2009 H1N1 Flu Information for People with Disabilities and Their Caregivers or Personal Assistants

• 5 Things People with Disabilities Need To Know About the Flu
• 5 Things Caregivers of People with Disabilities Need To Know About the Flu

The term “disability” refers to limited physical or cognitive capacity. It includes people with neurological and neuro-developmental conditions, such as disorders of the brain, spinal cord, peripheral nerve, and muscle (e.g., cerebral palsy, epilepsy/seizure disorders, stroke, intellectual disability/mental retardation); moderate to severe developmental delay; muscular dystrophy; and spinal cord injury. These chronic conditions interfere with functional capacity. Disability also includes people with other chronic health conditions that interfere with functional capacity.

People with certain types of disability have a higher risk of getting flu-related complications, such as pneumonia. Some physical disabilities can affect how well your body fights off infection. People with conditions that affect their immune system, which controls how well your body fights off infections (including chronic and respiratory diseases) are at increased risk for getting more severe illness and requiring hospitalization.

Other disabilities are cognitive in nature.  Cognitive conditions can lead to challenges in processing information and making decisions. Cognitive disabilities may affect implementation of prevention measures, such as follow through with hand washing, cough and sneeze protection, self-monitoring of illness, and ability to avoid contact with people who are sick.

If you have one of the disabilities listed below, you may be at increased risk of becoming infected or having unrecognized illness.  You should discuss your risk of illness with your healthcare provider.Disability groups at risk of getting flu and/or having unrecognized flu symptoms include:

• People who have limited mobility or who cannot limit coming into contact with others who are infected, like staff and family members
• People who have trouble understanding or practicing preventive measures such as hand washing
• People who may not be able to communicate symptoms of illness
• People who may not be  monitored closely for symptoms of illness

The symptoms of 2009 H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1, and have respiratory symptoms without a fever.

The flu is spread from person-to-person, mostly through coughing or sneezing. You can take simple actions to protect yourself and others from getting the flu:

• Get a seasonal flu shot now and the 2009 H1N1 flu shot as it becomes available.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. If soap and water are not available, use an alcohol-based hand rub.
• Avoid touching your eyes, nose, and mouth. Germs spread this way.
• Try to avoid close contact with sick people.

If you get sick with flu-like illness:

• Contact your health care provider. Your health care provider can determine if you need to be treated with antiviral medication.
• Keep away from others as much as possible to keep from making them sick. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone without the use of a fever-reducing medicine.

Yes.  A vaccine for the 2009 H1N1 flu has been developed and is becoming available.  Groups prioritized for initial doses of influenza vaccine based on their risk of developing severe disease include  (see also http://www.cdc.gov/h1n1flu/vaccination/vaccine_keyfacts.htm):

• pregnant women,
• persons who live with or provide care for infants aged <6 months (e.g., parents, siblings, and daycare providers),
• health-care and emergency medical services personnel,*
• persons aged 6 months--24 years, and
• persons aged 25--64 years who have medical conditions that put them at higher risk for influenza-related complications. Chronic medical conditions that confer a higher risk for influenza-related complications include chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, cognitive, neurologic/neuromuscular, hematologic, or metabolic disorders (including diabetes mellitus) or immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus).
  

Providers of home and community-based health-related services (personal care attendants, direct support staff, paraprofessionals, itinerant therapists and others providing ADL support) who have close and consistent contact with people with disabilities and those providing healthcare support services in day and residential programs for people with disabilities should be considered in the same priority as ‘health care personnel’.

CDC recommends seasonal influenza vaccine for anyone that wants to reduce their risk of seasonal flu.  The vaccine is especially important for persons at increased risk of severe influenza and for caregivers and close contacts of high risk persons, including certain persons with disabilities such as those described above. For more information about influenza vaccines, please see  "Key Facts About 2009 H1N1 Flu Vaccine".

There are some things you can do to prepare yourself or the person to whom you provide care for this flu season:

• Plan what you will do if you or your caregiver gets the flu. Create a contact list of local family, friends, and local service agencies that can provide support in case you or your caregiver becomes ill or unavailable. 
• Plan at least two ways of communicating from home and work that can be used rapidly in an emergency (e.g., land-line phone, cell phone, text-messaging, email).  Write down this information and keep it with you.
• Ask your health care provider or pharmacist about possible drug interactions and side effects of your regular prescriptions with flu-related medications.
• Plan for and stock extra supplies of medicines and medical equipment if you or the person you care for uses them.  Make a photocopy of prescriptions, as  this may help in obtaining medications in an emergency situation.

• Avoid contact with others. You should stay home and avoid travel, including not going to work or school, until at least 24 hours after your fever is gone except to get medical care or necessities. Your fever should be gone without using fever-reducing medications.
• If you leave the house to seek medical care, wear a facemask, if available and tolerable, and cover your coughs and sneezes with a tissue.
• Do not stop taking any medicine you take unless told to do so by your physician.
• Contact your health care provider to discuss the need for antiviral medication. Treatment is most effective if given early.

• H1N1 Flu:  General Information
• CDC’s Take 3 Strategy
• Flu Shot Locator
• Additional information for caregivers