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Flu Season: What You Need to Know

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Are you ready for flu season? Yearly epidemics of seasonal influenza occur typically during the late fall through early spring. The best way to prevent the flu is by getting vaccinated each year. Vaccination is recommended for anyone over six months who wishes to reduce the likelihood of becoming ill with influenza or of transmitting the virus to others should they become infected.

The flu is unpredictable, but the 2009 H1N1 viruses as well as the regular seasonal viruses will likely cause illness in the U.S. this flu season. The 2010-11 flu vaccine will protect against three different flu viruses: an H3N2 virus, an influenza B virus and the H1N1 virus that caused so much illness last season. The 2010-11 flu vaccine is now available, and Capital Health Plan members have multiple ways to receive it. Members may receive vaccination at their primary care physician’s office.

The vaccine is also available at the Leon County or Wakulla County Health Departments. Beginning October 1, CHP members may also get the vaccine at one of the following pharmacies: CVS, K-Mart, Publix and Winn-Dixie.

When a Virus Attacks Be Careful How You FIght Back

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Antibiotics are not always the answer. Most illnesses, like colds and the flu, are caused by viruses. Unfortunately, antibiotics are not effective against viruses. With this in mind, don’t rush to your doctor the next time you get the sniffles. Chances are your illness is viral and will resolve itself on its own within 10-14 days. Remember, antibiotics are strong medications. Use them only when necessary. This helps them to be fully effective when you need them to be. For more information, go to and search "antibiotics."

Ask Dr. Nancy: H1N1 Flu

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

I’m worried about Swine Flu. What do I need to know?

Novel H1N1 flu (previously called Swine flu) is in our community now and has been percolating across the country all summer long, passing from infected people to non-infected people. It can range from a mild to a severe illness. The concern is that the number of cases will increase dramatically when the children return to school and start sharing their secretions. Other concerns are that cooler weather is the preferred environment for all influenza viruses and mutations may occur which can make the virus more dangerous and resistant to treatment. New information is coming quickly so refer to the Florida Department of Health’s web site at or the Center for Disease Control’s web site at or call 1-800-CDC-INFO.

The best defense will be to avoid the spread of flu from infected people to non-infected people through control of droplet spread. Infected people cough, sneeze and spread the virus to other people directly. Indirect spread occurs when infected secretions land or are placed by hands on surfaces which are then transferred to others when handled. Here’s an example: an infected person transfers the virus to a handrail and the uninfected person holds onto the handrail, gets the virus on their hand, touches their nose, mouth or eyes, and ends up with the flu. These modes of transmission are true for any flu and most other respiratory infections so taking precautions protects you from more than novel H1N1.

(Please see information regarding seasonal influenza vaccine in this Healthline. The recommendations for who should get this vaccine have been expanded. This is obtained from your Primary Care Physician’s office.)

People who are sneezing or coughing should cough into their arm or a tissue (then throw the tissue away). Everyone should wash their hands frequently. Alcohol-based sanitizers are also effective. The CDC recommends that anyone with flu-like symptoms stay at home as long as they are ill since they can be contagious as long as they are symptomatic. The latest recommendation is for the infected person to stay home from work and/or school as long as he/she has a fever >100 degrees. The body temperature should be less than 100 degrees for 24 hours without fever reducing medication before returning to school/work. Remember that anyone younger than age 18 should not be given any aspirin containing products because of a rare, but potentially awful, complication called Reye’s syndrome.


What about testing and treatment? The CDC does not recommend testing for the novel H1N1 unless the person is seriously ill or to establish the cause of an outbreak. If the person has the symptoms of flu, assume flu. Those symptoms are fever, sore throat, cough, headache, muscle aches, chills and fatigue. Treatment with antivirals is also not recommended for everyone, rather it is recommended for patients who are severely ill, those at high risk for complications from the flu, health care workers with significant exposure and pregnant women. Close contacts of people who are at high risk for complications should be offered prophylaxis. Overuse of antivirals will increase the likelihood of resistance meaning that people who really need treatment may end up with no treatment options as the season progresses and if the virus mutates.


What about a vaccine for novel H1N1? The government has contracted with multiple vaccine manufacturers for H1N1 vaccine and the hope is that it will be available in October. It will be distributed through the Departments of Health in each state and county to the highest risk groups. The targeted groups for the vaccine are: children/young adults ages 6 months to 24 years, pregnant women, people who work with children and in health care and people under age 65 with a condition, such as diabetes, that makes them more susceptible to catching the flu and having complications. Just how the vaccine will be distributed through the Health Department is being worked out in advance of its arrival.

Complications from the flu include other infections that take advantage of the person’s weakened immunity like pneumonia. People who are in the age ranges to have the pneumococcal vaccine should make sure they are up to date. The pneumococcal vaccine recommendations are also included in this Healthline.

There has been a tremendous effort by the U.S. public health agencies to reduce the health impact from novel H1N1 ever since it made its appearance earlier this year. We all should do our part to follow recommendations not only because it will help us protect ourselves and our families, but also because we can all participate in the efforts to reduce illness in our community.


Dr. Nancy Van Vessem, MD Chief Medical Officer

Dr. Nancy Van Vessem is board certified in internal medicine. She has developed innovative disease management and quality improvement programs promoting the use of best evidence medicine and propelling CHP to national recognition for quality of care.




Inactivated Influenza Vaccine

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

What you need to know for 2009 – 2010:

1. Why get vaccinated? Influenza (“flu”) is a contagious disease. It is caused by the influenza virus, which can be spread by coughing, sneezing or nasal secretions.

Other illnesses can have the same symptoms and are often mistaken for influenza. But only an illness caused by the influenza virus is really influenza.

Anyone can get influenza, but rates of infection are highest among children. For most people, it lasts only a few days.

It can cause: fever, sore throat , chills, fatigue, cough, headache, muscle aches

Some people, such as infants, elderly, and those with certain health conditions, can get much sicker. Flu can cause high fever and pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. On average, 226,000 people are hospitalized every year because of influenza and 36,000 die – mostly elderly. Influenza vaccine can prevent influenza.


2. Inactivated influenza vaccine There are two types of seasonal influenza vaccine:

1. Inactivated (killed) vaccine, or the“flu shot,” is given by injection into the muscle.

2. Live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement.

Influenza viruses are always changing. Because of this, influenza vaccines are updated every year, and an annual vaccination is recommended.

Each year, scientists try to match the viruses in the vaccine to those most likely to cause flu that year. When there is a close match the vaccine protects most people from serious influenza-related illness. But even when there is not a close match, the vaccine provides some protection. Influenza vaccine will not prevent “influenza-like” illnesses caused by other viruses.

It takes up to two weeks for protection to develop after the shot. Protection lasts up to a year. Some inactivated influenza vaccine contains a preservative called thimerosal. Some people have suggested that thimerosal may be related to developmental problems in children. In 2004 the Institute of Medicine reviewed many studies looking into this theory and concluded that there is no evidence of such a relationship. Thimerosal-free influenza vaccine is available.


3. Who should get inactivated influenza vaccine?

  • Anyone who wants to reduce the likelihood of becoming ill with influenza or spreading influenza to others. All children 6 months and older and all older adults: all children from 6 months through 18 years of age, anyone 50 years of age or older.
  • Anyone who is at risk of complications from influenza, or more likely to require medical care: women who will be pregnant during influenza season, anyone with long-term health problems with: heart disease, kidney disease, liver disease, lung disease, metabolic disease, such as diabetes, asthma, anemia, and other blood disorders
  • Anyone with a weakened immune system due to: HIV/AIDS or other diseases affecting the immune system, long-term treatment with drugs such as steroids, cancer treatment with x-rays or drugs
  • Anyone with certain muscle or nerve disorders (such as seizure disorders or cerebral palsy) that can lead to breathing or swallowing problems.
  • Anyone 6 months through 18 years of age on long-term aspirin treatment (they could develop Reye Syndrome if they got influenza).
  • Residents of nursing homes and other chronic-care facilities.
  • Anyone who lives with or cares for people at high risk for influenza-related complications: health care providers, household contacts and caregivers of children from birth up to 5 years of age, household contacts and caregivers of people 50 years and older, or anyone with medical conditions that put them at higher risk for severe complications from influenza.

Health care providers may also recommend a yearly influenza vaccination for:

  • People who provide essential community services.
  • People living in dormitories, correctional facilities, or under other crowded conditions, to prevent outbreaks.
  • People at high risk of influenza complications who travel to the Southern hemisphere between April and September, or to the tropics or in organized tourist groups at any time.


4. When should I get influenza vaccine? You can get the vaccine as soon as it is available, usually in the fall, and for as long as illness is occurring in your community. Influenza can occur any time from November through May, but it most often peaks in January or February. Getting vaccinated in December, or even later, will still be beneficial in most years.

Most people need one dose of influenza vaccine each year. Children younger than 9 years of age getting influenza vaccine for the first time – or who got influenza vaccine for the first time last season but got only one dose – should get two doses, at least four weeks apart, to be protected.

Influenza vaccine may be given at the same time as other vaccines, including pneumococcal vaccine.


5. Some people should talk with a doctor before getting influenza vaccine. Some people should not get inactivated influenza vaccine or should wait before getting it.

  • Tell your doctor if you have any severe (life-threatening) allergies. Allergic reactions to influenza vaccine are rare. Influenza vaccine virus is grown in eggs. People with a severe egg allergy should not get the vaccine. A severe allergy to any vaccine component is also a reason to not get the vaccine. If you have had a severe reaction after a previous dose of influenza vaccine, tell your doctor.
  • Tell your doctor if you ever had Guillain-Barré Syndrome (a severe paralytic illness, also called GBS). You may be able to get the vaccine, but your doctor should help you make the decision.
  • People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to your doctor or nurse about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.


6. What are the risks from inactivated influenza vaccine? A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small.

Serious problems from influenza vaccine are very rare. The viruses in inactivated influenza vaccine have been killed, so you cannot get influenza from the vaccine.

Mild problems: soreness, redness, or swelling where the shot was givenhoarseness; sore, red or itchy eyes; cough, fever, aches. If these problems occur, they usually begin soon after the shot and last 1-2 days.

Severe problems:

  • Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot.
  • In 1976, a type of infuenza (swine flu) vaccine was associated with Guillain-Barré Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS. However, if there is a risk of GBS from current flu vaccines, it would be no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe influenza, which can be prevented by vaccination.


7. What if there is a severe reaction?

What should I look for?

Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.

What should I do?

  • Call a doctor, or get the person to a doctor right away.
  • Tell the doctor what happened, the date and time it happened, and when the vaccination was given.
  • Ask your provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at, or by calling 1-800-822-7967. VAERS does not provide medical advice.


8. The National Vaccine Injury Compensation Program A federal program exists to help pay for the care of anyone who has a serious reaction to a vaccine. For more information about the National Vaccine Injury Compensation Program, call 1-800-338-2382, or visit their website at


9. How can I learn more?

  • Ask your provider. They can give you the vaccine package insert or suggest other sources of information.
  • Call your local or state health department.
  • Contact the Centers for Disease Control and Prevention (CDC): Call 1-800-232-4636 (1-800-CDC-INFO) or -Visit CDC’s website at



Information Provided By:




Vaccine Information Statement (Interim)

Inactivated Influenza Vaccine (8/11/09) 42 U.S.C. §300aa-26

Many Vaccine Information Statements are available in Spanish and other languages. See





Telephone Line available to Floridians for Information on Flu

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

We always want to keep our members informed on all health issues. As a service to you, here is some information released today by the State of Florida Department of Health on the flu pandemic:


As of 11:00 a.m. today, the State of Florida has opened a toll-free telephone service where residents can call to receive health information about swine flu.

The number for Florida residents to call is 1-800-342-3557.

The line will be staffed from 8 a.m. to 8 p.m. daily until further notice. After hours calls will be handled by an automated service.

As Florida responds to swine flu, the Florida Department of Health offers the following recommendations:

  • People with respiratory illness or fever should stay home from work or school to avoid spreading infections, including influenza, to others in the community. .
  • Avoid close contact with people who are coughing or otherwise appear ill.
  • Avoid touching your eyes, nose and mouth.
  • Wash hands frequently to lessen the spread of respiratory illness.
  • Symptoms of swine flu are rapid onset fever, cough fatigue and in some cases vomiting and diarrhea.
  • If you think you have the flu, please call your health care provider and discuss whether you need to be seen in their office or an emergency department, or stay home.

Swine flu is not transmitted by food and you cannot get swine flu from eating pork products.

The State of Florida is receiving frequent updates from the CDC, and working with local health departments to monitor the situation and immediately follow up on suspected cases. The Florida Department of Health has created a webpage with information at, and the CDC has a webpage at