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The Asthma Section

H1N1 (Swine Flu) and Asthma

Just before the arrival of the second wave of H1N1 (swine flu), The Canadian Lung Association convened an expert panel to offer advice to the public, including specific suggestions for those with asthma. The main message from the four doctors on the panel was clear: do everything you can to make sure your asthma is under control, and take simple measures, such as proper hand washing, to slow the spread of the virus.

“We don’t know what the attack rate will be,” said Dr. Ken Scott, director of pandemic preparedness at the Public Health Agency of Canada. However, his department is preparing for the worst.

A new vaccine against H1N1 is now available and being distributed to medical clinics in Canada, with 3.5 million doses available each week. Dr. Darcy Marciniuk, a respirologist in Saskatoon, urged those with lung disease not to delay getting the shot once it is locally available.

Following is a helpful Q&A for those with Asthma

Q. Are any drugs used to treat H1N1 of concern for me if I have asthma?

A. A doctor may prescribe an anti-viral medication for two reasons: first, if you have the flu, to reduce your symptoms; and second, as a “prophylaxis”, which means, to reduce the likelihood that you will contract the virus. (This would likely be to stop the spread of the flu in a closed setting, such as a hospital.)

The two anti-virals that are available are called Relenza and Tamiflu. Tamiflu is taken orally, while Relenza is an inhaled powder. The makers of Relenza caution those with asthma that the drug has caused exacerbations in some people with the condition. They say if you take Relenza to make sure you have your reliever puffer on hand.

Dr. Darcy Marciniuk, a respirologist in Saskatoon, says it’s unclear whether the complications for those with asthma have been limited to people who don’t have their asthma under control. He says he would make sure the person he is prescribing the drug to has good control of their asthma, and if needed, the person could take the first dose in the doctor’s office.

Tamiflu could also be used if available, as there have been no reports of complications with this drug in people who have asthma.

• More information from Public Health Agency of Canada of the use of anti-virals. here
• GlaxoSmithKline’s advice on Relenza for people with asthma.

Q. Am I more likely to get H1N1 because I have asthma?

A. People with underlying diseases such as asthma are not necessarily more susceptible to contracting H1N1. However, they are more likely to have serious complications from the flu – as it could exacerbate the asthma.

For that reason, people with asthma should make sure they have their disease under control and to take their medication regularly. It’s a good idea to have an “asthma action plan” that will tell you what to do if you start to have flu symptoms. Talk to your doctor about filling one out now, before flu season hits.

Click here to get an Asthma Action Plan.


Q. If my child can’t get the vaccine, can he or she still be protected from H1N1?

A. If your child is unable to receive the H1N1 vaccine for health reasons, there are other measures that can be taken to protect him or her from contracting the flu, says Dr. Sharon Dell, an expert in airway diseases at the Hospital for Sick Children in Toronto. For one, she suggests that if all the other members of the child’s family get the vaccine, then that would provide some protection. Furthermore, “meticulous hand washing” and avoiding contact with other people who are sick will also help.

If the child has reacted to a previous vaccine, but it’s unclear what the cause of the reaction was, he or she could be tested to this particular vaccine first, and could receive the vaccine if there’s no indication of reaction.

Next Page: General Questions

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Allergic Living acknowledges the assistance of the OMDC Magazine Fund, an initative of the Ontario Media Development Cooperation.