I received this in my inbox today from my allergist's office, and
thought it was worth reading. Cheers, Kathryn
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Navigating the Upcoming Flu Season
Throughout the past few months, many of us have heard about the novel
H1N1 flu virus that began affecting people througout the world. In
June of 2009, the Centers for Disease Control declared this virus a
pandemic for its high transmission rate among individuals. It is quite
likely that many of us will experience disruptions to our schedules
related to the H1N1 virus. The current estimate is that approximately
50% of the population will develop H1N1. The CDC has also predicted
that 1.8 million patients may require hospitalization. As a healthcare
organization, we have been asked to plan accordingly if 20 to 40% of
our clinic employees are home sick at any given time. In the event of
a disrupted clinic schedule, Allergy Associate s will make every
effort to notify patients should their appointment be affected.
Likewise, patients experiencing signs and symptoms of influenza
including a fever greater than 100 degrees Fahrenheit, sore throat,
nasal congestion, body aches, headache, wheezing, vomiting and
diarrhea, along with a cough are likely infected by H1N1 and are
advised to stay home. Those infected should remain home until they no
longer have a fever and have been off of medications such as ibuprofen
or acetaminophen for at least 24 hours. In the event you fall ill and
are scheduled to visit the clinic, any advanced communications via
email ([email protected]) or a phone call is appreciated.
One of the concerns with the influenza virus is that it also can
decrease your resistance to secondary bacterial infections -
specifically pneumonia. If you begin to improve, but suddenly have
recurrence of symptoms, marked worsening of symptoms, or a significant
increase in temperature, these are all signs that you could
potentially have a secondary bacterial infection. These symptoms
require physician evaluation. It may be helpful to call ahead to your
primary doctor to make sure you are going to the appropriate place
(Urgent care, Emergency room, vs. primary care office).
Flu-related Frequently Asked Questions
Additional questions and answers are also available atwww.CDC.gov/
h1n1flu/dick.htm
What is the difference between intradermal and intramuscular flu
vaccination? At Allergy Associates of La Crosse, we provide our
patients and employees with the annual flu vaccination through
intradermal administration. This form has been shown to be superior
for younger children, elderly patients and those who are immuno
compromised. Intradermal administration also uses 1/5th of the amount
of the vaccine compared to intramuscular administration and will give
equal protection against the seasonal influenza. Research also
suggests that intradermal delivery may provide a broader range of
immunity against other flu strains, which could include H1N1.
Therefore, if you are able to get the flu vaccine intradermally, we
would recommend it. If you are unable to receive the flu vaccine at
our clinic, we do have templates available which will act as an order
for a local physician or nurse to give the flu vaccine intrader mally
along with a reference sheet to explain why the use of the intradermal
vaccine is preferrable.
If I have an egg allergy, can I be vaccinated? For the annual flu
vaccine, patients with a mild egg allergy that are able to eat foods
containing egg can be vaccinated. However, we recommend that you
receive a reduced dose intradermally to decrease the risk of reaction
to the vaccine. For individuals with a severe egg allergy who are
interested in receiving the annual flu shot or H1N1 vaccine, more
caution needs to be taken. Skin testing or IgE antibody testing should
be conducted for both the egg allergy and also for either the annual
flu or H1N1 vaccine. Dependent upon your test reactions, we can
properly determine the appropriate and safe dosing level for the
vaccination. Our physicians at Allergy Associates of La Crosse have a
treatment protocol developed for both mild and severe egg allergic
patients that can be sent to your primary care physician providing
guidance for testing and vaccination if you are inter ested in
receiving the annual flu or H1N1 vaccinations.
If I suspect I have the flu, can I call the clinic for a Tamiflu
prescription?Tamiflu is currently being reserved for patients who are
at a very high risk of complications such as those who are
immunosuppressed. As clinicians, the CDC is urging us not to use
Tamiflu for milder cases because of the risk of developing resistance
to the flu strain. Therefore, we recommend that patients be seen by
their local healthcare provider before being prescribed Tamiflu. We
can not prescribe Tamiflu to patients calling in to the clinic.
Are there any other additional measures I can take to help reduce my
chance of illness? Standard measures include practicing basic hygiene
including hand-washing, coughing etiquette, and following local public
health officials advice in the event of school/work closures. It may
be also helpful to take supplemental vitamin D3 from now until the
spring. There is some evidence that this may help decrease the risk of
getting influenza and also appears to decrease the severity of illness
should you contract the flu. Children age 12 and above along with
adults should take 2000 IU's of Vitamin D daily. Children below the
age of 12 should receive 600-1000 IU's.
