By Julie Stachowiak, PhD
Multiple Sclerosis Guide; Guest blogger

During the H1N1 peak epidemic months of October and November, it seemed like lots of people had lots to complain about in terms of the response to the epidemic. However, listening closely (as I did until I got tired of it), the kvetching kind of came down to a couple of things that weren't really even problems - just poor communication or inconveniences.

For instance, being a mother of young children myself, I know many other mothers of young children. We all wish the vaccine would have been available to our kids sooner. Many of us needed the shot, rather than the mist, which was even later in coming. And, of course, when the vaccines did show up, it often involved hurrying somewhere just to be told that there would be a wait.

Then I heard from my relatives who are older than 65. They wanted the vaccine, too, but were told that they were not in the first priority group (or even the moderate priority group). They were told that they could get the vaccine, but only after everyone who was at higher risk had their chance to get it. They didn't like that. One bit.

However, when we analyze the situation, it turns out we did okay. Government public health officials acted aggressively, but not rashly. They followed logic and data instead of emotion and didn't do things like close down whole school systems. They used a safe vaccine, rather than try something new or add adjuvants, even though the vaccine supply was delayed.

Of course, things could have been better and that is what is the best part of this whole experience: it provided a chance to learn about things in case something worse (deadlier, quicker, more infectious) comes. We also got to observe public behavior around vaccines, which surprised many experts as people screamed for vaccines, complained about delays, then refused to get them.

Of course, none of this is to say H1N1 is a thing of the past. Many experts predict a "3^rd wave," based on how other influenza pandemics have behaved. If that is to happen, it is predicted to come in late winter. The suffering and deaths caused by H1N1 are also not insignificant. However, it could have been worse for many, many people and I, for one, am grateful that this "practice epidemic" was taken so seriously.

For further information, read US Reaction to Swine Flu: Apt and Lucky.

By Julie Stachowiak, PhD
Multiple Sclerosis Guide; Guest blogger

Remember in April and May when it seemed like every other school was closing down temporarily to try to stop H1N1 swine flu? I wondered at the time if that was doing any good to slow down the number of students that became infected. Well, a recent study seems to have answered my question...

Researchers at the University of Pittsburg used a computer simulation model to see what the effect of closing schools during an influenza outbreak would be.

The results were surprising:

• Closing entire school systems did not help slow an epidemic any more than closing individual schools
• Schools needed to be closed for at least 8 weeks (the length of the worst part of an epidemic) to have an effect on the numbers of students infected. Even when closed 8 weeks, the peak in epidemic numbers were delayed by only one week.
• When schools were closed for 2 weeks or less, the data showed that this could actually make things worse, as susceptible students could be brought back together at the peak of the epidemic.

Researchers concluded that while school closures alone could not stop (or even put a serious dent in) an influenza epidemic, taking such measures could buy time to do something that is effective - vaccinate susceptible students.

Source:

Lee BY, Brown ST, Cooley P et al. Simulating School Closure Strategies to Mitigate an Influenza Epidemic. J Public Health Manag Pract. 2009 Dec 23.

By Julie Stachowiak, PhD
Multiple Sclerosis Guide; Guest blogger

Do you know someone for whom English is a second language (or doesn't speak English at all)? Then direct their attention to this page from the CDC that presents information about the flu (seasonal and H1N1 swine flu) in Arabic, Chinese, Spanish, French, German, Italian, Korean, Russian, Tagalog and Vietnamese.

There are information sheets that cover topics for specific populations, such as pregnant women and people with certain conditions, such as asthma and diabetes. There are sheets about symptoms and warning signs, as well as information about how to stay healthy at work and about vaccines.

Think about how confused many of us have been at times during this epidemic, even though the news (and the gossip) that we were listening to was in our own language. Now, imagine if you were trying to figure out what was going on in a language that wasn't your native tongue.

Do someone a favor and send them a link to this page so that they can get the plain facts in their own language and make decisions for themselves.

By Julie Stachowiak, PhD
Multiple Sclerosis Guide; Guest blogger

If you have diabetes, you have probably been advised by your physician to get vaccinated for both H1N1 (Swine flu) and the seasonal flu. Ask about it if you haven't already.

If you end up getting the flu (or experiencing flu-like symptoms), you should contact your doctor for next steps. During the course of your illness, you should follow a couple of simple guidelines:

• Keep taking your medicine, even if you can't eat. Ask your doctor about how to adjust medication levels accordingly.
• Test your glucose levels every four hours. Write down the results. Any levels lower than 60 mg/dL or sustained at over 300 mg/dL means you need to call your doctor or get to the emergency room.
• Try to keep eating normally. If you can't, at least try to get some of your normal carbohydrate levels through soft foods and liquids. If you cannot eat or can't keep food down for more than 6 hours, call your doc.
• Weigh yourself daily to make sure you are not losing weight, which might indicate that your blood glucose is high. If you lose more than five pounds, call your doctor immediately.

The following things should also prompt a call or visit to your doctor immediately: diarrhea, temperature over 101 degrees, trouble breathing, feelings of lethargy or confusion or moderate to large levels of ketones in your urine.

People with diabetes are especially vulnerable to effects of the flu, as well as to complications from pneumonia, which often accompanies the flu. Take care of yourself.