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SEASONAL FLU VACCINE (11/4/09)

Health Services is out of seasonal flu vaccine.  Additional vaccine is expected; at this time, a campus 'flu shot' clinic for seasonal flu vaccine is not planned. Please note that seasonal flu vaccine will not protect against H1N1 flu.

H1N1/Swine Flu Vaccine (11/18/09)

Health Services is receiving limited quantities of H1N1 vaccine, both in the form of nasal/live virus and injectible vaccine. The attenuated, live virus nasal spray can only be used in people between the ages of 2 and 49 who are not allergic to eggs and do not have underlying medical conditions.  The injectable H1N1 vaccine does not contain live, attenuated virus. Please note: you cannot get the flu from the vaccine these are not new vaccines: they are made the same way as seasonal flu vaccine. You may schedule an appointment to receive the vaccine at Health Services by going to:

www.timecenter.com/healthservices

PLEASE NOTE ELIGIBILITY BEFORE SCHEDULING THE VISIT:

• Students and staff ages 24 and younger
• Students and staff 25 to 64 with qualifying conditions:

        pregnant women/person living with a pregnant woman in the 3rd trimester

        person who lives with or provides care for infants aged <6 months (e.g  

           parents and daycare providers)

        medical conditions that put them at higher risk for influenza-related

           complications:    

           immunosuppression (by medications or HIV)

           renal,

           metabolic disorders (including diabetes)

           chronic pulmonary (including asthma),

           hepatic, hematologic, and neurologic/neuromuscular disorders

Please note: if you are pregnant or have an underlying condition, you can ONLY receive the injectable vaccine.  Nasal/attenuated live virus vaccine is only for healthy people 49 years of age and younger.

Only one dose of H1N1 vaccine is needed for people 10 years of age and older.

The initial doses of vaccine are being reserved for use in the target group identified by the ACIP for vaccination:

• pregnant women
• person who live with or provide care for infants aged <6 months (e.g. parents, siblings, and daycare providers)
• health-care and emergency medical services personnel who have direct contact with patients or infectious materials
• children aged 6 months-4 years, and
• children and adolescents aged 5-18 years who have medical conditions that put them at higher risk for influenza-related complications.

Please contact Health Services (x2813) if you fall into one of these categories.  The intial vaccine allocations are expected to be the attenuated, live virus nasal spray. This vaccine can only be used in people between the ages of 2 and 49 who are not allergic to eggs and do not have underlying medical conditions.  The other 4 formulations of H1N1 vaccine will be the injectable form of vaccine, not containing live, attenuated virus.

Please note:

• you cannot get the flu from the vaccine
• these are not new vaccines: they are made the same way as seasonal flu vaccine

www.cdc.gov/mmwr/PDF/rr/rr5810.pdf

www.cdc.gov/h1n1flu/vaccination/vaccine_safety_qa.htm

www.nytimes.com/2009/10/10/health/10primer.html?_r=1&scp=4&sq=H1N1&st=cse

H1N1/Swine Flu Update (9/17/09)

The Massachusetts Department of Public Health has published a helpful document of frequently asked questions regarding flu.

As the situation evolves, it is important to consider the following:

1. At the present in the United States, the great majority of people with swine flu have been mildly ill.

Symptoms are similar to seasonal flu with fever (>100), cough, sore throat and body aches. In some instances, there may also be nausea, vomiting and diarrhea.

2. The best prevention of any flu, including H1N1, is frequent hand washing and/or the use of hand sanitizers. Also, if you are ill with cough, it is important to ‘cover the cough’ so as not to spread viruses.

3.  While the 'regular' seasonal flu vaccine does not protect against H1N1, it is recommended that college students receive it. 

4. The vaccine for H1N1 is expected to be available in October. The ACIP has recently recommended it for all individuals up to age 24 (in addition to other groups). Once Health Services learns of the distribution timeline, we will inform the campus of our plans to administer it.  At present, it is likely to consist of 2 injections, separated by 3 weeks.

5.  In preparation for returning to campus, we suggest students consider bringing an electronic thermometer and ibuprofen and/or acetominophen.

In our experience, these will be helpful in any illness, not just H1N1.

6.  The Boston Public Health Commission has published helpful guidelines for ill college students in the event H1N1 emerges on campus.

Please note that the CDC has recently shortened the period for isolation to 24 hours after no longer having a fever.

7.  On August 20, the CDC issued new and extensive guidelines for Institutions of Higher Education (http://www.cdc.gov/h1n1flu/schools/).

The following information is taken directly from that document:

a.  Who should receive a flu vaccination?

* Vaccines will be available this year to protect against seasonal flu. Children 6 months through 18 years of age, people of any age with chronic medical conditions (such as asthma, heart disease, or diabetes), and everyone age 50 and older should be vaccinated against seasonal flu as early as possible.

The 2009 H1N1 flu vaccine should be available in the fall of 2009. Certain groups at higher risk for complications from this flu are recommended to get the 2009 H1N1 flu vaccine when it first becomes available. These groups include:

+ pregnant women,
+ people who live with and care for children younger than 6 months of age,
+ healthcare and emergency medical services personnel,
+ people between the ages of 6 months and 24 years (this includes most students attending institutions of higher education), and
+ people ages 25–64 years of age who have chronic health conditions (such as asthma, heart disease, or diabetes) or compromised immune systems.

b.  Symptoms of seasonal flu and the 2009 H1N1 flu

Symptoms of flu include fever or chills and cough or sore throat. In addition, symptoms of flu can include runny nose, body aches, headache, tiredness, diarrhea, or vomiting.

c. How do I recognize a fever or signs of a fever?
A fever is a temperature that is equal to or greater than 100 degrees Fahrenheit or 38 degrees Celsius when taken with a thermometer. Look for these possible signs of fever: if he or she feels very warm, has a flushed appearance, or is sweating or shivering.

d.  How do I know if someone has 2009 H1N1 flu or seasonal flu?
It will be very hard to tell if someone who is sick has 2009 H1N1 flu or seasonal flu. Public health officials and medical authorities will not be recommending laboratory tests. Anyone who has the symptoms of flu-like illness should stay home and not go to work.
Symptoms of flu include fever or chills and cough or sore throat. In addition, symptoms of flu can include runny nose, body aches, headache, tiredness, diarrhea, or vomiting.

e.  What fever-reducing medications can students, faculty, and staff take when sick?
Fever-reducing medications are medicines that contain acetaminophen (such as Tylenol) or ibuprofen (such as Motrin). These medicines can be given to people who are sick with flu to help bring their fever down and relieve their pain. Aspirin (acetylsalicylic acid) should not be given to anyone younger than 18 years of age who have flu; this can cause a rare but serious illness called Reye’s syndrome.

e  When should I seek medical care and/or speak to a medical provider?

Students should promptly seek medical attention if they have a medical condition that places them at increased risk of influenza-related complications, are concerned about their illness, or develop severe symptoms. Severe symptoms include increased fever, shortness of breath, chest pain or pressure, rapid respirations, cyanosis (bluish skin color), vomiting, dizziness, or confusion.

f.  What are the medical conditions that place a person at increased risk of complications?

Groups that are at increased risk of complications from influenza if they get sick (i.e., high-risk groups) include: children younger than 5 years old; people aged 65 years or older; children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye’s syndrome after influenza virus infection; pregnant women; adults and children who have asthma, other chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders such as diabetes; and adults and children with immunosuppression (including immunosuppression caused by medications or by HIV). People 65 years and older, however, appear to be at lower risk of 2009 H1N1 infection compared to younger people. But, if older adults do get sick from influenza, they are at increased risk of having a severe illness.

g. Who should get treatment with anti-viral medications?

People at high risk for influenza complications who become ill with influenza-like illness should call their health care provider as soon as possible to determine if they need antiviral treatment. Early treatment with antiviral medications often can prevent hospitalizations and deaths. People on antiviral treatment may still shed influenza viruses and transmit the virus to others. In addition, people taking antiviral medications can develop infection with antiviral resistant virus strains. To lessen the chance of spreading influenza viruses that are resistant to antiviral medications, people on antiviral treatment should remain in self-isolation according to the current recommendations and adhere to good respiratory etiquette and hand hygiene.

To stay informed, the following websites are recommended:
  

   www.cdc.gov/h1n1flu/

   www.cdc.gov/h1n1flu/schools/
   www.who.int/csr/disease/swineflu/en/index.html

   www.smith.edu/influenza

                                           West Nile Virus

(update 8/20/2009)

West Nile Virus is spread to humans by mosquitoes. The majority of people exposed to the virus (80%) have no symptoms and those that do have mild ones, indistinguishable from other viruses: mild fever, swollen glands, headaches and muscle aches. The symptoms (and virus) go away without treatment.

Uncommonly (less than 1%), West Nile Virus can cause serious illness, including encephalitis and meningitis. People over the age of 50 are at greater risk for the serious symptoms of West Nile Virus. There were 6 cases of West Nile Virus in Massachusetts in 2007. The Massachusetts Department of Public Health reports that the virus has been found in mosquitoes throughout Massachusetts. They recommend ways to decrease your risk for mosquito bites until the first hard frost eliminates them.  For more information go to www.mass.gov/dph

 

MRSA (pronounced 'mersa')

MRSA stands for methicillin-resistant staphylococcus (“staph”) aureus and is a kind of bacteria that is resistant to certain antibiotics.  About 25-30% of us carry staph on our bodies all the time and often without symptoms.  That is called being “colonized” and the bacteria can still be passed to others.  The spread of MRSA outside of the hospital often occurs through skin to skin contact and by contact with items that have been touched by someone with staph, such as used towels, gym equipment, and shared clothing.  MRSA infections often start by a small pimple or spider bite pustule and then become more painful and swollen. The spread of MRSA can be prevented by keeping open wounds covered with bandages at all times, not sharing personal items, cleaning athletic equipment between each use, and most importantly, through frequent careful handwashing.  Most campus buildings now have dispensers at doorways with instant hand sanitizer for student and staff use.  For more information go to www.mass.gov/dph .

HPV Vaccine Available at Health Services

This summer, the FDA approved Gardasil, a vaccine that will reduce infection with Human Papilloma Virus and the risk of cervical cancer. HPV is the most common sexually transmitted infection with studies indicating that a third or more of sexually intimate young women have been infected. Usually, there are no symptoms of infection; but HPV can cause genital warts and cervical cancer.

There are many strains (more than 100) of HPV but only a small number are responsible for genital warts and cancer. The new vaccine is protective against 4 strains: 6 and 11, which are responsible for 90% of genital warts, and 16 and 18, responsible for 70% of cervical cancer.

The vaccine is approved for girls/women between 9 and 26 years of age. Even if a woman has HPV infection (i.e. is sexually experienced and/or has had genital warts), she may choose to have the vaccine to prevent further infection.

The vaccine is available at Health Services at our cost of $125/dose. Three doses are required for protection. While many health insurances (including the Smith College Student Health Insurance) do not cover vaccines, many do (e.g. Harvard Pilgrim, Aetna and Cigna). You may want to call your insurance company to find if this vaccine is covered. If you are interested in receiving the vaccine, schedule an appointment with a nurse (x2823) to administer the vaccine.

Cancer.gov This is the National Institute of Health's cancer division.

Center for Disease Control The website of the Centers for Disease Control and Prevention has an excellent HPV questions and answers page.

HIV Testing Expanded

The Centers for Disease Control and Prevention (CDC) has recently recommended that HIV testing become a standard practice in the health care setting. HIV testing is available at Health Services. To facilitate access to it, the cost of the test ($56) is now covered by our optional on campus health plan in addition to the Student Health Insurance Plan (if the test is done at Health Services). Students with private or other 3rd party insurance will be charged $56. You may schedule an appointment with a provider (x2823) for testing or ask to be tested as part of a visit scheduled for a different purpose.

Center for Disease Control The Center for Disease Control provides an excellent resource for information regarding HIV, including recommendations and guidelines, reports, and fact sheets.

Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings The latest recommendations for HIV Testing by the Center for Disease Control.

Avian Flu

Avian flu is an emerging infection of great concern. Currently, avian flu virus (H5N1) infects birds in a number of Asian and European countries. The virus has infected a small number of people with close contact with infected poultry. At present, the virus does not pass readily between humans. The concern is that the virus will mutate/evolve to make person to person transmission efficient, similar to current human influenza. In the event that occurs, a pandemic (worldwide epidemic) is likely.

While it is important to keep in mind that this is a potential concern, and that there is no spread of avian flu at present, it is advisable to be knowledgeable of this emerging health issue. Below are links to references that provide useful information regarding current knowledge.

PandemicFlu.gov This is the official U.S. government Web site for information on pandemic flu and avian influenza.

Center for Disease Control The website of the Centers for Disease Control and Prevention covers the topic of avian flu broadly and is updated as information warrants.

World Health Organization (WHO)This is the page from the World Health Organization, an international coalition monitoring health and disease around the globe. The site is updated frequently as new cases develop.

PBS's Wide Angle
Much useful information; the interview with Dr. Anthony Fauci is particularly recommended.

New England Journal of Medicine
This is a state of the art review of avian flu in a medical journal.

For Information of the regular flu, see our Influenza Fact Sheet