H1N1 flu: plan now for fall and winter

By LYN KUKRAL, U.S. Army Center for Health Promotion and Preventive MedicineJune 11, 2009

ABERDEEN PROVING GROUND, Md. (Army News Service, June 12, 2009) Aca,!" Public health professionals at the U.S. Army Center for Health Promotion and Preventive Medicine advise that summer is a good time to get ready for fall and winter flu season.

In summer, flu viruses, including H1N1 (formerly called swine flu) are less active in infecting those who live in the northern hemisphere, according to John F. Ambrose, the epidemiologist leading CHPPM's flu surveillance efforts. In fall and winter, flu cases always increase, he said.

"One theory is that social distancing decreases in fall and winter, when children go back to school and groups that have stopped meeting during the summer resume," Ambrose explained. "It's also easier for viruses to survive in fall and winter, when there's less ultraviolet light."

Along with scientists at the Centers for Disease Control and Prevention and the World Health Organization, CHPPM public health experts are uncertain of what to expect from H1N1 in the next flu season.

"There's really no way to tell what H1N1 flu will do; expert opinions differ," Ambrose said. "The best advice is hope for the best, but plan for the worst."

History provides examples of "best" and "worst" flu epidemic and pandemic behaviors.

"Some have started out mild and then come back aggressively during flu season, causing serious illness and deaths," Ambrose said. "Others just don't come back or remain relatively mild."

Given that it is unknown what H1N1 will do, making preparations at home and planning how to manage possible school closures and work-from-home is prudent.

Ambrose advises that the CDC and the Department of Health and Human Services are reliable sources of information for Soldiers and their Families. Both maintain Web sites with advice for coping with flu.

Basic tips:

At home, stock two weeks worth of extra food, water and other emergency supplies.

Keep a supply of non-prescription medications to treat flu and other common illnesses.

Ensure a continuous supply of any prescription medicines for Family and pets.

Plan for childcare if schools are closed, and check your organization's telework policies.

To date, CHPPM's disease surveillance of the Army population indicates that the majority of H1N1 cases have been mild with full recoveries, according to Lt. Col. Rodney Coldren, a physician and CHPPM's disease surveillance program manager.

Like other flu, H1N1 spreads via the respiratory system, through close contact (6 feet or less) or by respiratory droplets on surfaces such as telephones, doorknobs and desks, Coldren said.

A fortunate few may not even realize they have the H1N1 flu, but most will experience typical flu symptoms.

Preventive measures for flu are also available on the CHPPM, CDC, and HHS Web sites.

"Amazingly, the most effective preventive measure against flu, as well as other respiratory diseases and gastrointestinal diseases, is effective hand-washing," Coldren emphasized.

Other preventive measures include covering the nose and mouth when sneezing or coughing, keeping distance from others who are ill and staying home from work or school when ill, he added.

If you think you have the flu, treatment at home is effective for the majority of cases, Coldren said

It's important to contact a caregiver before going to the clinic or hospital, to ensure that caregivers are alerted that the patient may be infectious and can protect themselves and other patients, he added.

Coldren, Ambrose and their CHPPM colleagues are continuing Army-wide surveillance of cases, determining numbers and locations to help ensure that public health measures are in place where they are needed and to help ensure continued unit readiness.

(Lyn Kukral serves with U.S. Army Center for Health Promotion and Preventive Medicine.)