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.
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
Q. What can I do to prevent the spread of illness?
A. Following are some precautions to take from the Centers for Disease Control:
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
Q. Should I take my child to a “flu party” to expose him or her to the virus now, before it gets worse in the fall and winter?
A. It is not a good idea to deliberately expose anyone to the H1N1 virus. According to Dr. Ken Scott, director of pandemic preparedness at the Public Health Agency of Canada, while most people who have contracted H1N1 have had relatively mild illness so far, “this particular virus has been causing significant and severe illness in previously healthy people between the ages of six months and 50 years.”
While no one should try to purposely contract this flu, it’s especially important that people with underlying conditions such as asthma do everything possible to avoid becoming sick as it could exacerbate the asthma.
Q. Should I or my child wear a mask?
A. While it’s important to take steps to avoid spreading the H1N1 virus, wearing a mask is not recommended or needed. First, a mask gives a false sense of security, and “there’s no evidence that wearing these masks will actually make any difference in terms of whether you actually acquire influenza virus or not,” says Scott of the Public Health Agency of Canada.
Instead, to avoid catching and spreading the virus people should wash their hands properly and often, eat well and get enough sleep, and if you are sick, stay home from school or work.
However, if you are caring for a sick child at home, it may be prudent to wear a mask.
- Vaccine, Anti-Viral Ingredients  – What they contain.
- Health Canada Info  – Full product leaflet on the vaccine.
- AL’s December H1N1 Update  – Quebec Study Looks for Egg Reactions.
- H1N1 and Allergies  – All about the vaccines and food allergies, other allergies.
- Discuss H1N1 Concerns  – See what others have to say on the Forum.
- Warning Signs of Severe Flu  – From The Lung Association of Canada.
- Pregnancy and H1N1 virus  – from the Public Health Agency of Canada.
- CDC Resource Center  – All About the H1N1 flu, the vaccine, actions to take.
- Taking Care of the H1N1 sufferer .
- CDC on medications .
• H1N1 media call with experts, organized by The Lung Association of Canada .
• Websites linked above.
• Centers for Disease Control and Prevention (CDC) .
• E-mail interviews with Dr. Wade Watson and Dr. Michael Cyr.