Influenza: Your questions answered

this guest blog is brought to you by Dr. Megan Littlefield, Medical Director, RiverStone Health

While the flu season overall has been fairly mild in Montana, last week brought a tragic reminder that influenza is a serious illness that can be deadly. During the week of April 3-8, two young children and one adult in Yellowstone County died from lab-confirmed H1N1 influenza-related complications. These deaths are heartbreaking for family members and friends. As a mom and a pediatrician, I know that these deaths, coming so close together, have created a great deal of anxiety among parents.

So far, Yellowstone County has had 338 reported influenza cases and 70 of those patients were hospitalized. We have had four influenza-related deaths in our county, three of them last week. Statewide, there have been nine deaths and 259 hospitalizations. Compared to historical averages, the state and local influenza numbers are on the low side. This year’s flu season started late but appears to have peaked, both locally and statewide.

I’ve been getting many questions about influenza and wanted to share answers:

Q: What is H1N1?

H1N1 is a type of Influenza A that has circulated since 2009 and it is the predominant strain of influenza this season. This strain does not usually cause severe disease, but it has been associated with significant complications among some young children, elderly, pregnant women and those with chronic diseases.

Q: Will we see more cases of influenza in Yellowstone County?

While influenza cases had been declining in Montana and across the nation, we may see an increase in new cases in our area as awareness of the deaths last week prompt more people to seek medical attention.

Q: Should I still get a flu vaccine?

The best way to prevent seasonal flu is by getting a flu vaccination each year. Everyone 6 months and older should get vaccinated, ideally soon after the vaccine becomes available in the fall. If you have not gotten your influenza vaccination, area healthcare facilities still have a limited supply of the vaccine.

Q: What are the symptoms of the flu?

Influenza is a respiratory illness with fever being a hallmark symptom. It usually comes on suddenly and can cause mild to severe illness, and at times can lead to death. Other symptoms of the flu include: cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea, although this is more common in children than adults.

Q: How does the flu spread?

Influenza viruses mainly spread from person-to-person in respiratory droplets of coughs and sneezes.

Q: How long is a person with flu virus contagious?

Symptoms usually start one to four days after being exposed. People who are sick may infect others for one day before symptoms appear and they remain contagious for five to seven days after becoming sick. Children may pass the virus for more than seven days.

Q: What are possible complications?

Some of the complications caused by flu include: bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as asthma or diabetes. Children may get sinus problems and ear infections.

Q: How do I know if I have the flu?

Tests are available to diagnose flu. Based on symptoms, it’s difficult to tell the flu from other viral or bacterial respiratory illnesses.

Q: Can the flu be treated?

Influenza can be treated with prescription medicines known as antiviral drugs. If you have a high-risk condition, check with your healthcare provider right away if you have flu symptoms. Antiviral drugs work best when they are started within two days of getting sick. Starting them later can still be helpful, especially if the sick person has a high-risk health condition or is very sick.

Antiviral drugs can lessen symptoms, and shorten the time you are sick, and may prevent serious flu complications, like pneumonia. For people with a high-risk medical condition, treatment with an antiviral drug can mean the difference between having a milder illness and having a very serious illness that could result in a hospital stay.

Q: Is the “stomach flu” really the flu?

Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. While those symptoms can sometimes be related to the flu, they are rarely the main symptoms. The flu is a respiratory disease, not a stomach or intestinal disease.

Q: What is the best way to prevent the flu?

A flu shot is the best way to prevent getting the flu and there are other ways to help prevent it as well. When you cough or sneeze, remember to cover your cough/sneeze with a tissue or cough/sneeze into your sleeve. It’s always a good idea to wash your hands often with warm soapy water. If soap and water aren’t available, hand sanitizer with at least 60 percent alcohol will do. Most importantly, if you are ill, stay home from school or work to avoid infecting others.

The heartbreak of last week’s deaths related to influenza is a tragic reminder of what a serious disease this is. As this year’s flu season comes to a close, there is still a limited supply of vaccine which is a good match for the H1N1 virus that is circulating. In addition to vaccination, it’s always a good idea to heed the above prevention tips to help lessen the spread of influenza.

About the author...Dr. Littlefield joined RiverStone Health as the Medical Director in September 2011. Prior to joining RiverStone Health, she practiced primary care and served as Medical Director at Revere Family Health Center at Cambridge Health Alliance in Massachusetts. She received her B.A. from Connecticut College, graduated from University of Maryland Medical School, completed a combined Internal Medicine and Pediatric residency at the University of Chicago, and then served as chief resident at McNeal Hospital prior to starting in clinical practice in 2005. Her clinical interests include improving healthcare access to underserved populations, obesity and diabetes prevention, and healthcare system transformation to create a team-based, efficient, population focused, and patient centered approach to healthcare. She is currently a clinical instructor of Family Medicine at the University of Washington.