INFO - ACR: H1N1 virus: implications for rheumatology

[Guest guest]

American College or Rheumatology

Sep 2009

H1N1 Virus: Implications for Rheumatology

Excerpt:

Seasonal Influenza Vaccines: Seasonal influenza occurs in the U.S.

during the late fall to early spring period, and its associated

morbidity and mortality has led to recommendations to immunize

high-risk groups (children < 2 years of age, adults ≥ 50, patients

with a serious medical condition, and immunocompromised patients).

Groups at risk for transmitting the virus, including children < 18

years of age, healthcare workers, and household contacts of high-risk

groups, should also be vaccinated. Vaccination is recommended as soon

as the vaccine is available for the season (usually in September each

year), and a single dose is adequate. A live attenuated nasal vaccine

is available, but should not be given to those taking

immunosuppressive medications, or in contact with immunosuppressed

persons. The humoral response to influenza vaccine, while potentially

diminished, appears to be adequate for patients receiving biologic and

non-biologic DMARDs. There is also no evidence that vaccinating

patients on these medications leads to complications or worsening of

the underlying disease. Influenza vaccination is appropriate for

patients treated with both biologic and non-biologic DMARDs, and

concern over the level of response should not preclude this.

Novel Influenza (2009 H1N1) Strains: April 2009 brought the first

reports of a novel influenza A (H1N1) virus causing human infections.

Termed swine flu because this virus is endemic in pigs, it is distinct

from the human influenza A (H1N1) viruses previously in circulation.

Therefore, most individuals have no pre-existing antibodies to its key

surface epitopes. Several companies are developing vaccines directed

against this novel H1N1 influenza A and these will be available by

mid-October 2009. It appears that a single injection will be adequate

and will confer protection 8-10 days after vaccination. The vaccines

themselves are made using the same process used to produce seasonal

influenza vaccines, so that adverse reactions are not anticipated to

be any different. Seasonal influenza vaccine and H1N1 vaccine may be

administered at the same time. A live, attenuated H1N1 vaccine is

expected to be available, but its use should be subject to the same

restrictions as the seasonal live, attenuated influenza vaccine.

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http://www.rheumatology.org/publications/hotline/2009_09_29_h1n1.asp

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