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October 1, 2009

H1N1 influenza recommendations include “common sense”

By Chris Tachibana
Special to UW Health Sciences


Even before classes started, the first suspected cases of H1N1 influenza hit campus. On Sept. 10, Dr. Jean Haulman of Campus Health Services e-mailed the university community to announce two probable H1N1 cases at a sorority on the Seattle campus, whose members returned early for rush.


The next day, coincidentally, public health experts in Seattle were part of a H1N1 public panel sponsored by the Washington Biotechnology and Biomedical Association (WBBA) called the “WBBA Success Series Event: H1N1-Swine Flu Pandemic.” Panelists included UW’s Dr. Jeffrey Duchin, assistant professor of medicine and chief, Communicable Disease Control, with Public Health-Seattle, & King County and Dr. Ann Marie Kimball, professor of epidemiology, who studies global trade and disease transmission. Awareness was high because of several thousand suspected cases at Washington State University (WSU) in Pullman, which started classes on Aug. 24. These cases fit the pattern of the H1N1 virus, which disproportionately affects young people, including those of college-age.


Duchin advised, however, that we all relax a little bit and use common sense.


“We’re going to have a bad flu season, but fundamentally, it won’t be different from the flu season we have every year,” he said.


Although the H1N1 virus appears to be easily transmitted from one person to another, and college students are not expected to have immunity to this strain of the virus, it causes a relatively mild illness compared to other types of flu. Most of the WSU students who became ill reported only a few days of discomfort.


Although this is not a “killer pandemic” and the official message is “don’t panic,” an outbreak is inevitable, according to the panel, which also included Dr. Terry McElwain of the WSU Animal Disease Diagnostic Laboratory and Dr. Anthony Marfin, a Washington state epidemiologist for communicable diseases.


“Wherever people come together, this virus will be there,” said Duchin.


Pandemic means global 

H1N1 is designated a pandemic because it is an epidemic that is occurring globally, said Duchin.


The panel members stressed that the pandemic designation does not indicate the seriousness of the illness. Using a severity scale that is applied to infectious diseases, H1N1 influenza, like a mild hurricane, is a relative safe category 1 disease.


H1N1 contains genes derived from several sources, but is being called swine flu. According to McElwain, pigs are the key to new influenza viruses, because both human and avian influenza viruses can infect them. The pigs become only mildly ill, but they provide a perfect “mixing vessel” for generating new influenza strains. The viruses enter the general population through interaction between infected animals and humans, for example agricultural workers.


Get your flu shot


To minimize our risk of getting the flu, Marfin and Duchin both stressed the importance of the annual seasonal influenza vaccination, calling it “the single best method of prevention.”


For the UW community, Kimball recommended that everyone check the university influenza websites regularly for updates on status of flu outbreaks, and advice about avoiding infection. The websites are http://www.washington.edu/emergency/pandemic/  and http://depts.washington.edu/hhpccweb/h1n1/index.php  


The H1N1 panel experts stressed that most people with suspected influenza do not need to be tested, do not need antiviral medications, and may not even need to see a doctor. If you get sick, unless you have a condition that increases the risk of complications from the flu, such as pregnancy or chronic respiratory illness, Duchin said, “stay home, drink some fluids, you’ll be better in three-to-five days.”


H1N1 influenza is a respiratory disease with fever, fatigue and sore throat. The official advice in this case is to stay home until your temperature is under 100ºF for 24 hours, without fever-reducing medications.


Science writer Chris Tachibana is a researcher in biochemistry and an instructor in honors biology at the University of Washington. She has a Ph.D. in molecular biology.