We've been fielding a lot of calls about the flu this fall—and understandably so! Along with the seasonal flu, there's now the universal worry over the flu caused by the H1N1 virus. Often called the “swine” flu because it’s common in pigs, this virus first started getting humans sick in April 2009. Our bodies had never been exposed to this particular virus before, and therefore had no experience in fighting it off.
Those most at risk for infection and complications from the seasonal flu virus are also those at risk for problems with the H1N1 virus—such as people with multiple chronic medical or systemic inflammatory illnesses like lupus, or those taking medicines such as prednisone that dampen (lower) immune system activity.
We asked leading lupus doctor Richard Furie, MD, to answer some of the most common questions we've gotten so far. Dr. Furie is chief of the division of rheumatology and allergy-clinical rheumatology at North Shore–LIJ Health System in New York.
Q. I have lupus. Should I get the seasonal flu shot—as well as the H1N1 shot?
A. If you have lupus, you should strongly consider getting the seasonal flu vaccination, as well as the H1N1 vaccination-as long as neither is in the form of a “live attenuated nasal vaccine.” There are safer forms for you to get. Both vaccinations can be given at the same time, but don't have to be. A single shot against the H1N1 virus appears to provide protection starting 8 to 10 days later. (Note that since these vaccines are made in chicken eggs, you shouldn't get it if you are by chance allergic to eggs.) It’s also a good time to ask your doctor about getting the pneumonia (pneumococcal) vaccine to protect against this dangerous type of bacterial infection—I suggest that vaccine to many of my patients with lupus.
Q. What else should I do if I have lupus, to protect myself from getting infected with either the seasonal or the H1N1 flu virus?
A. Experts believe that the seasonal and H1N1 flu viruses are spread in the same way—primarily from person to person through coughing or sneezing. Sometimes a person can get infected by touching a surface or object that has the droplets of the virus on it, and then touching their nose or mouth. So follow the basics of prevention—wash your hands thoroughly with soap and warm or cold water (or an alcohol-based hand rub) before touching these areas of your body (or eating), and keep your distance from people who may be infected!
Q. What should I do if I think I have the flu?
A. Since antiviral medicines should be taken within 48 hours in people who are at high risk for complications-which includes people with lupus, or who are taking medicines that suppress the immune system—call your doctor right away if start to feel sick with some or all of the following flu symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, fatigue, chills, diarrhea and vomiting. Then wait for 24 hours to pass after your fever has stopped (on its own, without medicines) before going to work or school, or traveling.