H1N1: What every first responder should know


CarolinaFireJournal - David Hesselmeyer
David Hesselmeyer
10/18/2009 -

Public health and other first responder agencies have been in planning mode for a pandemic influenza event for many years now. Unfortunately, that planning was used for the first time this year since 1968. In April of this year the “swine flu” (a novel flu virus known as H1N1) was first confirmed in Mexico. Since then over 254,000 people have gotten sick and over 2800 have died worldwide (Source: World Health Organization, as of September 8, 2009). 

Every pandemic has waves. The first wave in North America ended around the end of the school year. However, we need to be more vigilant now as we expect a second wave anytime.

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People do not have any natural immunity to this novel virus since it is new. Thus anyone can get sick. The H1N1 virus has affected mostly the age group of 16 to 58 years of age.

What is the flu?

The flu (influenza) is an infection of the respiratory tract (e.g. nose, throat, lungs) caused by the flu virus. There are three main types: A, B, and C. In addition, there are subtypes of the flu virus based on their structure. These subtypes allow us to name the viruses, for example H1N1 (swine flu).

The numbers refer to the hemagglutinin and neuraminidase receptors on the virus cell wall. Symptoms of the flu may

include:

  • Fever
  • Tired feeling
  • Headache
  • Dry cough
  • Sore throat
  • Runny or stuffy nose, and sore muscles

The flu virus spreads from person to person through droplets (i.e. mucus from coughing or sneezing). People get exposed when a person sneezes or coughs into their hands. This person can then shake hands or touch an object that another person touches. Then the second person can touch their eyes, mouth or nose thus exposing him or herself and potentially getting sick.

 

Differences between the seasonal flu and a novel flu virus

There are differences between the seasonal and a novel flu virus.

Seasonal Flu Virus
Seasonal flu is the virus that we see annually starting around November of every year. The peak of this season is around February depending on the subtype of the virus.

Citizens have options to take a seasonal flu vaccine. This vaccine cannot make you sick since it is a dead virus vaccine. You can have side effects to this vaccine such as redness around the injection site, soreness, and malaise, which some misinterpret as getting the flu.

People have natural immunity to this virus. This allows us to be exposed and not necessarily get sick. This is due to our being exposed to this virus earlier in life as well as by taking the flu vaccine. However, the elderly and young children are normally at higher risk for getting sick or dying.

Novel flu virus

The H1N1 (swine flu) virus is an example of a novel flu virus. We do not see a virus like this annually or at regular intervals. This virus could appear unexpectedly.

People do not have any natural immunity to this novel virus since it is new. Thus anyone can get sick. The H1N1 virus has affected mostly the age group of 16 to 58 years of age.

There is no vaccine immediately available for a novel virus. As is the case with the H1N1 virus, creating a workable vaccine for a novel strain of the virus would take between 6 to 8 months.

What do you need to do, or know?

There are some actions you can do to better prepare yourself as a first responder, as well as your family.

Seasonal flu vaccine

Make sure you and your family get your seasonal flu vaccine shot. These are normally available starting in September and can be taken as late as February-March of each year. This seasonal flu vaccine does not protect you directly from a novel virus, but can limit your other risk factors which could ultimately protect you in some ways.

Get your H1N1 vaccine

The federal government purchased all of the H1N1 vaccine for the United States. This vaccine will be distributed to local medical providers that agreed to certain conditions. There is no cost for the vaccine itself but the medical provider can charge you an administrative fee. This H1N1 vaccine will likely be two shots which will be taken 21 days apart.

EMS and other first responders with direct patient contact (e.g. firefighter who provides medical first response) are on the initial priority group. However, family members are not. They will be included in additional waves of vaccine delivery.

Talk to your doctor or call your local health department to determine the best method to obtain your vaccine.

Stay current

Information on the H1N1 virus is constantly changing. The information included in this article could change prior to its printing. I suggest keeping up to date with information from the Centers for Disease Control and Prevention (CDC). This can help you make decisions on if and when to wear surgical masks or N95 respirators, etc. Go to www.cdc.gov for more information.

Family emergency plans and emergency kits

As with hurricanes and other disasters, it is important to have a family emergency plan as well as an emergency kit for your home. Take the time to ensure this has everything in it needed to maintain life for seven to 14 days. If you are not sure what to include go to www.ready.gov and look for the guidance documents they have to help you with this.

Preparing your department

You should take many of these same steps when trying to prepare your department. It should not be a different process than it is to plan for an inbound hurricane. But just take the time to ensure that there are more disaster specific plans, stocks, etc. on hand to plan for an event such as a second wave of a pandemic, as we expect shortly with the H1N1 virus.

Want to help?

If you are interested in helping out in this response, contact your local health department or emergency management agency. They will point you in the direction where your assistance can be of most use. Some EMS levels could be able to administer the flu vaccine, depending on your medical director. Other staffing could assist in potentially filling the various roles that will be needed during this time.

In summary

Now is the time to prepare for the second wave of the H1N1 virus. First Responders will be very helpful for responding to such an emergency. Preparing local departments and personnel in being ready to handle such an event will help every citizen in their response area, county and state. If you have any further questions contact your local health department for more information.

David Hesselmeyer is an 11 year veteran of fire and EMS. He is currently serving as a lieutenant and President of the Board for Patetown Volunteer Fire Department in Wayne County and with Pitt County EMS as an EMT-Intermediate. He works as a Regional Preparedness Coordinator for the Public Health Regional Surveillance Team 3 in Fayetteville, which is a specialty emergency response team that responds to public health emergencies. He can be reached at [email protected] yahoo.com.
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