Wednesday, December 1, 2010

In flu season, H1N1 likely to return

Vaccine manufacturers produce some 165 million doses


By TREVON MILLIARD
Express Staff Writer

Hailey doctor Julie Lyons said she hasn't seen a case of the flu yet, but patients ask daily about the imminent flu season and what it holds.

"People are concerned about the hype," she said, adding that the media built up H1N1, commonly known as swine flu, as a great danger last year. "A lot of what I do is comforting people."

Last winter's arrival of H1N1 caused the first influenza pandemic in 40 years, meaning a global outbreak of disease caused by a new flu virus. Despite more people being infected last winter than normal, the U.S. Centers for Disease Control and Prevention reported that the number of flu-associated deaths was actually fewer than normal. About 2,000 Americans died from complications caused by the flu last winter. Most were 65 or older or with pre-existing high-risk medical conditions.

The CDC added morbidly obese people to the high-risk list this winter based on information from last winter. The country's average death rate, using data back to 1976, is 6,300 people a year. About 88 percent of these people have been 65 or older.

South-central Idaho experienced two flu-related deaths last winter, falling in line with the Idaho Department of Health and Welfare's average for the area.

"We certainly didn't see the number we thought we'd get," said Cheryle Becker, family and children's health administrator for the South Central Public Health District, which is the area's main flu-vaccine supplier.

She said the district saw few cases of people testing positive for H1N1. Then again, she said, most people don't come to the hospital for the flu unless complications arise.

"The virus proved to be less virulent, or dangerous, than we initially thought," Lyons said.

She said H1N1 is expected to return this winter along with the seasonal flu.

"We are hoping that it continues to be a less deadly strain," she said.

Unlike last winter, the country is ahead of the game for the upcoming flu season.

Becker said vaccine producers have to pick three flu strains in the spring that are forecast to cause the most illness the next winter. She said it takes six months to make the vaccine to fight all three viruses. However, last winter's H1N1 outbreak was identified after production started.

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"Producing two influenza vaccines in one year is an unprecedented challenge," the nation's largest flu-vaccine provider, Sanofi Pasteur, stated last winter.

Vaccine producers have the advantage this year of seeing H1N1 coming, which has enabled them to combine the two most threatening forms of seasonal flu with the returning H1N1 vaccine to create one vaccine. Lyons said the government has assured medical providers that supplies will be ample this year. The CDC said its manufacturers project about 165 million doses being produced this season. The CDC reported on Nov. 19 that 162.8 million doses have already been distributed, an increase from 114 million doses for all of last flu season, and 103 million for the year before that.

The CDC is recommending that everyone 6 months and older be vaccinated, a change from previous years when healthy adults 19 to 49 years were told that it wasn't imperative. The decision comes because of evidence from the 2009 H1N1 pandemic that even healthy adults can develop complications such as pneumonia.

Lyons said people have no reason to abstain from vaccination, referring to a myth that the shot will make you sick. She said people commonly wait to get vaccinated until the flu season, but it takes two to four weeks to build the antibodies after receiving the vaccine. If someone contracts the virus before then, the shot won't do any good. She said physicians already have the shots in hand and people should be vaccinated as soon as they can.

However, Lyons said, the shot doesn't protect against every form of flu—just the three identified as predominant. The CDC asserts that it got it right 16 out of the last 20 flu seasons. One of this year's identified strains included in the vaccine is A(H3N2), which is responsible for a death rate 2.7 times higher than when it wasn't present, according to CDC studies of the past 31 flu seasons.

How to get the seasonal-flu vaccine

Vaccines are available through medical providers as well as the South Central Public Health District at 117 E. Ash St. in Bellevue. The district's flu clinics have already started in Bellevue on Tuesday afternoons and cost $23 for the injectable vaccine. The FluMist nasal spray costs $30 and users must be adults without any underlying medical conditions. A high-dose flu shot is available for those older than 64 needing a more robust immune response, and costs $38.

Call 788-4335 to make an appointment. Becker said the district briefly tried online appointment scheduling, but suspended it.

"It was a good idea but wasn't working well. It just didn't mesh with our clients' needs," she said, adding that the district is still considering Internet scheduling. "It's the wave of the future."

Trevon Milliard: tmilliard@mtexpress.com




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