Swine flu Q&A

We know that colds and flu are triggers for around 90% of people with asthma and that if they catch viruses during the colder months their asthma can get much worse. This can result in periods of prolonged illness or even hospital admissions.

As swine flu is a new virus that we know relatively little about, it is therefore extremely important for people with asthma to give themselves as much protection against the virus. Asthma UK therefore recommends that people with asthma take steps now to ensure that their condition is well-controlled, and that they have the swine flu vaccine when it becomes available.

What we do know about swine flu, is that it spreads easily and people will not have built up immunity to it as it is a new virus, unlike seasonal flu.  Having the swine flu vaccine will greatly reduce the chances of getting the virus but not remove them altogether. Exactly how much protection it will give is not yet fully known.

People who are concerned about having the vaccine should talk through the pros and cons with their doctor or asthma nurse.

A random sample of 192 people admitted to hospital due to swine flu has shown that 25% had asthma, 15% had heart disease and 10% had diabetes. However, among the under fives admitted to hospital - eight in 10 did not have any form of underlying health condition (data released October 2009)

Unfortunately some people who have caught swine flu have had underlying health conditions which have made them far less able to fight off swine flu than others.  

Of the deaths so far due to swine flu, we don’t know (and may not find out) how many people had asthma and none of the official Government reports on swine flu so far have highlighted asthma as a risk factor for death from swine flu.

Some research suggests that swine flu infects cells deep in the lungs, as opposed to seasonal flu which tends to infect cells in the upper respiratory tract. This could put people with asthma at a greater risk of becoming seriously ill with pneumonia, which is why it is important to get your asthma under control and to have the swine flu vaccine.

If you have been recovering from swine flu and your asthma takes a sudden turn for the worse, we advise you to seek immediate medical attention.

We don't really know whether people with asthma are at an increased risk of contracting viruses such as swine flu, but there are reasons to suspect that they may have a greater risk. It’s therefore advisable that people with asthma have the swine flu vaccine.

We do know that people with asthma who catch swine flu are more likely to suffer with serious breathing complications and be hospitalised than the general population, so it’s important that they take steps to keep their condition under good control. This includes using your preventer inhaler as prescribed if you have one, seeing your doctor or asthma nurse for your annual asthma review and getting a personal asthma action plan, which gives you information on what to do if your asthma gets worse and what to do in an emergency.

Yes people with asthma have been categorised as an at-risk group by independent experts and prioritised by the Department of Health. 

The at-risk groups have been listed as:

• People aged over six months and under 65 years in current seasonal flu vaccine at-risk groups (including people with asthma).
• All pregnant women (the timing may depend on the stage of pregnancy).
• Household contacts of people with compromised immune systems e.g. people in regular close contact with patients on treatment for cancer.
• People aged 65 and over in the current seasonal flu vaccine clinical at-risk groups. This does not include otherwise healthy over 65s, since they appear to have some natural immunity to the swine flu virus.

 This follows advice from independent experts on who should be first in line for vaccination. 

According to the Department of Health, pregnant women are more likely to catch swine flu as their immunity is suppressed and they are four times more likely to suffer serious complications if they catch swine flu or seasonal flu, so vaccination is essential.

The Joint Committee on Vaccination and Immunisation (JCVI) strongly recommends the use of the Pandemrix vaccine (manufactured by Glaxo Smith Kline) in pregnant women because it gives good protection from swine flu after one dose. 

Children with asthma have been identified as a priority group to receive the vaccine, so parents will be invited to get their children immunised from Monday 26 October. They are likely to be given the Pandemrix vaccine. 

Yes, regardless of whether a person with asthma has had a swine flu diagnosis, they are eligible to have the vaccine.

However, if you had swine flu and it was confirmed by a laboratory test, strictly speaking you will not need the vaccine as you will have developed some immunity against swine flu. If you are in doubt about whether you should have the vaccine, we advise you to have a discussion with your doctor.

It will not be harmful to have the vaccine if you have had swine flu and were not aware of it.

If you decide to be vaccinated against swine flu, a very tiny amount of inactive flu virus will be injected into your body, allowing it to build up a defence against the virus.  How effective this process will be depends on a number of things, including how alike the dose of injected swine flu is to the strain in your local community, how effective your body is at building up a response and when you decide to have the vaccine (having it as soon as possible will give your body more chance to develop a resistance to swine flu).

Flu vaccines have had an excellent safety record in recent years, with side effects being very uncommon.

The most common side effects with the Pandemrix swine flu vaccine are headaches, joint pain, muscle pain, soreness or redness at the site of the injection, fever and fatigue.

Side effects will be very carefully monitored and it’s highly likely that any small risks will be greatly outweighed by the benefits of vaccination among those in ‘at-risk’ groups such as people with asthma.

Flu vaccines are egg-based so anyone with anaphylaxis to eggs will need to have a discussion with their doctor over whether or not to have the vaccine. The Government is currently advising people with severe egg allergy including anaphylaxis to egg to have the vaccine known as Celvapan, manufactured by Baxter. People with less severe allergy to egg products are still advised to have the Pandemrix vaccine.

It’s unlikely that people with other allergies will have a reaction to the vaccine. However, if you have experienced severe allergic problems, it's probably best to discuss whether to have the vaccine with your doctor or asthma nurse.

Patients in hospital deemed at risk of contracting swine flu will be vaccinated from Wednesday 21 October. The main public vaccination programme will begin in GP surgeries on Monday 26 October. People in at risk groups, including those with asthma, will be among the first to have the vaccine.

A decision has yet to be taken over whether the rest of the population will be immunised, although the Government has ordered enough vaccine for the whole population.

Most people with asthma will be invited to their local GP surgery to have the vaccine, from Monday 26 October.

No, we advise people to have the seasonal flu vaccine as soon as they are invited to their surgery, as this will give your body more opportunity to develop immunity against seasonal flu.  You will then be invited to have the swine flu vaccine on a separate occasion.

Some surgeries, however, may invite people with asthma to have their seasonal flu jab at the same time as the swine flu vaccine. If this is the case, the vaccines will be given in different arms.

Anti-virals such as TAMIFLU can help to reduce the effects of viruses such as swine flu, including the severity and duration of the illness. When people with asthma receive a swine flu diagnosis, they should discuss the need for TAMIFLU with their GP or asthma nurse. It is important to start the treatment as soon as possible in order to get the maximum benefit. 

The most common side effects of TAMIFLU are nausea and vomiting. In rare cases,  serious skin reactions and allergic reactions have also been reported. You should stop taking TAMIFLU and call your doctor if you experience any of these reactions.

A.    There is no reason for the majority of people with asthma to avoid going
to work as most people who catch swine flu should only develop mild symptoms. Having the swine flu vaccine should also give you protection from catching the virus.

At work, people should continue to employ thorough hygiene control measures including regular hand washing. Anyone who does develop swine flu is urged to stay off work while they have flu symptoms as they will still be highly contagious to others.

Health professionals and carers will be among the first priority groups to get the swine flu vaccine, as this will give them added protection when in contact with people who have swine flu. This will also help to ensure that they don’t pose a risk to the people they are caring for and their families.

Children with swine flu are being asked to stay off school until they are well and have been fever free for 48 hours.  Schools may close in special circumstances but the majority are likely to remain open and functioning as normal, with an ongoing emphasis on regular hand washing, coughing and sneezing into a tissue and binning all used tissues.

It is vital that you go for your asthma review as normal to ensure your asthma is well-controlled during the colder months ahead. This will give you the best chance of protecting yourself from the effects of colds, seasonal flu and swine flu. Your GP or asthma nurse can also give you a personal asthma action plan which tells you what to do should your asthma get worse for any reason (including what to do if you catch swine flu).  

The National Pandemic Flu Service comprises a dedicated website and call centres which can quickly be accessed by people who have swine flu symptoms. The aim is to give access to antivirals as quickly and easily as possible to people who need them. Callers to the service will be told where their nearest antiviral collection point is. People can also find out where antiviral collection points are in their area on the National Pandemic Flu Service website at: https://www.pandemicflu.direct.gov.uk/CollectionPoints.aspx

People with swine flu symptoms should contact their doctor direct rather than using the National Pandemic Flu Service if:

• They have a serious existing condition which weakens their immune system, such as cancer;
• they are pregnant;
• they have a sick child under one year old;
• their condition suddenly gets much worse; or
• if their condition is still getting worse after 7 days (5 for a child).
  

The National Pandemic Flu Service website can be accessed at www.direct.gov.uk/pandemicflu.

People can also call 0800 1 513 100 or 0800 1 513 200 (Textphone) to check their symptoms.

People without swine flu symptoms who want to access general information about the virus should call the general swine flu information line on 0800 1 513 513 or visit the following websites:

• England - www.nhs.uk
• Northern Ireland - www.dhsspsni.gov.uk
• Wales - www.nhsdirect.wales.nhs.uk
• Scotland - www.nhs24.com

If you have any concerns or questions about the information provided above, you can speak to an asthma nurse in confidence on the Asthma UK Adviceline, on 0800 121 62 44.