BRYGGEKLINIKKEN AS D o c S i d e - august 2009
H1N1 (New Influenza)- also known as ”swine flu”
The name “swine flu” is both stigmatising and misleading. As a result the Norwegian healthauthorities (and WHO) has now designated the condition as “new flu”. This is supported byus here at Bryggeklinikken, and we furthermore support the guidelines published by theNorwegian health authorities at www.pandemi.no (available in English).
The vaccine for “new-flu” will most likely be ready for common use by the end of November. Apart from simple measures such as washing ones hands regularly and using Tamiflu (in caseof infection), there is little to be done to prevent infection and spread. We would, howeverlike to highlight a few points that are worth keeping in mind; Hand washing should beperformed regularly (soap and water is just as effective as commercially availabledisinfectants). It is not necessary to “shake hands with everybody”. And in case of coughing/sneezing, one should use a paper towel / handkerchief or try to cough/sneeze into the inside ofones elbow. Furthermore it is important that persons thought to be infected are isolated. Thismeans staying at home for about a week and avoiding all unnecessary contact with non-infected individuals.
It is obvious that the doctor’s office in itself could represent a substantial risk factorconcerning further spreading of the disease. We here at Bryggeklinikken would like to avoidthis as far as possible. As a result we have established a routine with “treatment pertelephone”. This means that we will prescribe Tamiflu and offer a sick leave certificate forthose of our patients contacting us per telephone, that have a fever of 38,5 C, headache, upperairway symptoms and typical aching pain in bones and joints. In other words, typicalinfluenza symptoms.
Treatment with Tamiflu must be initiated within 48 hours after symptom onset to be effective(length of treatment is 5 days). Drawing blood for testing is no longer required, as it takes 5-7days to get a reliable result from the laboratory and a positive test has few clinicalimplications. Prophylactic/preventive therapy with Tamiflu is not recommended as one is justas likely to be infected when it is discontinued and the pandemic is likely to last for months.
There are many conditions that might be mistaken for influenza, but these often present withmore focal symptoms, such as isolated upper airway problems (sore throat etc.), urinary tractinfections, skin manifestations and stomach problems etc. In such cases we will, of course,offer to see the patient as soon as possible. In cases where patients experience a new bout offever, after the initial infection, the same is valid. But remember; “No influenza withoutfever”. To “think” that you have a fever is no reliable scale, therefore we recommend ourpatients to buy an electronic thermometer (available at drugstores/ pharmacies).
Some patients will experience falling ill with influenza twice during the coming six months,first with the “new-flu” and then with the ordinary seasonal flu. It is important to point outthat the two viruses are not the same (although in the same family) and that antibodies formedagainst the “new-flu” will not offer protection against the “normal-flu” and vice versa. Thevaccine for seasonal flu will be available in September/October and we recommend this to allour patients. When the vaccine against the “new-flu” is ready for use by the end of this year,we will probably recommend this to those patients not already infected (and henceimmunized).
Organisasjonsnummer: Adresse: Teleforbindelse:945 918 497 Post: Pb 1912 Vika, 0124 Oslo Besøk: Vika Atrium, Munkedamsveien 45 E-Mail: [email protected]
OPT: 17-MONTH EXTENSION INSTRUCTIONS & REQUEST FORM Definition: The 17-Month Extension is an extension of the period of post-completion optional practical training (OPT) from 12 months to a total of 29 months for eligible F-1 students. The 17-month extension is allowed once per lifetime. Deadlines: Application must reach UCSIS prior to the end date listed on the EAD
Consigned by Flacco Family Farms, LLC, Alexis, IL BROWN FILLY; Foaled February 6, 2011; Brand 4J944 BANDS GIANT STAR Wall Street Banker 3,1:57.4Sr. Anthonita 4,1:58.1f By BAND'S GOLD CHIP 2,2:00.3; 3,1:53.4 ($241,649) by Pine Chip 4,T1:51. Sire of SPREAD THE CHIPS (M) 3,1:55.2, M L BROWN SUGAR 4,1:56.4f, HALLS OF GOLD 3,1:57.2, SPECIALITY TRAINING 2,1:57.4, BAND STAR 2,1:58.1, FRAH