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Before the Vaccine Arrives, It's Up to Citizens to Slow Swine Flu

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Aug. 26, 2009 -- Who's on the front line of this fall's flu fight? You are, say HHS and CDC officials.

Until Thanksgiving, at the earliest, it's going to be up to you to try not to catch the flu. And if you do catch the flu, it's going to be up to you to try not to infect anyone else.

Why? The government is rushing to deliver H1N1 swine flu vaccine to states on or around Oct. 15. Vaccination likely will take two shots given three weeks apart. No protection is expected until two to four weeks after the second shot -- around Thanksgiving for those who start vaccination in mid-October.

"We are not going to have vaccine before H1N1 disease gets here because the disease never went away this summer," Anne Schuchat, MD, director of the CDC's Center for Immunization and Respiratory Diseases, said this week at a pandemic flu symposium. "Schools are now opening and cases are appearing. I would expect to see clusters popping up soon."

"I think we're going to have an interesting fall," Steven C. Redd, MD, director of the CDC's Influenza Coordination Unit, said at the symposium.

All relevant branches of the U.S. government are making full-speed-ahead efforts to prepare for a bad flu season, as the new H1N1 swine flu collides with the seasonal flu. But in the end, the government can do only so much.

The rest is up to citizens, says Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services (HHS).

"It is essential people make plans, because we will not have a vaccine available for a few months," Sebelius said at the CDC symposium.

What plans?

The first part of the plan is to avoid infection:

• Wash your hands frequently and thoroughly. Use soap and warm water when available; use hand sanitizer between hand washings.
• Avoid close contact with sick people. Close contact means getting within 6 feet of a sick person. If you must care for someone who is ill, minimize close contact.
• It's not known whether face masks protect against infection. If you use one, don't slack off on hand washing or avoiding close contact with sick people. Use the face mask properly and throw it away after use.
• Get your seasonal flu vaccine as soon as possible. It's safe, and it protects against the three seasonal flu bugs expected to circulate this fall and winter -- even though it won't protect against H1N1 swine flu.

The second part of the plan is to keep from spreading the swine flu virus:

• Stay home if you are sick.
• Observe flu etiquette. Don't cough or sneeze into your hands. Cough/sneeze into a tissue -- or, failing that, your elbow.
• If you can do so comfortably, wear a face mask if you come into contact with others.
• If you are an employer, do not penalize workers for staying home if sick or for caring for sick children.
• Make plans -- now -- for what you'd do if you or your children get sick this fall.

Does this stuff really work? From the standpoint of an individual, nothing may seem to be happening.

"All these efforts are leaky," acknowledged Martin Cetron, MD, director of the CDC's division of global migration and quarantine.

But if enough people do these things often enough, it will slow the speed at which flu spreads through a community. This actually slows down the pandemic -- and buys precious time for vaccination to do its work.

"By altering patterns of transmission, we reduce the peak of an epidemic wave, we buy time, and we reduce the total number of cases," Cetron said at the CDC symposium.

SOURCES: Influenza Workshop for Journalists, Aug. 24-25, 2009, with:

• Kathleen Sebelius, secretary, Department of Health and Human Services
• Anne Schuchat, MD, director, National Center for Immunization and Respiratory Diseases, CDC
• Stephen C. Redd, MD, 2009 CDC H1N1 incident manager and director, Influenza Coordination Unit, CDC
• Martin Cetron, MD, director, division of Global Migration and Quarantine, CDC.

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