Swine-Flu-Palooza!: Demystifying the H1N1 Virus

by Sarah Gilman-Short, MD 2010

Baby & Swine FluSo, unless you’ve been lucky enough to have spent the last, oh, six months living in a cabin nestled deep in the forests of Massachusetts, keeping track of your daily expenditures and reading classical Greek literature and Henry David Thoreau’s Walden, you’ve probably heard about Swine Flu. And, unless you are a much more rational person than I (which isn’t saying much), you’ve probably had at least one episode of terror in which you’ve been convinced that you have contracted the virus and will die imminently. In this article, we will attempt to sort through the mounds of information we’ve discovered and give you our takeaways what to do the next time your paranoia strikes because, as we all know, that paranoia has been known to recur.

What is this H1N1 business?

Swine Flu Virus EvolutionSwine flu = H1N1 Influenza. It was initially called Swine Flu because scientists thought that the virus looked genetically similar to influenza viruses that commonly infects pigs.  However, further study has shown that this is not correct, so the name was changed to H1N1, which is definitely less catchy, however kinder to the pigs who have gotten a bad rap recently (Note Egypt’s approach to eradicating swine flu).  The virus’ new name is much more scientific in nature.  All flu viruses (including those that affect humans, birds, and pigs) have an “H” and an “N” in the name, each followed by a number (the avian flu strain that has been worrying people is H5N1, for example).  The letters refer to two proteins (hemagglutinin and neuraminidase) on the surface of the virus. The different numbers refer to slight variations in the form of each protein. These variations are important because our immune system hones in on those proteins to attack the virus.

Okay, overwhelm me with numbers.

You asked for it, my imaginary inquisitive friend. According to the WHO, as of September 2009, there have been more than 300,000 laboratory confirmed cases of pandemic influenza H1N1, and 3,917 deaths in the 191 countries reporting.  Does that seem like a lot?  When a paranoid TV reporter relays the numbers it sure does.  But let’s talk about a little thing called perspective.  During the regular seasonal flu, an average of 36,000 people die from flu-related complications and more than 200,000 people are hospitalized, almost ten times as many people affected as H1N1.  In addition, approximately 250 million people die of malaria every year. Why don’t we harness some of our pig rage and redirect it towards mosquitoes (these are the nasty creatures spreading malaria around the world, one bite at a time).

Terror!  I think I have it!  Wait, how do I know if I have it?

The symptoms are surprisingly similar to your traditional seasonal flu which makes it’s diagnosis even more difficult.  Some of your symptoms may include:

  • Swine SymptomsFever (usually greater than 100.4 degrees)

  • Cough

  • Sore throat

  • Runny or stuffy nose

  • Body aches all over

  • Headache

  • Chills

  • Fatigue

If you do have it, you’re going to feel crappy in general.   You might also have vomiting and diarrhea.   Yeah, the flu sucks.  We’re really sorry.  One of the most distinguishing features of swine flu from the regular flu is an extreme fever that lasts for many days (we’re talking over 100.4 degrees).  Even then, this could be a sign of a bacterial infection as opposed to a virus.  Any sustained fever over 100.4 degrees warrants a visit to the doctor.  On that same note, do not take your temperature after a long work out in the middle of the day…you will be warm, we promise, it’s science.

Wait!  Aren’t you going to do anything?!

Most people who have the flu, even if it’s the H1N1, don’t need anything but sympathy and TLC from their doctor or self-appointed nurse (which we physicians are happy to provide, as long as it’s over the phone during daylight hours). You need to stay home for at least 24 hours after your fever goes away, drink liquids, rest up, and wash your hands a lot so you don’t spread your nasty bug. We know it’s boring, but if you need something to watch, we recommend Twin Peaks or Californication. Both fabulous shows.  If you want some more medically-minded sympathy, try House.

How do I know if I’m “most people?” I’m feeling pretty special right now.

PregnantOf course you are, and that’s why we love you.  If you’re older than age 65 or younger than age 5 (so precocious), pregnant, or have a chronic medical condition such as diabetes, heart disease, asthma and kidney disease, you are more likely to have more severe symptoms with the flu. You should definitely check in with your doctor if you have the symptoms we mentioned above and fall into one of these groups. Better to be safe than sorry.  Your doctor can prescribe an antiviral medication (two examples of antivirals are oseltamivir or zanamivir) to help minimize the effects of the flu and keep you from becoming seriously ill.

I think I’m getting really sick.  When should I be worried?

The reasons that you would call 911 or go to the ER for the H1N1 flu are essentially the same reasons you would seek emergency help in general. If have difficulty breathing, chest pain, your lips turn blue, you’re vomiting so much you can’t keep liquids down, you have a fever above 100.4 degrees for more than a day, or you’re so dehydrated you feel dizzy when you stand up or can’t urinate, you should worry. Get yourself to a hospital, stat! General hysteria is not recommended, but really sick people should go to hospitals.

Okay, now I’m scared again.  How do I prevent this all from happening?

Now’s the time to unleash your inner germaphobe.  Here are some general recommendations to prevent the spread of viral illnesses (yes, we realize they are really obvious…we just thought we should remind you):

  • Preventing Swine Flu with StyleWash your hands a lot

  • Avoid contact with sick people

  • Give the evil eye to that coughing man on the subway

  • Avoid touching your eyes, nose, and mouth (Yes, you can acquire the flu through your eyes.  You can acquire the flu through any mucous membrane for that matter so watch where you put your hands)

  • You can get the vaccine when it comes out this month (expected October 6th, 2009, Vaccine Info)

This year, you can get two vaccines: the regular flu vaccine (the one that comes out every year), and the specific H1N1 vaccine.  Many places will offer them both on the same day. The H1N1 vaccine is scheduled to be released to the public October 6th in a rolling fashion.  People at increased risk of infection or with a great risk of severe illness (including pregnant women, health care professionals, people with chronic disease, and anyone between the ages of 6 months and 24 years old) should get the vaccine. Again, better to be safe than sorry.  If you’re worried about the vaccine killing you, stay tuned for our article busting that ridiculous myth.  Yes, it’s science.

Your “Swine” Flu Takeaways: Get vaccinated. Don’t stress out. Don’t kill pigs…Kill mosquitoes instead.

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10 2009

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