Mexican flu

Question

Dear,
I’m a 25-year old patient with CF and I’m worried about the Mexican flu. Can I protect myself from it ? Should I take antiviral drugs before I leave on holidays, are there countries that I shouldn’t go to ? What should I do if I start feeling ill? Thanks for your answer.

Answer

Dear questioner,
Presently the Mexican flu epidemic is a hot topic, so your question is really very timely and many patients will share your concern. You ask whether you can protect yourself against infection by the Mexican flu virus. The Mexican influenza virus is a new human virus with a mixed genetic origin. Part of the make up of the virus is from pig flu virus, part is bird flu virus and a part comes from the human flu virus. This virus was first discovered in Mexico on March 18th, 2009. The symptoms are comparable to the symptoms of a usual infection by influenza virus which means: sudden fever, muscle aches, fatique, feeling sick plus symptoms of infection of the airways that may be accompanied by diarrhea. To protect you somewhat against Mexican flu good hand hygiene is very important (read more in the question on hand hygiene). It is wrong to take antiviral drugs before you leave on holidays or before you become ill. That way you could become resistant to the effect of the medication when you eventually get the flu.
We advise you to avoid any contact with a sick person, to cover your mouth and nose with a tissue if you cough or sneeze, to throw away your tissue after use and to wash your hands regularly. This will help protect you from infectious organisms. Wash your hands with water and soap, especially after you have coughed or sneezed. The use of products based on alcohol to wash your hands can also be efficient. Avoid to touch your eyes, nose or mouth. Diseases often spread when people touch something that is contaminated and thereafter touch their eyes, nose or mouth.
Only after becoming ill by Mexican flu, antiviral drugs can be prescribed to patients who belong to a risk category. Patients with chronic respiratory diseases such as cystic fibrosis fall in this category. If needed, these antiviral drugs will be provided by the government (via your pharmacy, GP or hospital). You don’t need to buy these medicines yourself, at least not in Belgium. Healthy people do not need to be treated with these drugs routinely.

To your question whether you should avoid visiting certain countries we refer you to the ECORN website central archive and ask you to consult the question related to travel and CF. An overview of countries where A/H1N1 has been isolated is availabe on the WHO website www.who.int and for Belgium specifically you can also consult the FOD website (www.diplomatie.be and www.health.fgov.be). Currently there is no limit of travel to any of these countries. People who travel to these countries are adviSed to avoid contact with people who may be afflicted by the flu and to follow the hygiene precautions that we have listed above.
Your final question “what to do when symptoms of disease occur ?”. If you have symptoms that make you wonder whether you have the flu, isolate yourself at home and get into contact with your familiy doctor or lung doctor. If you have cystic fibrosis the doctor will most likely prescribe antiviral drugs, most likely in combination with antibiotics. A patient with severe symptoms (uncontrolable fever, shortness of breath, needing oxygen) has to be admitted to hospital. Symptoms that have to alert you to the possibility of flu are sudden fever, with or without diarrhea, muscle aches, fatigue, increase in respiratory symptoms such as cough, runny nose, sore throat and headache. The incubation period (the time between becoming infected and getting the first symptoms of the disease) is according to our current knowledge 2 to 7 days to a maximum of 10 days.
At present you cannot buy a vaccine against the A/H1N1 flu. Several manufacturers are making that vaccine but it will be a while before sufficient doses become available. For Belgium specifically the first vaccines are awaited in the fall and will be delivered to the authorities who will distribute them freely to people belonging to a risk category such as CF. For patients with CF it is important that this fall, just as all other years, they get the usual flu vaccine. There are similarities between the human flu viruses and the A/H1N1 flu so that some protection from that vaccine is likely. You will find more information for Belgium on the website www.influenza.be
T. Havermans

13.10.2009