I’m 50, and I Caught the Flu Too

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AL: How can someone reduce their risk of getting the flu?

Nakata: The most important way to protect yourself against regular flu and the novel H1N1 flu is to get the vaccine. These are two separate shots. Viruses mutate over time and every year the strains circulating are a little different. That’s why you have to get your seasonal flu shot every year.

Novel H1N1 is a new virus. This is the new name that the Centers for Disease Control and Prevention (CDC) has given it. According to communications with CDC, the vaccine for it is coming out in mid-October.

The next most important thing is to take everyday preventive actions. Hand-washing is the single most important thing you can do to stay healthy. Wash with soap and water or, if that’s not handy, use an alcohol-based hand rub.
Specifically for flu, avoid touching your eyes, nose and mouth unless your hands are clean.

Finally, avoid contact with sick people.

AL: Speaking of hand-washing, we read that antibacterial soaps kill bacteria, but flu is caused by a virus. Do we need to replace the antibacterial stuff on our sinks with regular soap?

Nakata: It’s really not necessary. The way that soap works, it lifts dirt and particles off your hands, making them easier to wash off with running water. It works the same way that laundry soap cleans dirt out of your clothing.
Some people are concerned because they were caring for somebody who was sick: Do I have to bleach my clothing? Regular laundering is fine. You don’t have to do any special measures or special cleaning with a flu virus.

AL: We all know it’s important to wash hands when you go to the bathroom or before you prepare food. Is that enough?

Nakata: You should wash your hands any time you might touch your eyes, nose or mouth, and any time before you make yourself a drink or prepare food or put something in your mouth. I’m a nail-biter, so I have hand gel on my desk and I am constantly using it. Besides, somebody may have coughed on a paper they were working on and put it in my in tray, and there could be virus on that paper.

This virus is not airborne. When people are sick with the flu, the fluids from their nose, mouth and throat contain virus particles. If they cough and don’t cover it, or if they sneeze on somebody, those droplets can get into other people’s membranes (like your eyes or inside your nose or mouth) and infect them. Or someone could cover their cough but not wash their hands, then use a computer or open a door—that’s another way it could be transmitted.

AL: How is this new flu—novel H1N1—different from the seasonal flus that we’re used to?

Nakata: In most ways, novel H1N1 is very much like the seasonal (i.e., “regular”) flu. It can cause the same complications, require hospitalization, and it can kill people.

What’s causing a lot of concern is that it’s completely new. That means everyone in the world is susceptible. That’s the main reason we’re so concerned. When you catch a specific strain of flu virus and recover, you develop immunity from catching that same strain again. So out of 100 people, you would be among the 10 or 20 people who have had it and are protected from it.
 
The other concern is that it could mix with another flu virus and possibly change into something that causes very severe illness. Right now the types of illnesses we’re seeing overall from 2009 H1N1, including the serious cases, are not much different from seasonal flu. Which is a good thing—this is not a virus that causes a lot of deaths. But there’s always a possibility that it could change into one that causes very high rates of illness and death, and that’s why we’ve been monitoring it so closely.

AL: What’s the status of the novel H1N1 vaccine?

Nakata: The new vaccine has received full FDA licensing. We expect the first doses to become available in October, and then we’ll have shipments through December.

Getting the vaccination will be completely voluntary.

The overall plan is to try to vaccinate as many people who want to be vaccinated as quickly as possible, starting with those who are at highest risk.

There are five target groups: pregnant women, household contacts and caregivers of children younger than 6 months, health care and emergency medical services personnel, individuals from 6 months to 24 years, and anybody 25 to 64 with health conditions that put them at risk.

These conditions include diabetes; chronic pulmonary disease like asthma; cardiovascular disease (excluding hypertension); kidney or liver disorders; neurological, neuromuscular or metabolic diseases; immune-suppressing conditions even secondary to medication, like chemotherapy for cancer; and people under 19 years old who are on chronic aspirin therapy.

The intent is that once we’re able to reach these target groups and vaccine continues to be available, we’ll expand to other groups of the population.

So it’s really important for people to talk to their doctor to find out: Am I in one of the initial target groups for this new vaccine or can I wait until it’s my turn?

AL: It’s striking that young people are at higher risk for novel H1N1 flu, but senior citizens aren’t. Why is that?

Nakata: We’re trying to find out why. One of the hypotheses is there may still be some cross-reactivity with a virus strain that may have circulated a very long time ago. So people who are very old may have had exposure and be somewhat protected.

It kind of makes sense. If it has some relationship to a virus that occurred in the 1920s and 1930s, younger individuals would be completely new to this virus and not have any kind of protection. This has been a fairly consistent observation with novel H1N1, not only in the United States.

However, if you’re over 64 and you do come down with any flu, your risk for a bad outcome is high. Antivirals and flu shots are strongly recommended. You should see your doctor.

AL: Some people think,” I’m healthy and I’ve never gotten the flu, so I don’t need the vaccine.” What would you say to them?

Nakata: I’m 50 and I caught the novel H1N1 flu. I consider myself to be healthy, I exercise and try to eat healthy, and I take my seasonal flu shot every year, but I was sick as a dog. (Of course, the seasonal flu shot wouldn’t have protected me against this new flu.) It put me in bed for a week.

We still do not have good data on novel H1N1, so we really don’t know what the full impact was and will be. Novel H1N1 occurred in the spring, just about when seasonal flu starts disappearing. But flu season normally runs from October through May; the concern is now it’s going to overlap. We’ve already started to see clusters of outbreaks in schools and skilled nursing facilities.

The other thing I stress to people is to stay home if they have symptoms. People don’t realize that flu is very, very contagious. Everybody’s busy and their job is important. But it’s not about sucking it up and coming to work— not getting the rest your body needs to fight off infection could put your health at risk. And you have to think of the people around you as well. You could potentially make somebody else sick, and maybe they’re at risk for having severe illness, or they could take it home to somebody in their family who’s at risk.

A lot of people think they don’t need to get their flu shot every year and that the seasonal flu is not that serious. But they need to realize that even the seasonal flu causes over 36,000 deaths in the United States every year.