Swine Flu (H1N1/09)

Many different ways, among them are:

• Let them dry out.
• Deprive them of a host.
• Use antiviral medication.
• Use friction, soap and warm water (see related question below).
• Use ethyl or isopropyl alcohol in solutions of a minimum of 60% alcohol.
• Use alcohol based waterless hand sanitizers (at least 60% alcohol).
• Use non-alcohol based waterless hand sanitizers*.
• Heat to temperatures at least as high as normal cooking temperatures (167-212°F [75-100°C]).
• Sterilize or autoclave with very high heat.
• Use household cleaning products (see related links below for link to information about products that are effective).
• Subject them to an animal's (including humans) healthy immune system activity.

*Common active ingredients in non-alcohol based hand sanitizers: benzalkonium chloride, triclosan, or povidone-iodine.

According to the Center for Disease Control (CDC), the swine flu responds to treatment with the anti-viral drugs oseltamivir and zanamivir.

A link to the CDC information about Swine Flu is provided below in the related links section. In addition see the related question below for information on tactics to use to keep yourself and your family less likely to contract the virus.

The answer to this depends greatly on some widely differing variables. Patient age, health status and how well the vaccine used in the trials matched the viruses circulating at the time of the study are three of the most significant influences on the trial results making comparisons difficult.

The US Centers for Disease Control and Prevention's (CDC) bottom line best estimate from studies is that, for healthy children, the intranasal flu vaccine made with the live attenuated (weakened) influenza virus (LAIV) is more effective in offering protection against the flu than the injected vaccines (the LAIV intranasal vaccine is recommended only for healthy people age 2 - 49), although there is not a huge difference.

For healthy children receiving live vaccine: efficacy was 86% overall. In one large study among children aged 15-85 months, the seasonal nasal-spray flu vaccine (LAIV) reduced the chance of influenza illness by 92% compared with placebo, but the match of the vaccine virus to the viruses in the wild was better during that trial period compared to the study with the efficacy results of 86%, too, which makes comparison more difficult.

For healthy adults under age 65, the studies mostly indicate that there is no statistical difference in effectiveness between receipt of live flu vaccines or inactivated vaccines. However specific studies of healthy college age adults suggested that inactivated vaccine may be more efficacious than live vaccine for this age group. The overall efficacy of LAIV and inactivated influenza vaccine in preventing laboratory-documented influenza from all three influenza strains combined was 85% for LAIV and 71% for inactivated injected vaccines.

In older trial participants aged 65 and over, the effectiveness of flu vaccines is generally overall lower (efficacy of 58%), but since this group also usually has more underlying health issues and may be more susceptible and more prone to complications and death (the majority of the estimated 36,000 deaths from seasonal flu each year in the US are among this older age group), that is not easily assessed. There are some flu vaccines made especially for this age group that give a stronger dose to help improve effectiveness.

The studies were also difficult for this > 65 age group because those who reside in long term care (LTC) facilities are typically more susceptible and have more incidence of transmission of flu viruses from staff, visitors, and other residents. Therefore, the immunization against flu in this LTC subgroup can significantly reduce infection rates and is highly recommended since this group has the highest morbidity and mortality rates from the flu. And these variables can also skew the statistics in trials, making estimates of the difference between the effectiveness very difficult to impossible to provide.

See the links below in the Related Links section to the CDC site for more specific details.

More information:

Flu vaccines have a relatively similar effectiveness regardless of the route of administration or regardless if it is LAIV vs. an inactivated vaccine within specific groups, but the effectiveness varies between the groups.

Those vaccines administered with needles are made with inactivated virus particles which can make a weaker immune response, while the intranasal vaccine for the flu is made with LAIV (Live Attenuated Influenza Viruses) that are treated so that they can not make an otherwise healthy person sick with the flu, but trigger a stronger response.

The immune response to an inactivated virus is less robust than that to the live weakened virus. However, the injected route can produce a more immediate and robust response compared to the less invasive, slightly slower acting intranasal route. So, the end restult is relatively the same in a general evaluation.

For the 2012-2013 Flu Season in the Northern Hemisphere:

The vaccine for the H1N1/09 virus is included in the seasonal flu vaccine as one of the three virus types expected this flu season, so a separate vaccination is no longer needed.

For the 2010-2011 and 2011 - 2012 Flu Seasons in the Northern Hemisphere:

The vaccine was available just like in the prior flu seasons for the "regular" flu vaccine. There was no separate distribution system this time. The vaccine for the H1N1/09 virus is included in the seasonal flu vaccine, so no separate vaccination was needed these years.

For the 2009 H1N1/09 pandemic and 2009-2010 Flu Season:

In the US now that the vaccine is being distributed, the supplies are going to the state health departments and from there, they are distributing to the communities and organizations in their states for local vaccination programs and individual providers to administer the vaccines.

Development of the vaccines was an international effort with government public health organizations working together with each other and with drug manufacturers along with the World Health Organization (WHO) for creation and recommendations for use of the different types of vaccines. The WHO and CDC were prominent in selecting and isolating the strain that would be most effective to grow and to use to create the vaccines.

In the US, the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health (NIH), Health and Human Services (HHS) and even the Homeland Security organizations are involved in plans for manufacture, testing, approval, and administration programs. The CDC's committee making the recommendations is called The CDC Advisory Committee on Immunization Practices (ACIP).

In the UK, it is the NHS who is primarily advising the governments in the UK. The WHO, CDC, NHS, and health ministries of other individual countries are making recommendations on immunization program planning and preparation, and then it will be up to the governments to determine the best use for their citizens of the vaccines as they become available. They will be available after testing by the manufacturers and by the government agencies, and when subsequently approved and released for distribution and use in the planned immunization programs.

In the US, the program will be entirely voluntary, leaving the choice to take the vaccine with each individual and parents. Some states and employers have mandated health care workers take vaccines for the A-H1N1/09 to continue to work with the ill patients in their care.

See also the related question, "Which cities states or countries have deaths or cases of swine flu?" in the related question section below for more information and regular updates on the vaccines, manufacture, and immunization approval processes.

Yes, but only tiny traces. The 2011-2012 flu season vaccine is made exactly like flu vaccines have been made for decades (including thimerosal) with an extremely high safety record even compared to other vaccines. The minuscule amount of mercury from the thimerosal preservative used in some doses of influenza vaccine may leave traces present in your body for a very short time. Single dose vials of the flu vaccines have no thimerosal in them, therefore no mercury, but may need to be special ordered in advance by your pharmacy or doctor, which may in turn raise the cost.

However, to put this in perspective, the amount of mercury from that compound in the flu vaccine when used, is approximately 24.5 mcg of mercury per dose of vaccine. This is well below the amount of mercury that a single serving of fish in your diet might contain.

Fish that are known to contain low amounts of mercury include catfish. It has been determined that for the amount of mercury in catfish to pose any potential danger, these hypothetical health risks from the mercury in catfish would only begin at a weekly intake of 342.8 ounces (21.4 pounds) of the fish. This should put into perspective the insignificance of the mercury from a flu shot. Scientific studies have proven no connection between thimerosal and untoward health consequences from vaccine use.

The following is quoted from the Centers for Disease Control and Prevention (CDC) website:

What is thimerosal?

Thimerosal is a very effective preservative that has been used since the 1930s to prevent contamination in some multi-dose vials of vaccines (preservatives are not required for vaccines in single dose vials). Thimerosal contains approximately 49% ethylmercury. There is no convincing evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. However, in July 1999 the Public Health Service (PHS) agencies, the American Academy of Pediatrics (AAP), and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure.

Today, all routinely recommended licensed pediatric vaccines that are currently being manufactured for the U.S. market, with the exception of influenza vaccine, contain no thimerosal or only trace amounts. Thimerosal preservative-free influenza vaccines are available, but in limited quantities. The total amount of inactivated influenza vaccine available without thimerosal as a preservative will continue to increase as manufacturing capabilities are expanded.

Does the influenza vaccine contain thimerosal?

Yes, the majority of influenza vaccines distributed in the United States currently contain thimerosal as a preservative. However, some contain only trace amounts of thimerosal and are considered by the Food and Drug Administration (FDA) to be preservative-free. Manufacturers of preservative-free flu vaccine use thimerosal early in the manufacturing process. The thimerosal gets diluted as the vaccine goes through the steps in processing. By the end of the manufacturing process there is not enough thimerosal left in the vaccine to act as a preservative and the vaccine is labeled "preservative-free".

Is it safe for children to receive an influenza vaccine that contains thimerosal?

Yes. There is no convincing evidence of harm caused by the small amount of thimerosal in vaccines, except for minor effects like swelling and redness at the injection site due to sensitivity to thimerosal. Most importantly, since 1999, newly formulated thimerosal preservative-free childhood vaccines (Hepatitis B, Hib, and DTaP) have been licensed. With the newly formulated childhood vaccines, the maximum total exposure during the first six months of life will now be less than three micrograms of mercury. Based on guidelines established by the FDA, the Environmental Protection Agency (EPA) and the Agency for Toxic Substances and Disease Registry (ATSDR), no child will receive excessive mercury from childhood vaccines regardless of whether or not their flu shot contains thimerosal as a preservative.

Rsearch suggests that healthy children under the age of 2 are more likely than older children and as likely as people over the age of 65 to be hospitalized with flu complications. In addition, children between 24-59 months of age have higher rates of influenza-related doctor and Emergency Department visits than older children. Therefore, vaccination with either reduced or standard thimerosal-content flu vaccine is recommended for children between the ages of 6 and 59 months by CDC's Advisory Committee on Immunization Practices.

Is it safe for pregnant women to receive an influenza vaccine that contains thimerosal?

Yes. A study of influenza vaccination examining over 2,000 pregnant women demonstrated no adverse fetal effects associated with influenza vaccine. Case reports and limited studies indicate that pregnancy can increase the risk for serious medical complications of influenza. One study found that out of every 10,000 women in their third trimester of pregnancy during an average flu season, 25 will be hospitalized for flu related complications.

Additionally, influenza-associated excess deaths among pregnant women have been documented during influenza pandemics. Because pregnant women are at increased risk for influenza-related complications and because a substantial safety margin has been incorporated into the health guidance values for organic mercury exposure, the benefits of influenza vaccine with reduced or standard thimerosal content outweighs the theoretical risk, if any, of thimerosal.

Some types do, although it is a very scant amount. Multi-dose vials of vaccines for some types of flu must have preservatives added and usually the one used is thimerosal. Thimerosal contains trace amounts of mercury. However, to put it in perspective, it is no more than the amount of mercury you would get when eating a single meal of fish. It has been proven safe for use as the preservative over decades of use in flu shots. If you are concerned, you can ask for vaccination with a single dose vial or pre-filled single dose syringe which do not contain the preservatives, however, these are not always available and you would need to plan in advance to find single dose preparations.

• Viet Nam with 4 cases and 4 deaths.
• Egypt with 36 cases and 4 deaths.
• China with 7 cases and 4 deaths.