The flu: Symptoms, vaccines, prevention and more

As chill enters the air across New Hampshire, the state is confronting the spectre of a potentially hazardous flu season.

While health-care providers have begun administering vaccinations for seasonal influenza virus, they are gearing up to combat a resurgence of the H1N1 flu virus, commonly known as swine flu. Declared a pandemic in June by the World Health Organization, swine flu has caused mild to moderate illness in most who have become infected, but it has also caused severe illness and deaths across the country.

As New Hampshire awaits arrival of its first shipment of federally purchased swine-flu vaccine, many state residents are asking how best to protect themselves this flu season.

Here are answers to some commonly asked questions:

Q: How are seasonal flu and swine flu different?

A: Like seasonal flu, swine flu is a virus that causes illness in people, and spreads person to person, often by coughing or sneezing. While the symptoms of swine flu are similar to those of seasonal flu -- fever, cough, runny or stuffy nose, body aches, headache, chills and fatigue -- data analysis by the U.S. Centers for Disease Control and Prevention indicates swine flu has caused greater disease burden in people younger than 25 than in older individuals.

"The difference is H1N1 has been able to transmit during the summer months, which is unusual," said Dr. Jose Montero, the state's Public Health director. "The other big difference is it causes severe illness in younger people."

Q: Who is most at risk of catching swine flu?

A: "There is no patient population with a higher risk of catching H1N1," Montero said. "What we do know is that once you catch it, there are subsets of the population that have a higher risk of developing complications."

These groups include pregnant women, those with chronic health conditions and people under 25, Montero said.

Q: When will swine-flu vaccine become available in New Hampshire?

A: The state Department of Health and Human Services expects swine-flu vaccine will ship to state health care providers starting this week, said Christine Adamski, the department's chief of disease control. New Hampshire is slated to receive an initial allocation of 7,700 nasal-spray doses, with shipments continuing throughout the fall and into winter, Adamski said.

"We fully expect that as time goes on, allocated amounts will grow and the types available will be varied," she said.

Q: Who will be eligible to be vaccinated first?

A: With early shipments of swine-flu vaccine, New Hampshire health care providers will target pregnant women; children 6 months to 4 years with medical conditions; and health-care workers and first responders with direct patient contact, according to the Department of Health and Human Services' vaccination distribution plan.

Providers will then target children 5 to 18 with medical conditions, household contacts of children less than 6 months old and young adults 19 to 24 with medical conditions.

Q: When will swine-flu vaccinations be available to the general public?

A: Once health care providers have offered vaccinations to target groups at high risk for complications, they will offer vaccinations to the general public, likely starting in late November, Adamski said.

Q: How is swine-flu vaccine administered?

A: The vaccine comes in nasal spray and injectable versions. A single dose is recommended for adults and children 10 and older, while two doses are recommended for children 9 and younger, with those doses separated by three to four weeks, Adamski said.

Personal health circumstances can govern which vaccine type is most advisable to receive. People with severe egg allergies, for example, should not receive the injected vaccine, while pregnant women, immunosuppressed patients and those with asthma should not take the nasal-spray vaccine, Montero said.

Q: Where will swine-flu vaccinations be offered?

A: Individuals at high risk for complications should seek vaccination through a primary-care physician or health care center. Hospitals will offer vaccinations to workers who provide direct patient care. Once the vaccine becomes available to the general public, state and local health officials expect to facilitate public clinics.

Q: Can I receive seasonal-flu and swine-flu vaccinations at the same time?

A: Seasonal and swine-flu vaccinations can be taken together in most cases. "By and large, you can get both at the same time, just in different anatomical parts," Adamski said. Certain flu-vaccine types should not be taken together, however, so it is best to consult a physician about vaccine interaction.

Q: How much will swine-flu vaccinations cost?

A: Because the federal government is purchasing a national vaccine supply, there is no charge for the vaccine itself. Health care providers may charge a fee for administering the vaccine, however.

"We are currently reviewing our policies on charging patients for H1N1 administration," said Dr. Rob Nordgren, associate medical director at the Dartmouth-Hitchcock Manchester outpatient group practice. "I anticipate we'll finalize those policies in the coming days."

Q: Will there be enough swine-flu vaccine to go around?

A: Although health-care providers acknowledge difficulty in gauging demand for swine-flu vaccinations and uncertainty about the timing of vaccine availability, the Department of Health and Human Services anticipates receiving enough vaccine to meet the state's demand.

"We feel confident, and all indications tell us there will be ample supply to vaccinate the general public, anyone who wants it," Adamski said.

Q: If I catch swine flu, how long will I remain contagious?

A: People can spread the H1N1 virus to others from one day before they get sick to one day after their fever resolves without fever-reducing medication, Montero said. Virus shedding can occur after this period, but the likelihood is drastically reduced, he said.

The CDC recommends that those who experience flu symptoms stay home for at least 24 hours after their fever subsides without medication.

Q: Once I've recovered from swine flu, can I catch it again?

A: Individuals who catch the H1N1 virus once can't catch it again, but they remain susceptible to other flu strains, Montero said.

Q: What preventative steps can I take to protect my health?

A: Common-sense steps include covering your nose and mouth with a tissue when you cough or sneeze, washing your hands often with soap and water or alcohol-based rub, and avoiding hand contact with your eyes, nose and mouth.

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