Influenza can be unpredictable, as evident this year with the emergence of a novel strain of virus now referred to as 2009 H1N1 flu. Originally referred to as the "swine flu" because testing revealed similar genes to the flu virus that normally occur in swine.

Further study has shown that this new virus is a combination of swine, avian and human genes never before encounterd by humans. That is why we have no natural immunity or protection against this virus.

The seasonal influenza vaccine developed for this year's expected flu will not provide protection against the new 2009 H1N1 flu virus. You still need to get a seasonal flu shot, because we could still see strains of the predicted seasonal flu in the late fall and winter months to come.

How severe is 2009 H1N1 illness?

Illness has ranged from mild to severe. Most healthy people will recover without needing medical treatment. People under the age of 25 have had the most infections with 2009 H1N1.

Relatively few cases of 2009 H1N1 have been seen in people 65 or older, which is unusual when compared to seasonal flu. If you do get sick with fever above 100 F and a cough or sore throat, runny nose, body aches and fatigue, you need to stay home from work, school and public places to avoid contact with other people. Stay home for at least 24 hours after your fever is gone without the aid of fever reducing medications. Seek medical care if you are in a high-risk group or have severe symptoms that warrant emergency care.

People at high risk for flu-related complications include pregnant women, children younger that 5 and people 65 and older. Anyone with cancer, lung disease, diabetes, heart disease, kidney, liver or neurological disorders or weakened immune systems may also be at increased risk for complications. If they develop flu like symptoms, they should call their health care provider to get advice about seeking medical care.

When is it an emergency to seek care for flu symptoms?

Emergency rooms in hospitals across the country have been overwhelmed with patients seeking medical care for influenza that does not require this advanced and expensive type of care or treatment. There are some common emergency warning signs that should signal anyone to seek medical care urgently.

For children these symptoms include fast breathing or trouble breathing, bluish skin color, not drinking enough fluids, not waking up or not interacting, being so irritable that the child does not want to be held, flulike symptoms improve but then return with fever and worse cough or fever with a rash.

For adults, be alert for difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion or severe or persistent vomiting.

If you are sick enough to seek emergency medical care, notify the first health care person you encounter so you can be provided with a mask, tissue, hand sanitizer and moved to an area to reduce the potential spread of influenza to other patients. Limit the number of family or friends you bring with you to reduce flu exposure opportunities. They may be asked to wear a mask as well.

Are there medications to treat the flu?

There are prescription drugs called "antivirals" that can treat influenza illness including 2009 H1N1. The priority use for these medications this flu season are people who are hospitalized with severe illness and sick people who are at increased risk of serious influenza related complications.

Prevention

To protect yourself from 2009 H1N1 there are everyday actions you can take to help prevent the spread of influenza and other viruses. Cover you nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after use. It is estimated that flu germs can live in tissues for 2 to 8 hours.

Wash or use hand sanitizer after handling tissues and secretions. Avoid touching your eyes, nose and mouth. Avoid close contact with ill people if possible. Stay home if you are sick.

Be prepared with these in case you get sick and need to stay home for several days; a supply of over-the counter medicines, hand sanitizer, tissues and don't forget the chicken soup. Face masks may be useful if you must make trips out in public while you are sick and contagious.

Vaccine

A vaccine is currently being produced and will be available in limited quantity some time in October. The CDC recommends people at greatest risk of getting sick or having serious complications, those likely to come in contact with 2009 H1N1 and those who could infect young infants receive the vaccine first. As supply and availability increase, so will the groups targeted to be vaccinated.

For more information, go to the Centers for Disease Control and Prevention Website at www.cdc.gov/h1n1flu/ or call 800-CDC-INFO, or the Missoula City County Health Department website at www.co.missoula .mt.us/Health/ or call the Public Health Hotline at 258-INFO.

Tammy Powers is a registered nurses and the Infection Control Coordinator at St. Patrick Hospital and Health Sciences Center.