Influenza-Like Illness/H1N1 Blog

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• H1N1 Phishing

  miller.21 1:09 pm on December 2, 2009 | 0 Permalink | Reply
  

  Caution - OSU Students, Faculty and Staff should be aware of a new e-mail scam related to the H1N1 flu vaccine.  This article comes from MedPage Today (R): 

  “These emails, known as phishing, are luring the unwary to a Personal H1N1 Vaccination Profile Web site that aims to steal users’ identities.

  Click here for the full story: http://www.medpagetoday.com/InfectiousDisease/URItheFlu/17250

  MedPage Today(R) provides physicians and ‘expert patients’ real-time coverage of breaking medical news and the top stories in health and medicine. Physicians, PAs, Nurses, and Pharmacists may also receive CME/CE credit as part of our news coverage.”

   

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• Seasonal Flu Vaccine news item

  miller.21 2:05 pm on September 30, 2009 | 2 Permalink | Reply
  

  We have gotten a couple inquiries about news reports describing changes in the Canadian Public Health System’s recommendations for seasonal flu vaccine.  Here is what we know:

  Folks in the Canadian public health system are doing a study looking at various trends related to H1N1 infections.  In their preliminary data, which has not yet been reviewed or published, or even confirmed by the authors, they are seeing a relationship between getting the flu shot LAST fall, and getting H1N1 this year.  This is based on news reports, not scientific assessment of the data. 

  It is hard to say how we should respond to this, but this relationship is not confirmed by any other studies, and it is unclear how these events would relate biologically.  A vaccine causing people to be more susceptible to a novel virus that appears months later would be very unusual, to say the least.  It is more likely that there are similar reasons for the people in this study to have been vaccinated last year and also been exposed to H1N1 this year.  You could see this in a group of healthcare workers, for instance.

  The World Health Organization is reviewing these findings, and is said to be preparing a response in the next few days.  We will have to see what they say, but for now, the CDC is not advocating a change in our current approach to vaccination.  People should get their seasonal vaccination this fall.  They should also get an H1N1 vaccination if they are in a targeted group.  Stay tuned for updates.

  Roger Miller, MD, MS

   

  • TG 9:22 am on October 16, 2009 Permalink
    

    Why is it that when I went to Wilce Student Health Center on Monday to see my PCP for a non-flu and non-cold matter I had to play musical chairs because of students (with no concern for others) coughing and sneezing on or near me?

    I first sat down and the person across from me started coughing without covering her mouth. I don’t know why she was coughing, but I don’t think she was aware of how far her germs could spread. Thus, I moved.

    Then a guy near me started sneezing wihout covering his nose and mouth. Again, I don’t know what caused him to sneeze, but I don’t think he was aware of how far his germs could spread. Thus, I moved again.

    Then, even worse, a girl comes in wearing a mask, coughing like crazy, holding her throat, and having a really red, wet-looking forehead and chin; she sat down two seats away from me. I thought she at least belonged behind the pink screens. Why didn’t the staff at Wilce make sure that she sat in the screened-off area?!!! Even though she had on a mask, she was using her hands to adjust it. And, at one point, she put her fingers up inside (maybe to scratch an itch or to wipe her mouth). As I got up to move (again), the guy she was with said to her “Don’t you think you should sit over there?” (pointing to the screened-off area) She replied “I guess so.” Then she moved to that area. Anyhow, I ended up standing back from the waiting room.

    By the way, I sanitized my hands after each incident, but those students never bothered to sanitize their hands.

  • miller.21 10:01 am on October 29, 2009 Permalink
    

    TG, thanks for your comment. At Student Health, we are aware of this concern, and are doing our best with signage and instructions to students about masking, tissues, sanitizers, and sitting in our separate waiting area. While we cannot constantly police the waiting areas to make sure people are compliant, we will ask people to move when it is necessary. It is also ok for you to make the request of another student, just as the other patient did in your case.

• Can a person get H1N1 more than once?

  miller.21 2:30 pm on September 23, 2009 | 12 Permalink | Reply
  

  Short answer – no, and maybe.

  Long answer – Virus particles are identified and destroyed by your immune system based on markers.  These markers are then templates for antibody production, which makes your body even better at killing the virus the next time you come in contact with it.  In the best case scenario, this means you are immune. 

  If the markers change through mutation, which is something the flu virus is very good at doing, then your immunity may no longer work when you are infected again. 

  So, you are unlikely to get sick again from the same virus, but if the virus changes, then you may be in for another round. 

  Roger Miller, MD

   

  • RH 7:25 pm on September 25, 2009 Permalink
    

    do you recommend student to get vaccinated for flu & H1N1? I’m a 25 yr. olf female student. Thank you & Have a nice day !

  • miller.21 9:24 am on September 26, 2009 Permalink
    

    Please visit http://flu.osu.edu/flu_Vaccines.html for more information. We are encouraging people to get the seasonal vaccine to reduce illness during the winter when we may be dealing with both seasonal flu and H1N1 flu. H1N1 will be distributed to the highest priority groups first, then available more broadly as supply allows.

  • NR 11:33 am on October 5, 2009 Permalink
    

    I have a different question, Dr. Miller. Could you speak to how long some one “sheds” the virus? A related question – if, some one is no longer carrying a fever but doesn’t do a good job of covering their mouth when they sneeze or cough, can they still spread it or only for a specific period of time? Thanks!

  • miller.21 12:01 am on October 7, 2009 Permalink
    

    Thanks NR.

    This is a good, but also difficult question to answer. Evidence has been collected from review of H1N1 illness earlier this year, and on the usual behavior of flu viruses in general. Based on this, the highest degree of viral spread that is likely to cause disease is during the period of highest fever. That is why an isolation rule of staying home until the fever has cleared for at least one day without suppression makes sense, unless a person is around highly sensitive contacts, such as a doctor or nurse in a hospital. Once the fever is gone for at least a day, the level of viral shedding has dropped low enough that most people exposed will not get sick.

  • G 5:47 am on October 20, 2009 Permalink
    

    Is a persistent cough a noted after-affect of having the swine flu?

  • WM 11:07 am on October 20, 2009 Permalink
    

    If you’ve been recently sick, how do you know if it was the H1N1 virus or something else?

  • Nicole 10:28 pm on October 28, 2009 Permalink
    

    We have H1N1 right now. Should we still get the H1N1 vaccine once it becomes widely available? My understanding is that if the virus mutates then we can get sick again. Will the vaccine do anything if it mutates?

  • miller.21 10:08 am on October 29, 2009 Permalink
    

    Yes. We are getting more and more reports of students who have recovered from their other symptoms, but have a persisting dry cough.

  • miller.21 10:09 am on October 29, 2009 Permalink
    

    There really is no way to be certain. If you had all the classic flu symptoms (high fever, sore throat or cough, muscle pain), then you likely had the flu, and it was probably H1N1 if it was during the summer or fall.

  • miller.21 10:12 am on October 29, 2009 Permalink
    

    The current recommendations are that unless your flu was confirmed positive by the Health Department, you should get the H1N1 vaccine. There is the potential that if the virus changes to cause more severe disease, then having been vaccinated with the H1N1 strain could be helpful.

  • JTH 4:09 pm on November 6, 2009 Permalink
    

    If the virus changes, isn’t there a chance that the vaccine will not be effective?

  • miller.21 10:55 am on November 25, 2009 Permalink
    

    Yes, but these changes tend to occur in small increments, so it is more likely that the vaccine effectiveness would be slightly reduced, rather than completely ineffective all at once.

• Can I get H1N1 from food served in a restaurant?

  miller.21 2:13 pm on September 23, 2009 | 0 Permalink | Reply
  

  Thanks for this question. 

  H1N1 is not transmitted by food. Transmission requires direct contact with droplets coughed or sneezed from a person with infection, and an opportunity for the virus to come in direct contact with a point of entry in an uninfected person. 

  Food service workers should remain home if ill, and practice good hand hygiene, like everyone else.  The US Food and Drug Administration also recommends that they avoid contact with exposed food, clean utensils or linens, and unwrapped single use items.  Visit http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm153285.htm for more information.

  Roger Miller, MD

   

• Flu Kit Assembly

  admin 9:58 pm on September 18, 2009 | 0 Permalink | Reply
  

  “Flu Kit Assembly”

  Ohio State students helped put together thousands of “flu kits” Friday evening, September 18, at the Jesse Owens North Recreation Center. The kits will be distributed during Move-in Day to encourage hand-washing and other preventative steps students can take to avoid contracting the flu.

  

  Students assemble flu kits for Move-in Day

  

  Students help assemble flu kits for Move-in Day

  

  Carts of flu kits waiting to be distributed

  

  Hand sanitizers have been installed throughout campus

  Photos by Jo McCulty, Photographer, Photo Services, Marketing Communications

   

• FDA Approves Vaccines for 2009 H1N1 Influenza Virus

  admin 3:40 pm on September 15, 2009 | 6 Permalink | Reply
  

  The Food and Drug Administration today (9/15/2009) approved four vaccines against the 2009 H1N1 influenza virus.
  View the press release

   

  • g 7:24 pm on September 25, 2009 Permalink
    

    Will Ohio State University offer the H1N1 vaccine to the students and faculty? How available will it be to the regional campuses? Are there any side effects we should be aware of, before taking the vaccine? What kind of charges should be expected?

  • miller.21 9:18 am on September 26, 2009 Permalink
    

    Thanks for your question on H1N1 vaccine. Like most other clinics and doctors’ offices out there, we are eagerly awaiting news about the arrival of the H1N1 vaccine. We are planning vaccine outreach with this vaccine in much the same way we do with the seasonal vaccine, but a lot depends on the number of doses we receive. This vaccine will be alloted through the public health agenices on the national, state, and local levels, and we are working closely with our collegaues there to stay informed.

    Regionals – since local health departments play a big role in distributing this vaccine, the regional campuses will be working on this with their contacts across the state.

    Side Effects – This is a new vaccine, but it is being produced in the same ways that flu vaccine is made every year, so we are expecting that the side effects will be similar, meaning that the injection site may be sore for a day or two, and this could be accompanied by some low grade fever. More information will be published by the Centers for Disease Control and Prevention in the form of a Vaccine Information Statement when the vaccine becomes available. Everyone receiving the H1N1 vaccine should review this statement prior to their vaccination.

    Charges – the H1N1 vaccine itself is being provided at no charge through the federal government. Nominal fees for administering the vaccine have been approved for clinics and doctors’ offices to use, so in some settings, you may have to pay this fee.

  • RZ 8:38 pm on October 5, 2009 Permalink
    

    The school is offering vacination starting October 6th, 2009. Is the “standard” flu vaccination or for H1N1? My son, a student at OSU, has already received the flu vaccination, but not for the H1N1. I do not believe he needs a second dose of the same vaccination if it is not for N1H1.

    Which flu strain vaccination begins to be offered in October 2009?

  • miller.21 12:09 am on October 7, 2009 Permalink
    

    RZ,

    Actually, Student Health Services has been vaccinating with the seasonal vaccine since early September. October 6 is our first evening vaccine program, and it is for the seasonal flu vaccine. Even with H1N1 going around, it is still important to get the seasonal vaccine. For more information, click here. We are currently recommending one dose of seasonal vaccine for all students, and one dose of H1N1 vaccine for students in the identified priority groups.

    We are planning to begin giving the H1N1 vaccine as soon as it is released to us by the health department.

  • SH 3:23 pm on October 16, 2009 Permalink
    

    SHS currently places me in the lowest priority category for receiving the H1N1 vaccine when it arrives; however, my wife is currently pregnant and me catching it and then bringing it home would put her at much higher risk than she is now. Will SHS honor spouses of pregnant women as well and, if so, what would we need to bring as proof?

  • miller.21 10:07 am on October 29, 2009 Permalink
    

    Just to clarify, the priority categories are from the CDC and the Ohio Department of Health. SHS agrees with and is using those categories, as part of our agreement to be a H1N1 vaccine site. The categories make sense, when you think about getting the vaccine first to the groups that suffered the most sickness and death earlier in the pandemic. At this point, there is no category for household contacts of pregnant women, but if your child is due in the next month or so, you would qualify as a caregiver for a child under 6 months of age, and can rank yourself that way on the H1N1line (614-514-4161).

• Can a person carry the H1N1 virus to others without knowing they are ill?

  armstrong.349 7:51 am on September 15, 2009 | 4 Permalink | Reply
  

  This question has been asked by an OSU staff member. Here, Dr. Roger Miller from Wilce Student Health Center provides an answer……………

  This is a somewhat difficult question, as we really are limited in our knowledge of the characteristics of the H1N1 virus at this time, but, generally, there is no carrier state with influenza. If a person exposed to this virus has no symptoms 24-48 hours after exposure, then it is unlikely they are (or were) infectious to others.

   

  • HL 7:42 pm on September 18, 2009 Permalink
    

    What would be the topical symptoms of individual during incubation time if H1N1 then? Some of my friends will come back from other countries and I don’t want to alienate them for fear for the 2 days period.

  • miller.21 11:49 pm on September 18, 2009 Permalink
    

    Thanks for your question. Incubation means the time from contact with a disease until becoming sick, so there are no symptoms during this time. Generally, the first symptoms to appear with influenza illness are fever and sore throat or cough, but this can be different from person to person.

    But the key to your question for me is your mention of alienation and fear. Would your friends have felt alienated if you had a cold or a stomachache when they returned? Fear does not have to be part of dealing with H1N1 flu, if you know how to manage it properly.

    You and all your friends should be covering the mouth and nose with a tissue when you cough or sneeze, and washing your hands frequently. If one of your friends is pregnant or immunocompromised or has chronic illness, and you have recently been around someone with sickness, maintain a safe distance (6 feet) for the first few days after your exposure. By that time, you will know if you are becoming sick.

    These are simple measures, and as long as H1N1 remains a mild to moderate illness, this is the safest recommendation to follow. While you are welcoming your friends back, perhaps all of you could look into getting a seasonal flu shot, too.

    Good Health to all of you!

    Roger Miller, MD, MS

  • Jeff 10:19 pm on November 9, 2009 Permalink
    

    Several people over the past few weeks whom I have been around have been diagnosed with H1N1 shortly after I have been around them; yet I have not had any symptoms of the flu and am seemingly healthy. All of my research has shown that there is no carrier state for H1N1. Over the past month or so another person gets infected with H1N1 nearly every weekend. Because of the time frame of people getting infected I know that I’m likely to not have H1N1 in the incubation stage which came to mind. Is this just coincidence that several people I have been around have become ill or should I see a doctor to prevent spreading the infection further?

  • miller.21 10:32 am on November 25, 2009 Permalink
    

    Jeff, given the level of influenza currently in the community, I think this is coincident illness.

    Roger Miller, MD

• Student email from Dr. Javaune Adams-Gaston

  admin 11:55 am on September 14, 2009 | 2 Permalink | Reply
  

  All students received an email message from Dr. Javaune Adams-Gaston, Vice President for Student Life. In it she outlined the university’s approach to flu prevention, health and safety, and recommendations for students who become ill while at Ohio State.

  View Dr. Adams-Gaston’s  email message.

   

  • KM 6:45 pm on September 14, 2009 Permalink
    

    From what I am understanding about H1N1, it becomes severe enough to be fatal when it develops into pneumonia. Perhaps we should think about promoting the pneumonia vaccine. I recognize that the reluctance is that vaccine’s protection lasts only 5 years and can be given only 2 times in one’s life. Perhaps under these circumstances, young people (who are in the high risk population) should be vaccinated for pneumonia now and then again at age 65+.

  • admin 11:29 pm on September 16, 2009 Permalink
    

    Ms. Murray,

    This is an excellent insight. Influenza does increase the risk of developing all forms of pneumonia as a complication, and Pneumococcal pneumonia is a common bacterial cause. In fact, Pneumococcal pneumonia, or Strep pneumonia as it is also called, is the leading vaccine-preventable pneumonia in the United States. Another concern is that while a vaccine against this bacteria is available, very few of the high-risk people under age 65 years get vaccinated. You can visit http://www.cdc.gov/h1n1flu/guidance/ppsv_h1n1.htm for a more detailed discussion of this vaccine, and the people who should get vaccinated.

    Roger Miller, MD, MS

• Staff email from Larry Lewellen

  armstrong.349 12:43 am on September 13, 2009 | 0 Permalink | Reply
  

  All staff received an email from Larry Lewellen, Vice President, Office of Human Resources on Sunday, September 13. In his email, Vice President Lewellen discusses OSU Staff’s role in maintaining a healthy campus. He also outlines some of the measures that OSU has taken to help support staff members during a large influenza outbreak.

  View Vice President Lewellen’s message.

   

• Faculty email from Provost Joe Alutto

  armstrong.349 12:42 am on September 13, 2009 | 0 Permalink | Reply
  

  On Sunday, September 13, Provost Joe Alutto sent an email to all Faculty members outlining OSU’s response and asking for their help in keeping our students healthy.

  View this message.