At SAA we recently recieved the following email regarding H1N1 vaccination that we would like to share wtih you.

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Dear Friend,

The H1N1 "Swine" Flu is a strain of influenza virus is different from the seasonal flu.

The H1N1 season is expected to be from early October-January while the seasonal flu typically comes later (December-March). Patients with autoimmune illness like pemphigus and pemphigoid are NOT at any increased risk for either viral infection.

However, immunosuppressing medications such as prednisone, CellCept, Imuran, Methotrexate and the like can increase your susceptibility to infection. Therefore, patients with pemphigus and pemphigoid, including those taking immunosuppressant medications, are encouraged to get BOTH the H1N1 and seasonal flu vaccination. It is possible that your degree of immunosuppression could diminish the effectiveness of the vaccine, but this is not a reason to avoid the vaccination.

MOST IMPORTANTLY, immunosuppressed patients should NOT have the nasal spray form of vaccination - this contains Live Attenuated Virus and can result in viral dissemination. Rather, you should receive the "usual" injectable vaccine which contains inactivated virus.

Protect:

To protect you and your family from the flu:

• Wash your hands often with soap and warm water. Alcohol-based hand cleansers are also effective.
• Avoid people who are ill.
• Stay home from work or school if you are sick (for 7 days after onset)
• Use tissue when you cough, sneeze or spit, and dispose of the tissue in a covered trash bin.
• Keep hands away from your face. Avoid touching your eyes, nose or mouth.
• Clean shared space more often such as phone receivers, keyboards, steering wheels and office equipment.
• Refrain from sharing personal items such as forks, spoons, toothbrushes and towels.

Prepare:

If you have a chronic medical condition, during a flu outbreak you should:

• Get a written record of the kind of chronic disease(s) you have and the treatment you are receiving. Keep this information with you at all times.
• Prepare a typed or printed list of all medications usually taken and the times of day they are taken.
• Keep the name, phone number, and office address of your doctor or health care provider with you at all times.
• If you use medications for your condition, continue taking those medications even if you become sick with the flu, unless your doctor or health care provider says otherwise.
• Be alert to changes in your breathing, especially if you have heart failure, congestive heart disease or COPD. Promptly report changes to your doctor or health care provider.
• Inform family members or close friends of your medical condition.

Vaccine:

• Like the seasonal flu shot, the new novel H1N1 flu shot does not contain a live virus. It is advised that people with immuno-compromised systems take this vaccine. Discuss the specifics of your situation thoroughly with your doctor.
• The nasal spray form of both the seasonal and H1N1 vaccines is made from a live virus, persons who are immuno-compromised should not take live vaccine.
• Adverse reaction after the vaccine? If you are concerned about a potential adverse event you should contact your own health care provider or go to the local emergency department for medical evaluation.

Treating the Flu:

Symptoms include: mainly upper respiratory symptoms (cough, sore throat, stuffy/runny nose) AND a fever of 100 degrees F or higher. If you have these symptoms, stay home and rest, drink plenty of fluids and maybe use over-the-counter products to treat symptoms. There may be no need to see a health care provider. However, if symptoms get worse, call a health care provider, who can decide if the sick person needs prescription medicines called "antivirals." Most people find that the flu goes away after a few days even without these medicines.

When you should see a doctor:

If you can answer yes to any of the following, contact your health care provider immediately. (If at all possible, try to reach your own doctor or an urgent care center rather than going to a hospital emergency department.)

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion or change in level of consciousness
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough
• An existing health care condition is now much worse

For more information at the New York Department of Health website, click here.

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