Swine flu 101: Clinics, updates and information

Buckle your seat belts for a bumpy flu season.

As if the regular flu wasn’t bad enough, this year’s pandemic H1N1 strain, commonly known as swine flu, will add more cases to the sniffling masses, and produce them earlier.

 Here’s what you need to know.

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How can I find an H1N1 flu vaccine? 

One way is to check the Google flu clinic locater tool at www.H1N1Get1.com . You can also call the Virginia Department of Health's H1N1 call center at 1 (877)  275-8343.

Some local Walgreens pharmacy locations have received the nasal spray vaccine for the H1N1 flu, .
The stores will  offer  the swine flu vaccine to healthy people 9 to  49 years old  who are not pregnant.
The vaccine costs  $18, and those with Medicare or Medicaid insurance can receive it at no charge.

The following Walgreens stores have received the H1N1 nasal spray vaccine.  Contact the store for vaccination times:
-Virginia Beach: 3965 Holland Road, (757) 306-9244; 3376 Virginia Beach Blvd., 340-8013; 1101 Nimmo Parkway, (757) 427-1655; 3364 Princess Anne Road, (757) 468-5879
-Portsmouth: 700 Frederick Blvd. (757) 391-9123
-Hampton: 919 W. Mercury Blvd. (757) 827-2995
-Newport News: 600 J. Clyde Morris Blvd. , (757) 599-6264; 12750 Jefferson Ave., (757) 833-0339
-Norfolk: 115 W. Little Creek Road, (757) 489-5291; 810 W. 21st St. (757) 623-7213
-Suffolk: 3633 Bridge Road (757) 686-4793
-Chesapeake: 201 Hanbury Road E., (757) 482-2563
Information about vaccination hours also is available by calling
1 (800) 925-4733 or going
to     www.walgreens.com/flu.

Health officials advise people to first call their doctor to see if pandemic H1N1 vaccine is available there, and then their local health department. Here are phone numbers and information from local health districts:

Chesapeake: (757) 382-8609

A  supply of H1N1
nasal vaccine spray is available and a limited supply of injectable vaccine specifically for children ages 6 months to 35 months. Immunization clinics are held at the Great Bridge clinic on Mondays and Wednesdays from 8:30-10:30 a.m., and Tuesdays and Thursdays from 1-3:30 p.m. Vaccines are also being administered at the South Norfolk Health Center at 490 Liberty St. on Mondays and Wednesdays from 1:30-3:30 p.m. The nasal spray vaccine is for healthy people 2 through 49 who are not pregnant.

Norfolk: (757) 683-2756, (757) 683-2860, (757) 683-2756

Children, young adults and day care providers who show up at the Virginia Zoo on Wednesday, Dec. 16, can get in free if they agree to a free H1N1 flu vaccine.

Norfolk's public health officials teamed up with Virginia Zoological Park for "The Virginia Zoo and H1N1 too!" day. The vaccine will be given to those who are 6 months through 24 years of age and day care providers, who are all high-risk groups for H1N1, or swine flu.

Both the nasal spray and the injectable vaccine will be available for free from 9 a.m. to 1 p.m. at the zoo, 3500 Granby St.

The first 500 children to be vaccinated will also receive a free train ride.

Health officials are reminding parents and caregivers of children 9 and younger that if their children received their first shot, they need a second dose four weeks later to have full immunity to the virus.

Vaccines will not be administered at the event without parental consent. Consent forms will be available there, or they can be downloaded on the Norfolk public schools' H1N1 Web site, http://tinyurl.com/y95h5ah.

For more information, contact the Norfolk Department of Public Health at (757) 683-2801 or (757) 683-2796.

A weekly H1N1 clinic for priority groups – pregnant women, day-care children, home schoolers, school-age children, private school children and college students – is held from 4-7 p.m. every Thursday at the Norfolk Department of Public Health, 830 Southampton Ave.

Nasal spray vaccine, which is for healthy people 2 through 49 who aren't pregnant is available at regularly scheduled immunization clinics at 830 Southampton Ave. Mondays through Fridays, from 2. to 4 p.m. and the Little Creek Center, 207 East Little Creek Road, Mondays through Fridays, from 8:30 to 10:30 a.m. and then again from 1 to 3:30 p.m. 

Portsmouth: (757) 393-8585

The Portsmouth Health Department will have an evening H1N1 vaccination clinic for high risk people on Tuesday, Dec. 15 .
The clinic, from 4-7 p.m., will be for pregnant women, people who are caregivers for children younger than 6 months, health care and emergency workers, people between 6 months and 24 years of age, and people 25 through 64 who have chronic health disorders or compromised immune systems.
The health department is located at 1701 High St. The vaccines, which are free of charge, will be given on a first come, first served basis. 

Virginia Beach: (757) 518-2700, or visit www.HealthyVB.com  for vaccine availability.

A clinic to administer H1N1 vaccine will be held on Thursday, Dec. 10, from 5-8 p.m. Another will take place on Friday, Dec. 11, from 1 -4:30 p.m. Both will be held at the Virginia Beach Health Department at 4452 Corporation Lane.
 

Children 9 and younger need to receive their second dose of the vaccine to be protected against the virus. Second doses aren't being provided in the schools, so parents have to take their children to their doctor's office or to a public clinic to receive the vaccine. Children CAN receive their second dose at both the Thursday and Friday vaccination clinics.

Additionally, the Virginia Beach health department has received preservative-free vaccine. 

Suffolk

Western Tidewater Health District:   (757) 514-4783.

Call first to check availability.

Military:

H1N1 flu vaccine will be available to all military dependents and retirees at Portsmouth Naval Medical Center and its branch clinics starting Friday, Dec. 4. 
Previously, the vaccine had been limited to people in high-priority groups.
Active-duty service members will be vaccinated when the Department of Defense vaccine arrives in one to two weeks.
Non-active-duty beneficiaries may get their H1N1 vaccine on a walk-in basis at the following immunization clinics: Portsmouth Naval Medical Center,  8 a.m. to 2 p.m. Mondays through Fridays; Boone Branch Health Clinic,  8 to 11 a.m. Mondays through Fridays and 1 to 3 p.m. Tuesdays and Thursdays; Oceana Branch Health Clinic,  8 a.m. to 2 p.m. Mondays, Tuesdays, Thursdays and Fridays; Sewells Point Branch Health Clinic, 7:15 a.m. to 2:45 p.m. Mondays through Thursdays and 7:15
a.m. to noon  Fridays.
Non-active-duty beneficiaries who wish to be vaccinated at Tricare Prime Virginia Beach or Tricare Prime Chesapeake must make an appointment at (866) 645-4584.
Beneficiaries will receive the H1N1 nasal-spray vaccine unless the patient needs the injectable version. Injectable vaccine will be administered after  nasal-spray vaccine is gone . Nasal-spray vaccine can provide protection within two days of being vaccinated; injectable vaccine can take up to two weeks to provide protection.
Nasal-spray vaccine is for healthy people ages 2 through 49 who are not pregnant.
For additional information, call the Portsmouth Naval Medical Center flu hot  line at (757) 953-3045 or visit www.med.navy.mil/ sites/nmcp .

How is this flu different from the regular type?

Because it’s a new strain, most people do not have any immunity, so more people are expected to fall ill from the virus.

So far, the H1N1 flu has had the biggest impact in people younger than 25.

The symptoms for most people have not been any worse than the regular flu so far. Like the regular flu, though, the virus has caused some people to be hospitalized and has led to some deaths. Some studies are also showing people with swine flu are contagious longer than those with the regular flu.

Virginia reached a "widespread" status of flu the week ending Sept. 12.

That’s based on the number of confirmed cases of flu tracked by certain health-care providers across the state.
The count includes all cases of flu, not just the pandemic H1N1 flu.

Virginia had nine weeks of a widespread level of flu during the months of May, June and July, which is unusual and has been attributed to the pandemic H1N1 virus. The level of flu in Virginia dropped in July and August, and has now returned to widespread.

How many doses of H1N1 vaccine will be needed?

Reports from clinical trials of the H1N1 vaccine are showing that children 6 months up to age 10 will need two doses of the vaccine shot, three weeks apart, and that children 10 and older and adults will need one dose. The early tests were on flu injections, and it’s expected dosing for the nasal spray vaccines will be the same.

The CDC says the swine and seasonal flu injections can be given in a single visit. However, the nasal spray form of both vaccines should not be given at the same time.

Nasal spray vaccine uses a weakened live virus, which gives more protection but carries slightly more risk and so is not recommended for children under 2 or children with asthma or who wheeze. The nasal-spray flu vaccine is approved for use in healthy people ages 2 to 49 who are not pregnant. It is not recommended for people with chronic conditions.

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What are the symptoms of swine flu?

Fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also have reported diarrhea and vomiting. Early studies and observations have shown the virus can cause infections deeper in the respiratory system than the seasonal strains.

A typical case lasts three to seven days.

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How does H1N1 virus spread?

The virus is spread mainly from person to person through coughing or sneezing. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose.

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What should I do if I get sick?

You should stay home and avoid contact with other people.

The Centers for Disease Control and Prevention recommends that you stay home, except to get medical care or for other necessities, for at least 24 hours after your fever is gone without a fever-reducing medicine.

Stay away from others as much as possible to keep from making them ill. Avoid normal activities, including work, school, travel, shopping, social events and public gatherings. Most people who get the flu will recover without complications, the CDC says.

If you have severe illness or you are at high risk for complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.

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Who is at high risk for flu complications?

Pregnant women and people with underlying conditions such as asthma, diabetes, suppressed immune systems, heart disease, kidney disease, cerebral palsy and neuromuscular disorders. Children younger than 5 are at risk for complications because their airways are small.

Children with nerve and muscle problems are at high risk for complications because they cannot cough hard enough to clear their airways.

Adults older than 64 are not at increased risk of contracting the H1N1 virus. It’s believed they may have some immunity to the new virus.

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How will I know if I need to seek medical care?

Emergency warning signs in adults include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu symptoms improve but then return with fever and worse cough

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What about my child?

In the vast majority of the cases, flu is best treated with fluids and bed rest, but if parents are concerned about a child’s health, they should call their doctor for advice.

Children who are at most risk of complications are those younger than 5 and those with chronic health problems such as asthma, diabetes, heart disease, metabolic conditions or neuromuscular disorders.

Call your doctor immediately if your child shows these symptoms:

• Difficulty breathing or fast, hard breathing.
• Listlessness or no interest in playing or other activities.
• Irritable, inconsolable and cannot be calmed down.
• Trouble waking up or interacting with others.
• Won’t drink fluids or cannot keep fluids down. Poor fluid intake and prolonged diarrhea can lead to dehydration, which can be very serious in children.
• Develops bluish or grayish skin color.
• Severe or persistent vomiting.

Flu symptoms improve but return with a fever and worse cough. That can be a sign of bacterial pneumonia, which must be treated with antibiotics.

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Are there medicines to treat swine flu?

Yes, but not everyone needs them.

The CDC recommends the use of oseltamivir (Tamiflu) or zanamivir (Relenza) for the treatment and prevention of the H1N1 flu virus for people at high risk of complications or those who are already severely ill with the virus. These antiviral drugs are prescription medicines that come in pills, liquid or an inhaled powder that fight against the flu by keeping flu viruses from reproducing.

During the current pandemic, priority will be given to those who are hospitalized or who are sick and have a condition that puts them at high risk for complications, such as children younger than 5, pregnant women, people with certain chronic medical or immunosuppressive conditions, and people younger than 19 who are receiving long-term aspirin therapy.

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How long can an infected person spread this virus?

According to the CDC, people infected with seasonal and H1N1 flu may be able to infect others from one day before getting sick to five to seven days after. This can be longer in some people, especially children and people with weakened immune systems.

Early studies are showing the H1N1 virus, though mild to moderate in nature, may last longer than regular flu.

At a microbiology conference in earlier this month, presentations included a Canadian study that showed 19 to 75 percent of people with H1N1 flu still showed signs of virus in their noses eight days after the onset of symptoms. Two other studies – one from Singapore, the other from Mexico – showed similar results.

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How many people are likely to get this new virus?

The World Health Organization has warned that up to a third of the world’s population could eventually become infected with the swine flu virus.

A presidential panel placed the estimate in the United States at 30 to 50 percent of the population, possibly causing 1.8 million hospitalizations and 30,000 to 90,000 deaths.

Seasonal flu strains, by contrast, generally infect between 5 and 20 percent of a population. Each year in the United States, about 36,000 people die of flu-related complications and more than 200,000 people are hospitalized.

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What can I do to guard my health?

Wash your hands frequently with soap and water, at least 20 seconds each time. If hands are not visibly soiled, hand sanitizers containing at least 60 percent alcohol are also effective.

Use good coughing and sneezing habits, such as coughing and sneezing into the inside of the elbow and properly discarding used tissues. Teach your children these practices.

Vaccinate children and yourself for seasonal flu early and get a vaccination against H1N1 once it becomes available. The seasonal flu vaccine does not protect against swine flu.

Some people should not get a flu vaccine – such as those who are allergic to chicken eggs, those who have had a severe reaction to a prior flu vaccine, those who developed Guillain-Barre syndrome within six weeks of getting a previous flu vaccine, children younger than 6 months and people with a moderate or severe illness with a fever.

The nasal-spray flu vaccine is approved for use in healthy people ages 2 to 49 who are not pregnant. It is not recommended for people with chronic conditions.

Health officials say you can get the H1N1 vaccine and the seasonal flu vaccine injections at the same time.

Patients who receive the live nasal sprays for both flu strains should separate them by four weeks.

Plan now for your children’s care if you or they become ill. If this happens, you or your child might be asked to stay home from work or school for at least 24 hours after the fever resolves without the use of fever-reducing medicines.

People who work in a health care setting may be asked to stay home a week after symptoms start.

If symptoms worsen or cause concern, contact your doctor’s office by phone for advice before arriving there in person.

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Where can I get a flu vaccine?

Check with your doctor or local health department. Drugstores, urgent care centers and grocery stores will offer the vaccine when it's available to the general public.

You can also check the Google flu clinic locater tool at www.H1N1Get1.com . Or call the Virginia Department of Health's H1N1 call center at 1 (877)  275-8343.

The American Lung Association has a Flu Clinic Locator Web site at www.flucliniclocator.org/ that will include information about where you can receive a vaccine for the regular flu and for the H1N1 flu vaccine once that is available.

Besides the H1N1 vaccine, there's the seasonal flu vaccine. The seasonal flu vaccine is recommended for children 6 months and older, women who will be pregnant during the flu season, people 50 and older, those with chronic health conditions, people who live in long-term-care facilities, health care workers, and people who care for people at high risk of complications from the flu.

 
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Who has priority for the swine flu vaccine?

The Centers for Disease Control and Prevention has recommended that pregnant women, children 6 months and older, young adults through age 24, people with underlying health conditions such as asthma, diabetes, suppressed immune systems, heart disease, kidney disease, neurocognitive and neuromuscular disorders, health care workers and emergency medical service providers be given priority for the vaccine.

Also, parents and caregivers of people with the above-mentioned health conditions and those with children 6 months and younger.

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Will there be shortages?

Gov. Timothy M. Kaine has said he expects that everyone who wants a swine flu vaccine will be able to get one within two months of its expected release in October. Virginia expects to receive 800,000 to 1 million doses in its first shipment.

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How can I find out how many swine flu cases are in my area?

In the spring, Virginia tested flu cases for the H1N1 virus, but as the virus has increased in its circulation throughout the summer, only certain people are being tested: those who are hospitalized, those in unusual or large clusters of cases, and those who see a health care provider that is part of a surveillance network.

The results of that surveillance can be found at this Web site: www.vdh.state.va.us/epidemiology/DiseasePrevention/H1N1/H1N1Tracking.htm.

Reports listed there show the percentage of patients with flu symptoms at emergency rooms and urgent care centers by district. The report also lists the confirmed cases of flu statewide by strain.

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More questions about swine flu?

The Virginia Department of Health has a toll-free number, (877)

275-8343, that will answer questions about swine flu between 8:30 a.m. and 4:30 p.m. on weekdays. The department will adjust hours as necessary to handle the volume of calls. Virginians also can ask questions by e-mail through the VDH home page at www.vdh.virginia.gov.

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Stay informed through these Web sites:

• U.S. Department of Health and Human Services: www.flu.gov
• Centers for Disease Control and Prevention: www.cdc.gov/h1n1flu/
• Virginia Department of Health: www.vdh.virginia.gov
• Virginia Department of Education: www.doe.virginia.gov

More information about swine flu is also available at HamptonRoads.com/health.

You can also send questions about the swine flu to The Virginian Pilot at SwineFlu@pilotonline.com.

Here’s a question received last week:

Will the H1N1 vaccines contain thimerosal?

Some H1N1 vaccines will contain thimerosal, a chemical preservative some people have linked to autism. However, there is no scientific basis for that claim. Manufacturers are producing thimerosal-free doses so if you have concerns, ask your physician about a thimerosal-free vaccine.

Sources: Centers for Disease Control and Prevention, New York Times, Associated Press, Virginia Department of Health, local health departments.