PEOPLE AT RISK OF SEVERE ILLNESS THIS WINTER

Why are some people at increased risk of severe illness from H1N1 influenza 09 this winter?

This winter, H1N1 influenza 09 will continue to spread within the population of NSW, along with other influenza viruses seen each winter. The H1N1 influenza 09 virus produces a mild illness in most, a severe illness in some, and is a moderate illness overall. Because there is little immunity to this virus in the community, it is likely more people will become sick with influenza-like illnesses this winter, compared to usual winters. This winter, it will be particularly important for people at increased risk of severe illness from influenza to seek medical attention early if they develop symptoms.

What are the symptoms of flu?

The symptoms of H1N1 influenza 09 are similar to the symptoms of normal seasonal influenza (fever, chills, cough, sore throat, tiredness, muscle aches),and some people have also complained of vomiting and diarrhoea. H1N1 influenza 09 can result in breathing difficulty and pneumonia. Symptoms generally appear between two to four days after exposure.

For further general information H1N1 Influenza 09, please see this fact sheet.

Who is at increased risk of severe illness?

Some people have been found to be more likely to develop severe illness from both seasonal influenza and H1N1 influenza '09. This group includes people who:
• Are pregnant (particularly in the second and third trimester)
• Have chronic lung disease (including asthma)
• Are very obese
• Have chronic heart conditions
• Have chronic kidney disease
• Have chronic liver disease
• Have blood disorders (including sickle cell disease)
• Have neurological disorders
• Have metabolic disorders (such as diabetes)
• Have weakened or suppressed immune systems (which may be caused by cancers, medications or HIV/AIDS)
• Are of Aboriginal of Torres Strait Islander background (of any age).

What should I do if I develop symptoms and I am at increased risk of severe illness?

Immediately contact your doctor and follow their instructions. Your doctor will determine if treatment is needed - most GPs will have access to anti-influenza medications oseltamivir (Tamiflu®) and zanamivir (Relenza®) (medicines used to treat the flu) that has been reserved for people at increased risk of developing severe illness. If you have trouble accessing your doctor you can attend your closest hospital with a 'flu clinic' for assessment. It is important to do this as soon as possible after you develop symptoms, as the medication that may be prescribed for you is more effective the earlier it is commenced.

You should stay home from work or school and limit contact with others until you are well again.

If you are very sick, call 000 for an ambulance or go to a hospital emergency department.

What should I do if I am at increased risk of severe illness and someone in my household has the flu?

Wherever possible, keep away from the person who is sick, including sleeping in a separate room. Encourage the person who is sick to practice good cough and sneeze etiquette. Practice good hand hygiene.

For more information, please see the NSW Department of Health fact sheets:

• Handwashing
• How to Handwash in the Community
• Cough Etiquette

Monitor yourself for symptoms of influenza. If you develop any symptoms, contact your doctor urgently as you may need early treatment with anti-influenza medications.  Some patients at very high risk of developing severe illness (such as those receiving treatment for cancer) may need to be provided with medication to prevent influenza developing. If you are in this group your specialist will be able to advise you.

Can I take anti-influenza medication if I have an existing health condition?

Yes, it is generally safe for you to take oseltamivir (Tamiflu®) or zanamivir (Relenza®). However, you should discuss any conditions you have with your doctor, including if you are pregnant or breastfeeding.

What about my usual medications?

You should continue to take your other medications as prescribed. Your doctor will advise you if your medications need to change.

Published by NSW Health - 18 June 2009

See NSW Department of Health Website

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