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Friday, December 4, 2009

H1N1 Influenza and Gastroenterology

It is not Colonoscopy Chronicles’ intention to provide specific medical advice to users of its blog, instead we provide users with information to help them better understand their health, diagnosed conditions, and the current approaches related to treatment, prevention, screening, and supportive care. Colonoscopy Chronicles urges users to consult with a qualified health care professional for diagnosis and answers to their personal medical questions.

Many of our patients are concerned about the current H1N1 influenza epidemic. As you probably know, both typical influenza and the H1N1 type influenza represent significant health risks. In fact, the Centers for Disease Control has reported their most recent statistics, and as of November 17,2009 there have been 26,315 hospitalizations for influenza and 1,049 deaths from the disease. These statistics include only confirmed cases, proven by laboratory tests. The true statistics are likely quite a bit higher. Naturally, patients want to know what they can do to prevent this illness and whether they should receive the conventional influenza vaccine, the H1N1 vaccine, or both. There is a tremendous amount of information available regarding the current influenza situation on the website of the Centers for Disease control(, a government run health agency that has some of the most up to date information and statistics about the disease.

Since the availability of the H1N1 vaccine has been somewhat limited, the CDC has detailed certain groups of people who they feel are a higher priority for the vaccine. Some of these recommendations include :
• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated;
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants younger than 6 months old might help protect infants by "cocooning" them from the virus;
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity;
• All people from 6 months through 24 years of age
• Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
• Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population; and,
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

The CDC has stated that when there is an adequate supply of the vaccine, that all people age 25-64 should receive the vaccine.

As far as the "regular" seasonal influenza vaccine, the CDC's recommendations are as follows:
• Children aged 6 months up to their 19th birthday
• Pregnant women
• People 50 years of age and older
• People of any age with certain chronic medical conditions
• People who live in nursing homes and other long-term care facilities
• People who live with or care for those at high risk for complications from flu, including:
• Health care workers
• Household contacts of persons at high risk for complications from the flu
• Household contacts and caregivers of children <5 years of age with particular emphasis on vaccinating contacts of children <6 months of age (these children are at higher risk of flu-related complications

There are some people who should not get a flu vaccine without first consulting a physician. These include:
• People who have a severe allergy to chicken eggs.
• People who have had a severe reaction to an influenza vaccination.
• People who developed Guillain-BarrĂ© syndrome (GBS) within 6 weeks of getting an influenza vaccine.
• Children less than 6 months of age (influenza vaccine is not approved for this age group), and
• People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Gastroenterologists recognize that some of our patients may have medical problems that put them at increased risk for influenza-related complications. The best source of advice for whether you should get a seasonal influenza vaccine or an H1N1 vaccine is your primary care physician. However If you have any questions about whether your gastrointestinal or liver related condition puts you at increased risk for flu related complications, please speak to your Gastroenterologist.