Early in 2009, there was an outbreak of a new influenza virus, H1N1 ("swine flu") in Mexico that subsequently has spread worldwide. The virus is thought to spread mainly person-to-person through coughing or sneezing of infected people. Symptoms, which could last up to a week, were similar to those of seasonal flu, and include fever, chills, headache, upper respiratory tract symptoms (cough, sore throat, rhinorrhea/runny nose, shortness of breath), myalgias (muscle aches), arthralgias (joint aches), fatigue, vomiting, or diarrhea. Although generally mild, the H1N1 virus has caused fatalities, and will need separate immunization from the "routine" flu shots that are given every autumn.
General recommendations
The Centers for Disease Control and Prevention (CDC) makes general recommendations that you should
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
Infectious period
As of May 2009, the CDC stated that the duration of shedding of the H1N1 virus is unknown. Therefore, until data are available, the estimated duration of viral shedding is based upon seasonal influenza virus infection. Infected persons are assumed to be shedding virus from one day prior to illness onset until resolution of symptoms. In general, persons with H1N1 virus infection should be considered potentially infectious from one day before to 7 days following illness onset. Children, especially younger children, might be infectious for up to 10 days.
Who should get vaccinated?
CDC's Advisory Committee on Immunization Practices (ACIP) has recommended that certain groups of the population receive the 2009 H1N1 vaccine when it first becomes available. These target groups include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems, presumably including diabetes. As of early September, it appears that the first vaccine availability will be in mid-October.
What about people with diabetes?
For people with diabetes, the CDC has a list of questions and answers, reproduced below.
How does diabetes affect how I respond to a cold or flu?
Being sick by itself can raise your blood glucose. Moreover, illness can prevent you from eating properly, which further affects blood glucose. In addition, diabetes can make the immune system more vulnerable to severe cases of the flu. People with diabetes who come down with the flu may become very sick and may even have to go to a hospital. You can help keep yourself from getting the flu by getting a flu shot every year. Everyone with diabetes--even pregnant women--should get a yearly flu shot. The best time to get one is between October and mid-November, before the flu season begins.
What should I do when I am sick?
If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
- Be sure to continue taking your diabetes pills or insulin. Don't stop taking them even if you can't eat. Your health care provider may even advise you to take more insulin during sickness.
- Test your blood glucose every four hours, and keep track of the results.
- Drink extra (calorie-free) liquids, and try to eat as you normally would. If you can't, try to have soft foods and liquids containing the equivalent amount of carbohydrates that you usually consume.
- Weigh yourself every day. Losing weight without trying is a sign of high blood glucose.
- Check your temperature every morning and evening. A fever may be a sign of infection.
Call your health care provider or go to an emergency room if any of the following happen to you:
- You feel too sick to eat normally and are unable to keep down food for more than 6 hours.
- You're having severe diarrhea.
- You lose 5 pounds or more.
- Your temperature is over 101 degrees F.
- Your blood glucose is lower than 60 mg/dL or remains over 300 mg/dL.
- You have moderate or large amounts of ketones in your urine.
- You're having trouble breathing.
- You feel sleepy or can't think clearly.
Also see
H1N1 Flu (Swine Flu) Information [for people with diabetes]
http://www.cdc.gov/diabetes/news/docs/swine_flu.htm
from the CDC
2009 H1N1 Flu (Swine Flu)
http://www.cdc.gov/h1n1flu/
from the CDC
Flu.gov
http://flu.gov/
From the U.S. Department of Health & Human Services.
Flu shots
http://www.diabetesmonitor.com/flu-shot.htm
at the Diabetes Monitor
