A to Z of MS Swine flu
The NHS Choices website reports that whilst the risk profile of the swine flu virus is still being studied, it is already known that certain groups are more vulnerable. This includes people with chronic neurological conditions including MS.
The following information was written in conjunction with neurologists and MS specialist nurses to answer the most commonly asked questions about swine flu in relation to the risks, symptoms, potential interaction with disease modifying drugs, and vaccination.
MS and swine flu: questions and answers
- I have MS: am I at more risk of getting swine flu?
- I have MS. Should I be vaccinated against swine flu?
- Which of the two swine flu vaccinations is recommended for people with MS?
- I am on a disease modifying drug treatment (Avonex, Betaferon, Copaxone, Extavia, Rebif, Tysabri [DMTs]): is it safe for me to have the vaccination for swine flu?
- What are the side effects of the swine flu vaccination?
- Can I have the swine flu vaccination at the same time I receive the seasonal flu vaccination?
- Do I have to have the swine flu vaccination?
- I have MS and think I might have swine flu. I am NOT on DMTs: what should I do?
- I am on a DMT and I think I might have swine flu: what should I do?
- I am on a DMT, should I carry on with it?
- I take paracetamol for my flu-like symptoms: can I increase the dose if I get swine flu?
- I am on other medication for my MS symptoms: should I continue with them?
- I am on DMTs: is it safe for me to have antivirals?
- How will I know if it is swine flu or a relapse?
- I have MS and am pregnant: what should I do?
- I have MS: what can I do to minimise the risk of getting swine flu?
I have MS: am I at more risk of getting swine flu?
Your risk of contracting the swine flu virus is the same as it is for everyone. For most people, unpleasant though it is, swine flu is not serious and can be managed at home.
Some people with MS will be at greater risk of complications from having swine flu. Those who have limited mobility and other health problems such as asthma or heart problems will be at the greatest risk.
I have MS. Should I be vaccinated against swine flu?
The UK government has identified people with chronic neurological disorders -including MS - among the priority groups for the swine flu vaccination. However, GPs will consider the clinical needs of their patients on an individual basis in making recommendations about vaccination.
Which of the two swine flu vaccinations is recommended for people with MS?
There are two different swine flu vaccinations: Pandemrix and Celvapan. It is safe for people with MS to receive either of these vaccinations but your GP may need to consider your personal circumstances/treatment history in making a recommendation for vaccination.
Pandemrix is prepared using hens' eggs in the same way that seasonal flu vaccinations are prepared. People who have egg allergies should not be given this vaccination. Celvapan is not prepared using eggs. Porcine (pig) proteins are involved in the manufacture of Celvapan but are not present in the finished product.
I am on a disease modifying drug treatment (Avonex, Betaferon, Copaxone, Extavia, Rebif, Tysabri [DMTs]): is it safe for me to have the vaccination for swine flu?
Experience with other vaccines suggests it is safe but there is no available data on the effects of this vaccination in the MS population as yet.
If you receive a swine flu vaccination, avoid having it injected into any pre-existing injection site reaction. Following vaccination, do not use the same injection site for your disease modifying drug until any localised injection site reaction has subsided.
What are the side effects of the swine flu vaccination?
The side effects of the swine flu vaccination are similar to those experienced with the seasonal flu vaccination including redness, soreness and swelling at the site of injection. Flu vaccines can also cause symptoms such as fever, headache and muscle aches, but are much milder than flu itself and usually pass after a day or two.
Can I have the swine flu vaccination at the same time I receive the seasonal flu vaccination?
The swine flu vaccination does not protect against seasonal flu as the virus is a different strain. If you would usually receive the seasonal flu vaccination it is important that you continue to do so. It is safe to receive the two vaccinations at the same time.
Do I have to have the swine flu vaccination?
Vaccination is not compulsory. As with all vaccinations, everybody retains the right to refuse it. If you have concerns about the safety of the vaccination itself then you should discuss these with your GP.
I have MS and think I might have swine flu. I am NOT on DMTs: what should I do?
Stay at home and inform your GP. Although most cases of flu can be managed at home you may be at risk if you have impaired mobility or other health problems. You will be given antiviral treatment as soon as possible. If someone in your family has flu you will also be given antiviral treatment.
For more information, visit the National Pandemic Flu Service website
I am on a DMT and I think I might have swine flu: what should I do?
Inform your MS specialist team if you think you may have swine flu. You may need to stop your DMT until you are fully recovered to avoid the risk of further complications.
I am on a DMT, should I carry on with it?
The DMTs do not increase the risk of contracting the swine flu virus. However, people receiving immunosuppressants, such as mitoxantrone, are at an increased risk of contracting infections and viruses such as swine flu.
I take paracetamol for my flu-like symptoms: can I increase the dose if I get swine flu?
The recommended daily dose for paracetamol is 1000mg every 4-6 hours (ensuring you do not exceed the maximum daily dose of 4000mg). You must not exceed this dose. Talk to your medical and nursing team about symptom relief.
I am on other medication for my MS symptoms: should I continue with them?
Continue taking your regular medication for managing symptoms. Steroids and immunosuppressants such as mitoxantrone may increase the risk of infection. Talk to your MS specialist team about any temporary discontinuation of immunosuppressants or steroid treatment.
I am on DMTs: is it safe for me to have antivirals?
The use of antivirals such as Tamiflu and Relenza is thought to be safe for people also receiving DMTs. There is no data on the combination of these specific antivirals with the DMTs but there is a very small theoretical risk of drug interaction. There would therefore need to be a risk-benefit decision by the prescriber in conjunction with the patient, based on individual circumstances.
How will I know if it is swine flu or a relapse?
The most common symptoms of flu are a fever (high temperature), sore throat, diarrhoea, headache, dry cough and feeling generally unwell. High fevers can lead to a temporary worsening of MS symptoms. A relapse is a sudden deterioration of previous MS symptoms or new MS symptoms that persist for at least 24 hours without a raised temperature.
I have MS and am pregnant: what should I do?
Follow the current guidelines available for pregnant women on NHS Choices website
I have MS: what can I do to minimise the risk of getting swine flu?
Follow the current guidelines at NHS Choices website
- Wash your hands regularly
- Keep surfaces clean
- Use a paper tissue if you cough or sneeze and dispose of it immediately
- Do not use any type of facemask
- Avoid contact with anyone who has got flu
- Avoid getting very stressed or run down. This could lower your immune response
- Eat a healthy diet
- Consult your doctor before taking any additional supplements or alternative therapies
- Have a plan of action and support in place in the event of getting flu
- Consider receiving the swine flu vaccination
Last reviewed: 16 February 2010
If this information doesn't answer your questions, please email the MS Trust Information Service or ring us on 01462 476700.
