The second wave of H1N1 flu spreads

You have surely heard a lot about this. H1N1 flu has been reported as widespread in 37 US states, and across the country it has increased doctor visits, hospital stays and deaths.

From 30 August to 3 October, laboratories confirmed 3,874 flu hospitalisations and 240 flu deaths, and there were 12,384 hospital admissions and 1,544 deaths from flu-related pneumonia. Nineteen children died of flu, 16 of them with H1N1 and 3 with an unsubtyped influenza A virus.

As H1N1 cases keep rising, government health officials continue to urge the public to consider vaccination against both swine flu and seasonal flu. "Unfortunately we're seeing more illness, more hospitalisations and more deaths," said Dr Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, at a press conference. "The number of children who have died of swine flu has reached 76, more than died of ordinary flu all last year."

Schuchat addressed public concern about the new vaccine: "Some people have reservations about this vaccine and aren't sure about it." A recent Associated Press-GfK poll in October found that 72% of those polled were worried about side effects, although more than half said that wouldn't stop them getting the vaccine to protect their children, and 38% of parents said they were unlikely to let schools vaccinate their children.

"There's always someone who brings up Guillain-Barré," says Dr Wally Ghurabi, chief of emergency services at UCLA Santa Monica and Orthopaedic Hospital and a member of UCLA's H1N1 steering committee. Guillain-Barré syndrome is a nerve condition that was linked with the 1976 swine flu vaccine, but experts stress that the link was never clear, vaccine production has improved since then, and the vaccines are tested for contaminants that might explain it.

Ghurabi's advice to patients is to weigh the pros and cons and consider the risks: "If you're caring for a two-month-old baby, or you're pregnant, you are in the groups most at risk."

Officials say the H1N1 vaccine is made the same way as the seasonal flu vaccine that has been used for years. "This isn't a new vaccine," Schuchat says. "It's made exactly the same way as the seasonal flu vaccine; it's basically a vaccine against the H1N1 virus instead of the seasonal virus. Based on everything we know now, we expect a good safety record."

According to Schuchat, the federal government has bought 250 million doses of H1N1 vaccine at a cost of 2 billion dollars. As of Friday, the states and the District of Columbia had ordered 3.7 million doses, and 6.8 million were available, with production continuing, though it's hard to predict exactly when the vaccine will reach each community. The CDC recommends that high-risk groups get the vaccine first, including pregnant women, healthcare workers and people with chronic conditions such as asthma.