Asthma and Swine Flu: What You Need to Know

Video: The H1N1 "Swine Flu" Virus

With the H1N1 vaccine becoming more widely available, news that asthma is the most common chronic medical condition found among people hospitalized for severe complications of H1N1 hits close to home for asthmatics and loved ones of people with the lung condition. Health experts say H1N1 data suggest that asthmatics need to be particularly cautious about avoiding the flu or managing it, as they are at higher risk for complications than the general population. What do they need to know? U.S. News consulted James Li, chairman of the Division of Allergy at the Mayo Clinic and coauthor of an article on H1N1 and asthma that was published this month in the Journal of Allergy and Clinical Immunology. Edited excerpts:

[Slide Show: 10 Do's and Don'ts to Protect Yourself From Swine Flu]

What do we know about asthma and the risk of H1N1 complications?
People who have asthma are at high risk for respiratory complications if they contract H1N1 influenza. Because of this, they should have an updated asthma action plan [which describes daily asthma treatment and how to control worsening symptoms] ready in the event that they do get sick.

Should all asthmatics get vaccinated against H1N1?
For the most part, yes. We recommend that patients with asthma get vaccinated, which we expect will reduce infections and thus reduce complications. They should get the injectable version of the H1N1 vaccine rather than the nasal version, which could trigger an asthma attack. Asthmatics should also get vaccinated against seasonal flu annually.

But there are some particular groups of patients who should not get H1N1 vaccinations, including those with egg allergies or those who've experienced a severe reaction to the seasonal influenza vaccine in the past. [In these situations, some people may still be able to get vaccinated after seeing an allergist to determine whether the dosage can be safely adjusted to avoid a negative reaction.]

What symptoms might asthmatics with H1N1 experience if they're having complications?
Two major complications that are seen in people with asthma are pneumonia and an asthma exacerbation. Symptoms of asthma exacerbation include increased cough, shortness of breath, and wheezing. A high fever, chills, and a productive cough would be more suggestive of pneumonia.

If a person is asthmatic and suspects he or she has H1N1, is it important to see a doctor immediately?
In general, if someone has asthma and thinks he or she may be coming down with an H1N1 influenza, my recommendation would be to call the doctor, because depending on severity of symptoms, if there is an asthma attack developing, that should be treated. Or, if there seems to be a rapidly progressive course of illness, such as problems breathing or an inability to hold down fluids, that could warrant hospitalization.

[Another reason to contact your doctor: The antiviral medication Tamiflu (oseltamivir) can help you get better faster, but it's available only by prescription. The antiviral drug Relenza (zanamivir) is not recommended for asthmatics because it carries a risk of breathing problems.]