Swine Flu (cont.)
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Swine Flu Prevention, Risk Factors, and Vaccines
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Simple measures have been shown to reduce the risk of transmission of influenza. These include frequent hand washing with soap and water or disinfection with alcohol. People should try to avoid touching their face or mucous membranes. The influenza virus can live about two hours on surfaces that become contaminated. During coughs and sneezes, the mouth should be covered with a tissue or a sleeve. In areas with large numbers of cases, it is best to minimize nonessential exposure to crowds. Sick people should stay home whenever possible.
To reduce the risk of spreading the flu to other family members, everyone in the household should wash their hands frequently. Alcohol-based sanitizing gels are available in stores and may be used instead of soap and water when hands are not visibly soiled. The most significant risk factor for the flu is contact with virus particles, usually hand-to-mouth contact, or contact with particles spread by coughing and sneezing.
Rarely, if a person has been exposed to a confirmed case of any type of swine influenza, a physician may recommend a course of medications to reduce the risk of disease. This is called "prophylaxis" and is usually reserved for people at very high risk for complications, such as pregnant women. The CDC has issued guidelines for prophylaxis in special circumstances (https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm).
For the first time during 2013-2014 flu season, one seasonal flu vaccine was composed of four different flu virus antigens instead of the usual three. However, the trivalent (three virus strains) vaccine was also available. The CDC indicated the following: The 2013-14 U.S. trivalent influenza vaccines contained an A/California/7/2009 (H1N1)-like virus, an H3N2 virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011, and a B/Massachusetts/2/2012-like virus. Quadrivalent (containing four viral types) vaccines included an additional vaccine virus, a B/Brisbane/60/2008-like virus. The CDC speculated that the quadrivalent vaccine would replace the trivalent vaccine in the future. In addition, a quadrivalent nasal vaccine is now available and is expected to replace the current trivalent live attenuated vaccine. This vaccine is used for people 2-49 years of age and not for pregnant women or people with any immune-compromising factors (cancer or chemotherapy, for example). A nasal mist vaccine was utilized in the past, but the CDC recommended to stop its use in 2016. For the 2017-2018 flu season, the CDC recommends either a trivalent (three-component) or quadrivalent (four-component) vaccine. The strength and dosage methods may vary according to age and other factors; your medical caregiver can help in selecting the best vaccine for you.
It is important to point out that the 2009 novel H1N1 vaccine was not related to the 1976 vaccine. The 2009 vaccine was made using a more modern process, and the 2009 virus was very dissimilar to the 1976 virus; consequently, the problems seen with the 1976 vaccine (neurologic problems) do not occur with the newer vaccines.
Some people have died from bacterial infections that attack lungs already damaged by influenza. For this reason, the CDC recommends that the pneumococcal vaccine (against Pneumococcus bacteria that may cause pneumonia) be offered to all people with underlying chronic illness and all people over 65 years of age. In addition, people who survive novel H1N1 (swine) flu are still at risk for the regular seasonal flu. For this reason, the CDC continues to recommend the seasonal influenza vaccine be used as recommended. Currently, there is no commercially available vaccine for H3N2v strains. However, a pilot vaccine in preliminary clinical studies may lead to a significant (protective) immune response.
Medically Reviewed by a Doctor on 9/17/2017
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