With the winter season on the doorstep, and with it the start of the traditional flu season, questions and concerns about the H1N1 (“Swine Flu”) vaccine are rising. Dr. Christine Jenkins, a member of the Thoracic Society Task Group for H1N1 in Australia, says people in the U.S.—especially COPD patients—should take proper precautions to minimize exposure and illness.

Australia just finished its winter season, which included a pandemic of H1N1. The country saw 36,733 confirmed cases of the illness (as of October 2nd). Overall, 4,844 people were hospitalized. Thirteen percent of those hospitalizations were admitted to Intensive Care Units, according to the Australian Influenza Surveillance Summary Report. The overall hospitalization rate is 22.7 people per 100,000.

The report also says that 183 deaths were associated with H1N1, with three of those being pregnant women and 22 classified as “Indigenous Australians.” The median age of individuals who died is 53, and most of the deaths had underlying conditions associated with them—including cancer, diabetes mellitus and morbid obesity.

Jenkins is a thoracic physician at Concord Hospital in Sydney, a member of Australia’s Federal Government Advisory Group for H1N1 and a professor of medicine at the University of Sydney. She says simple tasks such as hand washing and covering up each cough and sneeze helped to moderate the illness in Australia.

“We were able to actually emphasize to everyone in the community through very well organized public health communication messages,” she says. “People stayed away from places [where they could be exposed] and were very careful not to mix with others if they had cold or flu-like symptoms or fever . . . I do believe it made a big difference in terms of transmitting infection.”

Dr. Antonio Anzueto, a pulmonologist and a professor of medicine at the University of Texas Health Science, agrees.

“My advice [for COPD patients] would be to wash your hands, obsessive-compulsively, 10 times a day,” he says. “With children—it’s hard to stay away from children and grandchildren— but avoid children that are sick, and even when they are not sick, because they might be in an incubation period. Avoid crowds . . . if you feel sick or have a cough, call a doctor and go to the hospital as soon as possible.”

Anzueto says he already has two groups of patients with H1N1. The illness was diagnosed four weeks ago.

One group consists of younger patients, who have two to three days of flu-like symptoms, and the other is made up of people with medication conditions, like chronic lung disease, lung transplants and asthma.

Jenkins says that children, adolescents and young adults, pregnant women and obese individuals were the most affected by the disease.

“The reason older people weren’t [as affected] was because this virus was very similar to the one circulating in the years prior to 1957,” Jenkins says. “If you were a child before that [time], it was very likely you were exposed and had the illness [already] and developed antibodies. This is really important for COPD patients because many of them are already over that age. It’s good news in many respects for them . . . and so hopefully that will be the case in the U.S. and Europe. We did see older people with the infection, but it was very uncommon.”

She adds that although COPD patients are no more at risk of contracting the disease than other individuals, they become much sicker if they do get it.

“Their respiratory system is in very poor [condition] and it’s already very compromised,” she says. “When they get a simple infection, it takes a toll on them because the airway function deteriorates. If you can prevent yourself from getting the infection, you’re going to be in a much better position. So I guess I would say that COPD patients should probably have the vaccination.”

There are two types of vaccinations: a shot or a nasal spray.

“My advice is to tell COPD patients to get the shot . . . all the data supports that it’s a better immunization. The spray should be used for children,” Anzueto says. “The truth is, once you have the disease, there’s not much you can

do. The important message here is to get your vaccination—it’s very important.” He says that H1N1 will most likely widespread in the U.S., so COPD patients should get their vaccinations as soon as possible.

“It’s a very serious epidemic,” he says. Jenkins says there was a lot of community apprehension before the illness hit but it turned out to be relatively mild.

“I think we all breathed a big sigh of relief,” Jenkins says. “In general, it was a manageable problem. The biggest stress was the pressure on the ICU, because they become full of younger people, yet they still have the same load of other serious problems. Accommodating that was a challenge for us within the health system.”



Share This: Email To A Friend | Print