I want to spend the next few weeks trying to bring you up to date on the most current information concerning swine flu, which is now being referred to by the experts as the H1N1 virus.
Influenza is almost unheard of during the summer months, but we are experiencing quite a few cases in every state of the United States, as well as in most countries throughout the world.
Santa Cruz County has seen proven cases of influenza this summer caused by H1N1. Most cases have been relatively mild. It seems that H1N1 is so far no worse than the regular flu that occurs each winter season. That’s the good news.
The bad news is that I believe, as do many experts in the field, that we could possibly see a worldwide epidemic — a pandemic — of H1N1 beginning this fall. The worst-case scenario could rival the flu pandemic of 1918, during which 650,000 Americans died and there were 50,000,000 deaths around the world.
But we must also realize that 36,000 people die in the U.S. each year during a typical flu season.
I repeat, a pandemic occurring this year as we had in 1918 is only a theoretical possibility. This year’s flu season could be no worse, or even less dangerous, than usual.
Leading scientists agree that influenza viruses are very unpredictable. Therefore, there is no way to predict which of the various scenarios we will see this year. It could be serious or not. Time will tell, but I believe it is better to be prepared.
One method of preparation is through widespread vaccination programs. Most people will need one shot for the regular seasonal flu and another one (possibly two) shots for swine flu. The regular seasonal flu vaccine may be available as early as September, and it is recommended that people get this vaccine as soon as possible. The swine flu vaccine, which is on a crash development program, may be available as soon as October.
Unfortunately, both vaccines cannot be combined into one shot. They may, however, be given as two separate shots on the same day.
Because quantities of vaccines may initially be limited, some form of prioritizing will be necessary. The Center for Disease Control and Prevention has made the following recommendations as to who should be immunized.
Regular seasonal influenza:
• Health care providers
• People age 65 and older
• Pregnant women
• Those with chronic health or immune diseases
H1N1 swine influenza:
• Health care providers
• Pregnant women
• People who live with or care for children younger than 6 months of age
• People between the ages of 6 months and 24 years
• Those with chronic health or immune disorders
Once the demand for vaccine for the above priority groups has been met, and if there is still sufficient vaccine available, then all people who remain may be vaccinated.
One bit of good news regarding swine flu is that people age 65 and older seem to have a greater immunity to it than to the normal flu.
Subsequent columns will deal with what treatment may be available if an outbreak begins, how to prepare yourself and your home for a severe flu epidemic, and how medical providers and hospitals would likely cope with a flu pandemic.
• Terry Hollenbeck, M.D., is an urgent-care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley. A doctor with 36 years’ experience, he invites readers to view all of his previous articles at his Web site, valleydoctor.wordpress.com. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.

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