposure to infected respiratory droplets. It is not caused by eating pork.

Diagnosis:

How do you know you have the Swine Flu?
If Swine Flu is widespread in your community and you have flu symptoms with a FEVER (>100*F or 37.8*C), then you probably have the Swine Flu.

Tests:

You don’t need to get any special flu tests. The treatment for H1N1 and Influenza A are the same. If you are hospitalized, then you may be tested.

When to see your healthcare provider:

You don’t need to call or see your healthcare provider, unless you are HIGH-RISK (see list below) or develop a complication of the flu (see "When to seek medical care" section). Always call before coming in. We may be able to determine if you need medications and prescribe them over the phone. Besides, going to the office or ER needlessly can expose you to Swine Flu.

How to Treat Swine Flu:

The treatment of Swine Flu is no different from treating the symptoms of the common cold. Treat the cough, sore throat and fever in the usual way.

• Drink plenty of fluids.  Hot ginger and lemon tea, and chicken soup are helpful remedies. (Your grandma was right!)
• Get plenty of rest!
• Treat fever and aches with acetaminophen, ibuprofen or other nonsteroidal anti-inflammatory drugs if  you can tolerate them.
• Chinese herbal medicine can lessen and shorten symptoms. Make an appointment with our acupuncturist.
  

Antiviral medicine (such as Tamiflu)

The CDC recommends antiviral medicines be prescribed for all HIGH-RISK persons (see list below) who come down with Swine Flu symptoms. LOW-RISK persons recover fine without Tamiflu and only need it if they develop serious symptoms (such as pneumonia). Antiviral medicines must be started within 48 hours of the start of flu symptoms to have an effect. They usually reduce the time you are sick by 1 or 2 days. They improve the symptoms but do not eliminate them.

High Risk groups for complications from Swine Flu:

• All children aged 6 months--4 years (59 months);
• All persons aged >65 years;
• Children and adolescents (aged 6 months--18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection;
• Women who are pregnant.
• Adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological, or metabolic disorders (including diabetes mellitus);
• Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV);
• Adults and children who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration;
• residents of nursing homes and other chronic-care facilities.
  

Expected Course:

1-7 or most likely 1-4 days after exposure, symptoms begin. You will be conatgious 24 hours before you have symptoms. Symptoms begin with sore throat and runny nose which can last 1-2 weeks. The fever will last 2-3 days and a cough can last up to 3 weeks. So far the rate of complications is no higher than with regular Seasonal Flu. Again, if you do not have a fever, you do not have swine flu

Prevent the disease:  Protect yourself!

• Get vaccinated. The seasonal flu vaccine will be available end of Oct/early Nov and the H1N1 is due at the same time. We will have flu clinics for vaccinations.
• Make sure your Vitamin D levels are adequate. Make an appointment so we can draw your blood and recommend a dosage to get your levels high enough to help prevent colds and the flu.
• Take probiotics. Healthy gut flora can keep your immune system strong. Probiotics are found in supplements, yogurt with live cultures and kefir.
• Avoid sugars and simple carbohydrates. These weaken your immune system.
• Get plenty of rest, 8 hours a night
• Reduce stress
• WASH YOUR HANDS! Use hand sanitizer or wash with soap and water for 20 seconds.
   

Prevent the Spread! While you are sick

• STAY HOME! Do not go out unless you need medical care. Do not go to work or school until you have been fever free for 24 hours
• WASH YOUR HANDS! Use hand sanitizer or wash with soap and water for 20 seconds.
  
• Cover your cough and sneeze! Cough or sneeze into your sleeve or into a tissue which you then throw away. Not your hand!
• Wear a facemask, if tolerated, when you are in communal living areas like the kitchen or living room.
• If you are breastfeeding and you get sick, KEEP BREASTFEEDING! Wash your hands, wear a clean robe that you can take off when you are done feeding, keep babe away from your face and avoid sneezing or coughing on your baby. Breastfeeding will give your baby some of your immunity. This is the best way to protect your baby!

When to seek medical care:

Adults

• Have difficulty breathing or chest pain
• Have purple or blue discoloration of your lips
• Are vomiting and unable to keep liquids down, or
• Show signs of dehydration, such as feeling dizzy when standing or being unable to urinate or (in infants) crying without shedding tears
• Flu-like symptoms improve but then return with fever and worse cough.

Children

• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough

Flu Season Tips

• Cover your mouth and nose with a tissue when you cough or sneeze.
• If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.
• Put your used tissue in the waste basket. 

Wash Your Hands: The Right Way

When washing hands with soap and water:

• Wet your hands with clean running water and apply soap. Use warm water if it is available.
• Rub hands together to make a lather and scrub all surfaces.
• Continue rubbing hands for 15-20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend.
• Rinse hands well under running water.
• Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.
• Always use soap and water if your hands are visibly dirty.

If soap and clean water are not available, use an alcohol-based hand rub to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast-acting.

When using an alcohol-based hand sanitizer:

• Apply product to the palm of one hand.
• Rub hands together.
• Rub the product over all surfaces of hands and fingers until hands are dry.  

Flu Season Links

Flu.gov

Flu.Oregon.gov

World Health Organization Swine Flu