The 2009-10 flu season is likely to be more difficult than the past few years. In addition to the regular strain of influenza A (the flu) there is also the H1N1 virus and a new Center for Disease Control (CDC) bacterial vaccine recommendation that impacts people with mental illness.
Why is this flu season important for people with mental illness?
People with mental illness have extra reason to be mindful of the flu season as many are cigarette smokers and individuals with medical vulnerabilities. These issues increase the risks of getting and having trouble with lung-based infectious diseases like the flu. Prevention is particularly important, from regular hand washing to vaccination.
H1N1 is riskier for kids and teens than the usual seasonal flu, so children with mental illness and their families should be proactive. Infectious diseases like the flu have a way of surprising policy makers so it is important to stay tuned to the latest recommendations. The current H1N1 public health priority populations are likely to be children and teens, pregnant women and health care providers, but these are subject to change depending on the spread of the H1N1 flu as well as the availability of the H1N1 vaccine. The seasonal flu vaccine and Pneumovax (see below) vaccine are readily available in most locations so this is a good area to investigate for yourself or your loved ones even as the H1N1 vaccine is being manufactured.
What about hand-washing? Is that still a good idea?
Yes. Viruses thrive in cold weather, so the fall and winter are usually the most active flu seasons. Practicing good hygiene is especially useful this time of year. Simple preventive measures to help avoid the flu are washing hands frequently and not touching one’s mouth, eyes or nose.
I got the flu but I am now getting better. How long do I need to stay away from others?
Adults can be infectious for a week or so. People should check with their health care professional if they are sick to see how long they should stay home. Having no fever for 24 hours is essential. Given that little is known about how the current flu season will progress and assuming the possibility of a longer infectious period, being cautious and talking with one’s health care provider is a good idea.
How risky is the flu for people with mental illness?
Both the seasonal and H1N1 flu are caused by similar viruses, are infectious and will likely make an individual much sicker than a cold. Usually, people with the flu will experience fever, loss of appetite and muscle aches; some people will report headache and gastrointestinal symptoms. Most people who get the flu will do fine, but some people die from it every year. Knowing one’s own health history and vulnerabilities will help determine and manage any risks.
Is my psychiatric medication a reason not to get the vaccine or vaccines?
Psychiatric medications can be safely taken along with the preventive flu vaccines. Egg allergy and a history of Guillain-Barre syndrome (a rare type of muscle paralysis) are the two major reasons not to use the vaccine. People with mental illness should discuss their individual risks and the potential benefits of the vaccines with their health care provider.
The CDC has made changes to its recommendations regarding the flu vaccine. What do the changes mean for people with mental illness?
People with mental illness need to know that many people who get the flu die of bacterial super-infection, an illness that presents in addition to, and often in concert with, the flu. There has been a change in the CDC recommendation for the bacterial vaccine. The CDC has changed it recommendations on a vaccine called Pneumovax to prevent a bacterial pneumonia. Pneumovax is now recommended for smokers and for individuals with asthma. These are new guidelines reflecting an increased awareness that people who have lung vulnerabilities are at higher risk for trouble, or even death, if they are not given the vaccine.
For a more complete discussion of the flu and the anxiety around viruses and vaccines, including the benefits and risks, visit:
The New York Times article, “Nothing to Fear but the Flu Itself,” by Paul A. Offit, M.D., Infectious Disease Children's Hospital Philadelphia
By Ken Duckworth, M.D.
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