When pigs fly: Swine flu / influenza A / H1N1 and other types of flu

January 9, 2013

Mark L. Friedman, MD, FACEP, FACP

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Before beginning this article, if you are looking for more information about Influenza, visit our flu information page.

So you didn't get your flu shot this year. What's the big deal?

Well now that we are at the height of the flu season, ERs in some regions are overwhelmed with flu patients and the news media is in a frenzy.

Luckily the Influenza A H1N1 subtype known as "swine flu" is a distinct minority of cases this year (most reported case are A H3 and B).

This is important because the swine flu (H1N1 subtype) is closely related to the Spanish flu of 1918 that is thought to have caused 20 to 50 million deaths worldwide. The 2009 swine flu pandemic resulted in some 12,470 deaths in the U.S. alone.

Influenza is a rapidly changing, highly transmissible viral infection that spreads via aerosols "“ tiny droplets that spread through the air when people cough or sneeze. In this age of air travel, the flu can and does literally fly around the world in almost no time. Airplanes, airports, and anywhere that large numbers of people come in close contact rapidly facilitate its spread. The most common symptoms for diagnostic purposes are fever and cough. If influenza is epidemic and you have a high fever (greater than 102) and cough, the clinical presumption is that you have the flu.

The good news is that there are now antiviral agents effective against the flu (though not the common cold). Early treatment (preferably within two days and not more than five) is important. Definite indications for prompt treatment, according to the CDC's Advisory Committee on Immunization Practices, include illness requiring hospitalization and progressive, severe, or complicated illness regardless of previous health or vaccination status, and any of the following risk factors:

  • Age ≥65 years
  • Pregnant women and women up to two weeks postpartum
  • Individuals with certain medical conditions, such as asthma, pulmonary disease, heart disease, etc.

Adults younger than 65 with mild illness and no risk factors do not require testing or treatment. Within the first 48 hours of illness, antiviral treatment can be considered in order to reduce the duration of illness. The decision of whether to initiate antiviral therapy for each patient should be based on the doctor's judgment.

So if you think you're coming down with the flu, visit or call your doctor or give us a call at First Stop Health.

Originally published Jan 9, 2013 11:43:31 AM.