H1N1

Despite the relative newness of the H1N1 flu vaccine, experts from the Centers for Disease Prevention and Control say pregnant women can and should be at the front of the line to receive their shots.

The reason?  Pregnant women's immune systems and lung capacity are diminished by bearing another life within them, making them more susceptible to be hospitalized, miscarry or die due to contracting the flu.

So whether it is the H1N1 vaccine or Tamiflu (also used to treat garden variety influenza), the Los Angeles Times' Shari Roan reports that CDC scientists and doctors' associations recommend treatment of flu-like symptoms in pregnant women should begin even before it is confirmed they have the flu.

Understandably, pregnant women are reluctant to put drugs into their bodies that they fear could affect their babies, and subsequently they vaccinate themselves less than the general population.   But the known risks -- of death, pneumonia, hospitalization and miscarriage -- outweigh the unknown, doctors say.

Until this year, Tamiflu was not recommended for pregnant women because of the uncertainty about damaging the fetus.  That lack of data remains today, though recent Canadian studies did not find that Tamiflu caused a higher rate of birth defects than what is considered normal.

The CDC posts regular updates about how the H1N1 flu is rapidly spreading through the county, and who it is affecting most: 95 children have died so far.

How much of a problem is swine flu shaping up to be? Don't blame me if my head is spinning. Seems like I've been advised to be very worried -- like when the White House council of science advisers warned it could kill  30,000 to 90,000 Americans -- and then, maybe not so much. Symptoms are mild. Runs its course in three to five days. Wash your hands and you won't get it anyway. Like that.

This week the flu is filling emergency rooms in Spokane in Washington state, while around the West, parents and others seeking the vaccine line up, often futilely, waiting for a vaccine that is in extremely short supply.

The vaccine simply isn’t being produced in sufficient quantities due to production problems, reports the Associated Press. Only 13 million doses have been delivered, compared to the 12o million doses originally promised. Okay, I'm a little worried.

"As nervous Americans clamor for the vaccine, production is running several weeks behind schedule, and health officials blame the pressure on pharmaceutical companies to crank it out along with the ordinary flu vaccine, and a slow and antiquated process that relies on millions of chicken eggs.

In Spokane, where officials expected to have about 58,000 doses of swine flu vaccine by now, just 12,700 doses have been delivered.

Swine flu, also know as the H1N1 virus, is picking up speed as it spreads through California.

The Los Angeles Times' Rong-Gong Lin II reports that the proportion of patients coming into doctor's offices with flu-like symptoms has more than doubled to 5 percent.

The state's testing reveals that more than 95% of the flu samples received indicate swine flu, which has killed 219 Californians since spring.

The Centers for Disease Control and Prevention has found that the majority of people who have the virus experience only mild symptoms.  Here's their recommendation of what to do if you think you have it.

-Kristen Young

 A report that the Washington State Hospital Association is pushing for mandatory flu vaccination of health care workers takes on new urgency in the face of a study that warns 15 states -- including Washington, California, Oregon and Arizona --  could run out of hospital beds around the time the swine flu outbreak peaks.

The number of people hospitalized at the peak of the swine flu outbreak could hit 168,000 California and 30,500 in Washington, according to the report from the nonprofit Trust for America's Health. The public health advocacy group used government flu computer models to estimate how quickly hospitals might fill up during a mild pandemic like swine flu is predicted to be, the Associated Press reports.

Even though only a fraction would be sick enough to be hospitalized, health officials are bracing: When H1N1 first appeared in the spring, more than 44,000 people visited emergency rooms in hard-hit New York City, the report noted. Just sorting out which patients are sick enough to be admitted from the vast majority who need to go home is a big job. And hospital capacity varies widely.

By the outbreak's peak, the new report suggests Delaware and Connecticut hospitals would fill up soonest. Also on that list: Arizona, California, Hawaii, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia and Washington. 

The Washington State Hospital Association wants to make flu shots a job requirement for health care workers, and is pushing the state to make that happen.

School starts early at Washington State University in Pullman, WA, and so did the swine flu season. About 2,000 people in the small university town have become ill with the flu, almost as soon as the university opened for the fall term last week, the Seattle Times reported Friday.

"Officials halted testing after additional probable cases flooded in, but Martin said that based on the initial test results, 98 percent of the people who reported flu-like symptoms probably are infected with H1N1. Health officials ruled out seasonal flu because it typically doesn't strike until winter. Also, most of those sickened have been young people, not the elderly and very young children who account for most seasonal flu cases.

The good news is that most became only mildly ill. Two people were hospitalized and have been released. The bad news: expect more of the same as more colleges and schools open for fall term.

-- Rita Hibbard

Fear of swine flu is so great that Denver parents are eager to have their kids be guinea pigs for the swine flu vaccine.  I hope it goes well. Just thinking about the last great swine flu scare, when a hurried campaign resulted in first fear of  mass death by flu, then fear of mass death by vaccine.

As Salon reported earlier:

"On Oct. 1, 1976, the (swine flu immunization program began. By Oct. 11, approximately 40 million people had received swine flu immunizations, mostly through the new compressed air vaccination guns. That evening, in Pittsburgh, came the first blow to the immunization program: Three senior citizens died soon after receiving their swine flu shots. The media outcry, linking the deaths to the immunizations without any proof, was so loud it drew an on-air rebuke from CBS news anchor Walter Cronkite, who warned his colleagues of the dangers of post hoc ergo propter hoc ("after this, therefore, because of this") thinking. But it was too late. The government had long feared mass panic about swine flu -- now they feared mass panic about the swine flu vaccinations.

The deaths in Pittsburgh, though proved not to be related to the vaccine, were a strong setback to the program. The death blow came a few weeks later when reports appeared of Guillain-Barré syndrome, a paralyzing neuromuscular disorder, among some people who had received swine flu immunizations. The public refused to trust a government-operated health program that killed old people and crippled young people; as a result, less than 33 percent of the population had been immunized by the end of 1976. The National Influenza Immunization Program was effectively halted on Dec.

School officials are on the edge of their desk chairs over flu season.  Swine flu, also known as H1N1, is coming, along with the usual-suspect viruses, so schools are preparing with everything from teaching “defensive hygiene” to requiring new vaccinations to asking that everyone feeling ill stay at home.

College students are being encouraged to self-isolate if they have flu symptoms, reports Anne Ryman in the Arizona Republic. The U.S. Department of Health and Human Services issued the guidelines today as students begin moving into residence halls across the country. The agency would like to keep schools open, and recommends students obtain the fluvaccine when it becomes available in mid-October. (Students, be warned, it may take up to three innoculations, as previously discussed on InvestigateWest.)

Nearly 700 elementary school students in Anchorage were sent home from school Wednesday because they hadn't received their first round of chickenpox vaccines or didn't have paperwork to prove they had, reports Megan Holland in the Anchorage Daily News. This is Alaska's first year implementing the requirement, and many parents either didn't know about the new vaccine or ran out of time before school started. Elementary school students must be vaccinated for tetanus, measles, mumps, rubella, diphtheria, pertussis, polio, Hepatitis A and Hepatitis B.

Brace for workers' absences, don't ask employees' for doctors notes, tell workers to telecommute, Commerce Secretary Gary Locke tells employers. Send people home at the first sign of illness, the LA Times reports. That Puritan work ethic? That vision of the boss working through her cold to  'set an example' for the rest of the office wimps? fuhgeddaboudit.  You workers: Wash your hands a lot. Expect to get up to three flu shots to get adequate protection. Ouch.