A to Z of MS
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A to Z of MS Swine flu
Following the 2009/10 swine flu pandemic, the H1N1 virus is expected to be one of the main strains of seasonal flu in 2010/11. In view of this, health officials announced that the seasonal flu jab would protect against three strains of flu, including seasonal and swine flu.
The following information aims to answer the most commonly asked questions about swine flu in relation to the risks, symptoms, potential interaction with disease modifying drugs, and vaccination.
Multiple sclerosis and swine flu: questions and answers
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?
During the roll out of the swine flu vaccination programme last year, the UK government identified people with chronic neurological disorders - including multiple sclerosis - among the priority groups for the swine flu vaccination.
The seasonal flu jab now protects against three strains of flu including swine flu. Although MS is not listed in the clinical risk groups who should be offered a flu vaccination, the Department of Health's guidelines say that "GPs should take into account the risk of influenza infection exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from influenza itself... GPs should consider on an individual basis the clinical needs of their patients including individuals with multiple sclerosis."
I am on a disease modifying drug treatment (Avonex, Betaferon, Copaxone, Extavia, Rebif, Tysabri): 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 flu vaccination?
The side effects of the flu vaccination include 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.
Do I have to have the 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 a disease modifying drug: 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.
I am on a disease modifying drug 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 treatment until you are fully recovered to avoid the risk of further complications.
I am on a disease modifying drug, should I carry on with it?
The disease modifying drugs 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 a disease modifying drug: 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 disease modifying drugs. There is no data on the combination of these specific antivirals with the disease modifying drugs 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?
I have MS: what can I do to minimise the risk of getting swine flu?
Follow the current guidelines at NHS Choices website
- Ensure you wash your hands regularly
- Clean surfaces regularly to get rid of germs
- Use tissues to cover your mouth and nose when you cough or sneeze
- Put used tissues in a bin as soon as possible