Doctors find clues to why H1N1 is hitting younger generation hardest

The great majority of people who have caught the swine flu have recovered quickly, with nothing more than a few days of missed work or school to show for it. But the mystery of H1N1 is that unlike the seasonal flu, which can cause complications in the elderly or very young, H1N1 is hitting children and young adults the hardest.

The reason, doctors now believe, is that parts of the H1N1 virus were contained in flues circulating 30 to 50 years ago, while the seasonal flues circulating since that time have no similarities.

“Every year we have 40,000 die from flu,” said Dr. Sandy Kemmerly, associate head of the department of infectious diseases at Ochsner.  “The difference is H1N1 affects younger people because these people have never seen a virus that is similar to this. Older people have bits and pieces of the flu that makes them somewhat immune.”

According to Kemmerly, 98 percent of the H1N1 sufferers do fine. Only a small subset of those who catch the flu end up in the intensive care unit due to what doctors now think is an overactive immune response.

Recommendations from the CDC for who can get the first round of H1N1 vaccines are changing daily, Kemmerly said. Last week, they were recommending that the elderly and very young be vaccinated first but as of press time, the recommendation has changed to children under 5 years old and adults working with young children.

Flu Mist, the nasal vaccine that arrived last week at the St. Charles Community Health Center, can only be given to people ages 2-49 without immune deficiencies. Pregnant women should not take the nasal vaccine.

Ochsner offers new advice to help prevent the spread of H1N1
Ochsner Health System, in conjunction with the CDC, has new advice for healthy individuals who have flu-like symptoms – stay home and rest. Don’t plan to visit the doctor’s office unless your symptoms worsen, as you will be exposing even more people to the virus. However, physicians caution, if you are considered “high risk,” you should call your physician immediately for advice on what to do.

“We know that H1N1 is going to continue to spread throughout the community -therefore, our goal is to appropriately care for individuals, while reducing ER overcrowding and the additional spread of the illness,” said Ochsner Medical Director of Infection Control Dr. Katherine Baumgarten,
Ochsner is encouraging local residents to follow the recommended CDC advice:

Healthy individuals are asked not to visit the doctor with onset of symptoms. Instead, they should remain at home, away from other individuals, in order to recover and reduce the spread of H1N1.

Individuals who are asked to call their physicians, with onset of symptoms, include the following high-risk populations:

•Immuno-compromised (examples: cancer, transplant, diabetes, HIV, those with underlying lung disease)

•Pregnant women

•Parents of young children (less than 5 years)

•Older population (greater than 65 years)

“If you have flu-like symptoms and are otherwise healthy and not a high-risk category, Ochsner physicians recommend plenty of fluids, Tylenol, and plenty of rest,” Baumgarten says.

She also said that Tamiflu will only be administered to high-risk populations.

“Most individuals are able to weather the illness as they do the seasonal flu,” she said.

As with any illness, it can occasionally worsen in otherwise healthy adults. Those individuals are advised to seek care without delay if they begin experiencing the following symptoms: shortness of breath, chest pain, confusion, intractable nausea and vomiting, return of high fever after original fever has gone away.

If residents will follow this advice, potential overcrowding in local ER’s and the spread of the virus can be reduced.
One of the problems physicians are trying to avoid is non-infected patients getting the H1N1 virus from others in patient waiting areas.

Warning signs for children to seek immediate emergency medical care include: fast breathing or trouble breathing, bluish or gray skin color, not drinking enough fluids, not urinating as usual, severe or persistent vomiting, not waking up or interacting as usual, being so irritable that your child does not even want to be held, or if fever returns after being absent or there is a significant change in fever pattern (101 degrees for several days then 103 degrees).

“The H1N1 virus is comparable to the seasonal flu in its effects on the population. Every year millions of Americans catch the flu and recover, and every year we suffer some deaths,” Baumgarten said. “H1N1 can be dangerous to some individuals but for the majority of the population it’s simply an uncomfortable experience.”


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