QUESTIONS AND ANSWERS on H1N1

The following are some questions put to either Dr. Ar-Rushdi and/or Boyd Rowe from media attending the press conference last Thursday morning.

Aurora: For those who have the flu or flu-like symptoms, are those people recommended to get the [H1N1] vaccine as well?

Dr. Ar-Rushdi: If you have been confirmed as having H1N1, if you have been tested and the test came back positive, it is recommended you do not get the vaccine because you will have some immunity developed from having had the virus. But those people who have influenza-like illness and have not been tested, therefore it's not confirmed if they have H1N1, but suspected, it's recommended they do present to the mass immunization clinic.

CBC Radio: You mentioned there are 36 confirmed cases, what's the breakdown of that? Is it seen higher in a specific area?

Dr. Ar-Rushdi: It is mostly concentrated in the Northern Peninsula area and a smattering in the Western portion [of Labrador].

The Labradorian: You mentioned the schedule of the immunization clinics may change depending on the availability. Does this mean there isn't enough vaccine shots for everyone in the area?

Dr. Ar-Rushdi: The health body will have enough vaccine for the entire area but the vaccine is being delivered in a series of shipments. As the manufacturer gets the vaccine ready, the manufacturer is sending it out to St. John's and then it's being distributed across the province. It is dependent to a degree on how much vaccines we get and when, but we will have all the vaccine we need to immunize our entire population.

CBC Radio: Have you heard anything about how it's affecting children, are you seeing a lot of children being off sick?

Dr. Ar-Rushdi: Labrador-Grenfell Health is monitoring school absenteeism as part of our surveillance and generally the province's surveillance program. We do know that children are great vehicles of transporting all kinds of viral infections. A fair number, most of the cases are in the young age group. But the illness has generally been very mild.

The Aurora: A lot of people are talking about the 1976 [swine flu] and the association of Guillain-Barre Syndrome with the vaccine at that time. Is there any risk of that now and if so, what's the percentage of risk?

Dr. Ar-Rushdi: When you go back to 1976, and whenever you have mass immunization you are immunizing large numbers of people compared to [just vaccinating] schoolchildren. You will seem more adverse effects because you are dealing with larger immunization, [so] the adverse effects will seem larger. Now GBS is a neurological syndrome and it's usually reversible and it can occur with any vaccine but it is rare. That [in 1976] was an episode that happened with that vaccine preparation. This vaccine preparation is different. You know the development and technology and materials used have changed dramatically. There have been clinical trials with this vaccine and thus far the trial show this vaccine is safe.

The Labradorian: If we do have a crisis with H1N1, are both hospitals in Labrador equipped with the proper equipment like ventilators?

Boyd Rowe: In terms of the supply (in facilities) of equipment, there has been a lot of work done in preparation over the past number of months in terms of the acquisition of supplies. There was a significant acquisition of equipment such as ventilators, to provide enhanced services within our facilities. The answer is yes; there has been an acquisition of supplies that will allow us to provide an enhanced level of service to people within the region.

The Northern Pen: I hear the regular flu kills something like 1,300 or 1,400 a year. Why the big deal about this one? What's so special about H1N1?

Dr. Ar-Rushdi: You are correct, actually seasonal influenza kills up to 4,000 Canadians a year and these are predominantly the elderly and the very young. H1N1 to date looking at the epidemiology, I do not have the exact number but as of September, there was 76 deaths in Canada total. That was by the end of the first wave. We are now entering the second wave and it's a new virus influenza viruses mutate that is what they do and that is why you get the annual flu shot every year to keep up with the new mutations. Because we don't know what this virus is going to do, it may continue to be mild; we developed the H1N1 vaccine in order to prevent cases of it so we do not see large numbers in terms of deaths.

The Aurora: For those who have the flu or flu-like symptoms, you say stay home and contain it, but at what point do you recommend they been seen by a doctor?

Dr. Ar-Rushdi: What is being recommended across the province is, if you do come down with influenza-like symptoms, it is recommended to stay home and rest until you are feeling better and able to resume your usual activities or approximately seven days, whichever is sooner.

The recommendation is, if you are staying home and getting worse you are developing worse symptoms like fever, shortness of breath and are not improving to call your health centre or clinic or come in and be seen and evaluated.

Now, we are recommending in our region -because of the difficulty with access to health in isolated and remote communities particularly that those individuals that know they are high risk (if they have underlying health problems or are pregnant) that they call their health care provider as soon as they develop symptoms to therefore get direction on whether to stay home or come in for care.

The Aurora: Are hospital emergency rooms prepared? For example, are people coming in with flu-symptoms automatically masked?

Dr. Ar-Rushdi: Actually yes, I was recently in Labrador West and it was amazing because people would come in and there were signs on the door, there were masks at entry and people would automatically -if they were coughing--would take the mask and go to the reception and wait. People do know what to do. So the message is getting out. That is good.

The Labradorian: You talked about enhancing equipment, what about staff? Do you have specialized staff coming in?

Boyd Rowe: No, there has not been an increase in human resources being associated with the lead-up to this. I think it's fair to say, as we move forward with the discontinuance of the various programs on the public health nursing side there will be relocation of staff in the case of the mass immunization in the region to allow us to do that work within the region. We have a respiratory therapist at the Labrador Health Centre and at the Curtis Memorial Hospital but, in case it is necessary, it is possible for those individuals to travel throughout our region.