Despite a huge amount of information about the H1N1 virus, Canadians still have questions about diagnosis, treatment and how to best respond.
Join André Picard, The Globe and Mail's public health reporter, as he answers a question a day from readers about the pandemic.
Come back daily for all the answers and leave your questions here using the Globe's comment function.
Questions from Nov. 3 to Nov. 6:
Friday, Nov. 6:
Q: My three-year-old daughter got the flu two weeks ago. The doctor said it was H1N1 but it was not confirmed because the region doesn't do routine testing. My husband and I did not get sick. How can this be? We took no special precautions. Now we're wondering: Should we get the vaccine or are we immune to this flu?
A: You have raised several interesting issues related to H1N1 and vaccination. First, about 90 per cent of all the flu cases in Canada today are caused H1N1. There is very little seasonal flu so far. That's why doctors assume that cases of the flu are H1N1. Testing everyone is not considered a good use of resources.
Second, there is a common assumption that everyone exposed to the H1N1 virus will get the flu. In fact, the large majority of people exposed to the virus will not get sick.
Even though you were in close contact with someone sick with swine flu, healthy young adults like yourselves have powerful immune systems that fight off a constant barrage of pathogens. When you are exposed to a virus, your body will produce antigens and develop immune resistance. In some people, this happens with very few disease symptoms; others will get quite sick. A vaccine does the same thing by tricking the body into thinking it is being exposed the virus.
Many people argue that there is no need to be vaccinated, that we should depend on our immune systems and bolster them with good nutrition. That is a bit of a gamble.
With H1N1, a new strain, it is anticipated that about one-third of the population will get sick. To date, it is estimated that about five per cent of Canadians have fallen ill with H1N1, so a lot more sick people are expected in the coming months.
While it is true that most cases of the flu are "self-limiting" - meaning you get better with rest and fluids, in rare instances people can get gravely ill and die. Again, the risk of complications is greatest in those with weaker immune systems - babies, children, people with chronic health conditions - but some healthy people will get severe illness.
So far in Canada, 1,779 people have been hospitalized with H1N1, including 351 who ended up in intensive care and required ventilators. There have been 92 confirmed deaths.
That is why public health officials recommend that everyone by vaccinated unless they had a laboratory-confirmed case of H1N1. That would include you and your daughter. Even if you have immunity to H1N1, the vaccine will do no harm.
Q: In the online posts, many comments suggest that journalists like yourself are queue-jumpers who use their insider knowledge to get the vaccine. Are you brave enough to answer honestly?
A: I am in the risk category healthy adults aged 18-65. I live in Montreal. I am eligible to receive the H1N1 vaccine after Dec. 7, and so I will get my shot some time after that date. Then I will get my seasonal flu vaccine.
Thursday, Nov. 5:
Q: Why aren't teachers and daycare workers considered "high-priority" for the H1N1 vaccine? Teachers are in daily contact with children (and sick children). Also, many teachers are in their childbearing years and lots of them get pregnant. I don't understand why teachers aren't at the front of the line for vaccination.
A: When outbreaks of infectious disease occur, schools and daycare centres are invariably among the places hit first and hardest. Children are virtual microbe-spreading machines and teachers know this well - they tend to get every bug out there. By virtue of being in contact with large groups of children, teachers at relatively high risk of contracting H1N1.
However, the priority groups for vaccination are not those at highest risk of contracting the disease, but those at highest risk of suffering complications and dying if they are infected. This in an important distinction.
The priority groups are:
- People under 65 with chronic health conditions;
- Pregnant women;
- Children aged six months to five years of age;