Hot Topic: H1N1 Snapshot : BC September 14

14 September; school is back in, and infections begin to rise. BC stats for this week include:

• 865 confirmed H1N1 cases
• 48 hospitalized due to H1N1
• 5 deaths.

(facts found at BCCDC FluWatch, ILI Watch, and Authority Bulletins)

As one dives into the spreadsheets and graphs, a picture begins to make sense beyond the obvious. Although children between the ages of 10 and 19 have the highest number of positive cases, when taking into account they were also the most extensively tested this week (possibily due to parental concerns upon sickness following return to school), it makes sense that the most positives were found in this demographic. Remember, testing of mild cases is now discouraged in otherwise healthy adults.

What concerns me from this weeks picture is that those healthy adults(20-39) seem to be the hardest hit, and most hospitalized. Usually the flu preys on "weak" populations, those with other conditions, the old, the very young, or in vulnerable states such as pregnancy. H1N1 has almost been taking a spanish flu like approach instead; the majority of hospitalized patients in this bulletin were adults or young adults.

As well, new this week is the magic percent of known positive cases upon which WHO suggests schools are to close: *drum roll* The magic number is: one percent. That means if a school of 700 has seven ill students, WHO suggests closing. That said, the Public Health Agency of Canada promptly replied that unless the severity of the pandemic gets a lot worse, or massive numbers of children fall ill, it is unlikely they will activate school closures. (http://www.cbc.ca/health/story/2009/09/11/h1n1-school-close-who.html.

Still no vaccine available in Canada, not even for health care workers.

Hot Topic: H1N1 Basics

H1n1 Basics: Recognition

The following symptoms have been found in patients testing positive:

• 92% had fever
• 92% had a cough, mild to heavy
• 66% had a sore throat
• Only 25% had diarhoeae or vomiting/nausea.

(Note that in elderly patients, the fever can be absent, substiting instead with delirium or decreased level of consciousness.)

H1N1 has not been a nosocomial infection, but instead has been transmitted via the community(on your commute, in the workplace, in the schools, etc). You do not need to be around one of these hospitalized sick people, or someone who has been to Mexico, to contact the flu anymore.

H1n1: So I have the above symptoms.... What next?

DO NOT run to the emergency room for mild flu symptoms. This clogs up the system!

DO take a self inventory. Are your symptoms mild? moderate? debilitating?

If your symptoms are mild and you don't have underlying issues, the BCCDC is not even recommending you go and get tested at the moment. If your symptoms are moderate or if you are pregnant, have concerns about a newborn, or immunocompromised, testing and follow up are still recommended.

The BC Centre for Disease control is currently recommending people who have a fever and respiratory symptoms do the following:

1. Self Isolate for seven days after your symptoms first start. This will prevent spreading.
2. Practise Hand Hygiene (Wash your hands with a non antibacterial soap often)
3. Practise Cough Etiquette (Cough into your elbow, or into a handerchief).
4. If your newborn has H1n1, encourage breastfeeding; this will help.
5. If you DO go out in public, use a surgical mask to prevent spread to other people.
6. Do NOT go to work.

If your symptoms worsen, there are several medications that are effective, as well as the vaccine coming out later this year.