Font ResizeHow do you know if this “cold” is really just that? Could it be the dreaded “swine” flu? What about regular seasonal influenza? Let’s take a few minutes to look at the different infections.
In March and April 2009, an outbreak of H1N1 infection, a novel influenza A virus, was detected in Mexico, with subsequent cases observed in many other countries, including the United States. On June 11, the World Health Organization raised its pandemic alert level to the highest level, phase 6, indicating widespread community transmission on at least two continents. The 2009 H1N1 influenza A pandemic was caused by an H1N1 virus that had not been recognized previously in pigs or humans. This strain represents a genetic reassortment of swine, human, and avian strains of influenza. As of September 20, there have been over 318,925 laboratory-confirmed cases of pandemic H1N1 influenza A worldwide, including at least 3,917 deaths. Most deaths have been related to respiratory failure resulting from severe pneumonia and acute respiratory distress syndrome.
The most common symptoms of H1N1 infection are the abrupt onset of high fever (greater than 101 degrees Fareneheit), cough, sore throat, muscle and joint pain, malaise (general “un-well” feeling) and headache. Vomiting and diarrhea have been reported, both of which are unusual features of seasonal influenza. It takes anywhere from 1-4 days to develop these symptoms once exposed and one is considered contagious until 24 hours after the fever has stopped. The influenza virus can be transmitted through sneezing and coughing via large-particle aerosols as well as by the more likely route of contact with surfaces that have been contaminated with respiratory secretions. A feature of the newly emergent influenza strain is that severe infection occurs disproportionately in individuals not at the extremes of age (ages 5-59). Testing is accomplished with a deep (posterior) nasal swab and is not recommended unless hospitalized.
There are two pharmaceutical anti-viral treatments available, oseltamivir and zanamivir. Treatment with one of these agents, when initiated in the first 24-48 hours can shorten the duration of symptoms by one to three days. There is some evidence that therapy reduces the severity of complications as well as the duration of hospitalization and risk of death. Treatment is not recommended for everyone. Treatment is recommended only for severe infection or individuals at high risk for complications. These two agents are the same recommended treatments for regular seasonal influenza.
A single dose vaccine is becoming available. The vaccine will be provided by the federal government and will be distributed through public health departments and doctor’s offices, though the specific sites have not been announced yet. Priority will be given to 5 groups: pregnant women, household contacts and caregivers for children under 6 months of age, healthcare workers, all people age 6 months through 24 years, people age 25-64 if they have health conditions that put them at increased risk for complications (diabetes, emphysema, etc.). The regular seasonal influenza vaccine is already available and is recommended for children 6 months up to their 19th birthday, pregnant women, people age 50 and older, people with chronic medical conditions, people who live in nursing homes, healthcare workers and people caring for those at risk for complications or children under 6 months of age. A nasal spray version of the seasonal vaccine is available for people age 2-49. Both vaccines can be given at the same time, however most individuals will be able to (and should) get the seasonal vaccine now to be protected by December.
The common cold is just that - a far more common respiratory tract infection caused by 200+ different viruses including types of rhinovirus, coronavirus, RSV (respiratory syncitial virus) and others. These viruses cause seasonal outbreaks, generally with milder symptoms than influenza including, sneezing, nasal congestion and discharge, sore throat, cough, low grade fever, headache and malaise. There are no approved anti-viral medications and treatment is symptomatic only.
The single most important factor in reducing the burden of these infections involves a simple task every single one of us can and should perform every day - hand washing. Proper hand washing during cold and flu season can dramatically reduce one’s risk of infection. Alcohol-based hand cleaners are also effective. Along with the sound advice - cough and sneeze into a handkerchief or one’s sleeve (instead of hand) and stay home when you are sick (until 24 hours after the fever is gone) - you can help stop the spread of infection in your community.
We at Redwoods Rural Health Center are committed to the health and wellness of our community and we are happy to help you with your health care needs - acute or chronic. Please call us at 923-2783 to schedule an appointment.
