October 2009 Patience

The Doctor Is In

Gail Hacker MD
Gail Hacker, MD

October 2009

Patience P-l-e-a-s-e... The Good News And The Bads News

health clinic graphic icon of stethoscopeThe Good News and the Bad news: The good news is that the H1N1 vaccine is now available, although still in very limited quantities. The bad news is that we are seeing the return of H1N1 influenza as expected. Locally, the past week has been the busiest yet for reported new infections, with a 160% increase in outpatient visits reported by Peace Health this week as compared to last week (540 vs. 205). Here are some of the more commonly asked questions we are fielding recently and the answers.

What are the symptoms of novel H1N1 influenza?
Basically the same as seasonal flu: fever higher than 100, headache, muscle aches, sore throat, and cough. One difference is that there tends to be more stomach-related symptoms such as nausea and vomiting with H1N1 than with seasonal flu, which make it more likely that a person could become dehydrated.

What should I do if I get sick?
STAY HOME. Unless you fall into one of the high risk categories or develop one of the symptoms of serious illness (see below), the best place for you to be is at home. Why? This is to prevent you from infecting someone else who may be at higher risk of complications. If you feel you need medical care, please call ahead and let us know what is happening. We will be happy to answer your questions to see if you need to come in or are better off at home. Your instructors have all been informed of these recommendations.

When should I get medical attention?
The following are symptoms of severe illness that require medical attention:

  • Shortness of breath
  • High fever that does not respond to fever-reducing medication
  • Bluish discoloration to hands, feet, or mouth
  • Decreased urine output
  • Dizziness upon standing
  • Getting better initially then getting worse
  • Rash
  • Symptoms that last longer than 5-7 days

If you develop these symptoms of severe illness, you should seek medical care immediately.

If the vaccine is available now, why do some people get it but I can't?
The vaccine is still in very limited supply, and so far the nasal mist may be the only form available to most healthcare providers. There are very specific requirements and limitations for its use.

Who CAN and should receive the nasal form of the H1N1 vaccination?
Otherwise healthy young adults under age 25.  Why? This is the group that is most likely to be infected with this novel virus.

Who CANNOT receive the nasal form of the H1N1 vaccination?

  • Anyone under the age of 2
  • Anyone over the age of 49
  • People with asthma
  • Immunosuppressed individuals.
  • Anyone who is or who might be pregnant (Please read below for important information for pregnant women.)

Although we are not anticipating an overall vaccine shortage, until it is more readily available, the following groups will take precedence in receiving vaccine at LCC, according to Center for Disease Control (CDC) Guidelines:

CURRENT PRIORITIES FOR VACCINATION (updated as we receive information):

  • Health care providers and students in health care professions: This includes only those who have direct patient contact. Those under 49, with none of the above contraindications, are strongly encouraged to get the nasal vaccine that is available now. The only health care providers that should not get this vaccine are those who care for severely immunocompromised individuals, such as bone marrow transplant patients.
  • Students and staff between the ages of 15 and 25: We are not appropriately staffed to provide care to pediatric patients.
  • Folks between the ages of 25-65 with other significant medical illnesses: such as diabetes, heart disease (not just high blood pressure), lung disease, liver or kidney disease, or history of stroke or paralysis may also receive vaccine, although may not be able to get the nasal vaccine.
  • Pregnant women: Please call your physician or midwife to receive an injectable vaccine. You will need to get the shot, not the nasal preparation.  Pregnant women are at very high risk, as are their infants. Providers of health care to this population have been the only providers in our area who have received injectable vaccine thus far.

PLEASE BE PATIENT if you do not fall into one of the above categories. It is very likely that the vaccine supply will increase substantially in the next few weeks. Until we get the highest risk patients protected, we simply cannot offer the vaccine to others. This is a public health directive. We have absolutely no control over when and what type of vaccine we receive. We have voluntarily signed up to administer this vaccine and will continue to follow CDC guidelines in distributing it.

And, to you, our students, although we, as health care providers, cannot control what your instructors require for attendance and allow for making up of missed classes, we are hopeful your teachers will be flexible on this for fall and winter terms.  You DO need to contact your instructor to let them know you are sick with symptoms of influenza. If you document this contact, the registrar has agreed to make allowances in financial aid evaluations for next term if your illness affects your grade. Please be aware that this applies to symptoms of influenza only.

woman in sunshineYour health care providers and clinic staff want all campus individuals to be well and happy. We are doing all we can to give you the care and information you deserve. Please help us to be able to do that by heeding your providers' recommendations and that of the Center for Disease Control.

Supporting you in good health,
Gail Hacker, MD

To help determine if you need medical care:

General information regarding H1N1: