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Swine Flu and Chronic Conditions

Experts explain the risks of swine flu for people with chronic health conditions.

Should people with chronic conditions get a swine flu vaccine, when it's available?

In the U.S., H1N1 swine flu vaccine started to become available in October 2009, although vaccine production was much slower than predicted. Until there's enough vaccine for everyone, experts are recommending that the vaccine should first be given to:

  • Pregnant women
  • Health care workers and emergency medical responders
  • People caring for infants under 6 months of age
  • Children and young adults from 6 months to 24 years
  • People aged 25 to 64 years with underlying medical conditions, such as asthma or diabetes

As with the seasonal flu vaccine, there may be people who shouldn't get the swine flu vaccine, including those with severe egg allergies or allergies to previous flu vaccines, the very young, and those with extremely compromised health.

The swine flu vaccine won't protect against seasonal flu, so it's important to remember that you'll need two flu vaccinations this season, not one.

How can those with a chronic illness protect themselves until a swine flu vaccine is available?

Swine flu spreads like the seasonal flu: primarily through droplets from coughs and sneezes. That's why tips for avoiding the swine flu are the same as those for avoiding the seasonal flu, and include:

  • Wash your hands frequently.
  • Avoid people sick with the flu.
  • When a vaccine becomes available, get vaccinated.

 And if you're not feeling well, stay home until at least 24 hours after your symptoms go away.

What about people with chronic conditions that may be institutionalized or attending school?

The same precautions should be taken for those in institutionalized settings like nursing homes and schools.

It's also important to separate sick people from healthy people, and avoid shared resources like towels and cups. With regard to "practicing good infection control -- one cannot talk often enough about washing your hands," says Glatt. "If you're caring for someone in an institutional setting and you leave the room, wash your hands -- that's what you should always be doing anyway, but people just sometimes need to be reminded."

What type of treatment should high-risk groups with swine flu follow? Can they take antivirals?

Antiviral drugs are prescription medicines that can make the flu milder in those that are sick, and they may also prevent serious flu complications.

Right now the antivirals recommended as effective against novel H1N1 flu are oseltamivir (Tamiflu) and zanamivir (Relenza). These are "useful for people who have symptoms of the swine flu or any flu", says Stubbs.

Tamiflu and Relenza are most effective if given within 48 hours of the first symptoms. But the drugs still benefit patients if given more than 48 hours after symptom onset.

Glatt adds that no over-the-counter flu medications are proven to work against swine flu virus or any other flu virus. However, medications to help with the flu symptoms are available. To stay well "you really need to do all the things your mother told you to do: Eat well, sleep well, exercise, stay as healthy as possible."

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