Updated H1N1 (swine) flu advisory for persons with lupus

The precautionary recommendations for the H1N1 (swine) flu in persons with lupus currently are not different from those for the general public, according to the Lupus Foundation of America (LFA). However, because persons with lupus often are at increased risk for infections, especially if they are taking immunosuppressive agents, they should be particularly vigilant about taking the generally recommended precautions.

The LFA recently revised an earlier notice about swine flu concerns that persons with lupus may have with updates on clinical trials for a potential H1N1 vaccine, the results of which are expected in September. The trials are using an inactive vaccine that should be safe for persons who have autoimmune diseases, the LFA emphasized, and if early evidence suggests that the vaccine is safe, similar trials will be started in children. The trials are scheduled to be conducted over weeks instead of months so that the vaccine’s safety might be assessed in time for its release to be approved in the fall, before the virus may spread widely in the general population.

To manage lupus effectively and reduce the chances of contracting the swine flu, the LFA recommends that patients with lupus and their family members take the following precautions:

• Refrain from discontinuing the medications being used to manage your lupus without first consulting with your physician.
• Avoid persons and family members who are ill and have symptoms (eg, fever, nausea, vomiting, and diarrhea). Limit or avoid face-to-face and personal contact (eg, hugging, shaking hands).
• Wash your hands frequently because public surfaces, including public bathrooms, store countertops, and restaurants, may retain the H1N1 virus. Use soapy water for at least 15 seconds or, when out in public, use an alcohol-based wipe.
• Avoid touching your eyes, nose, and mouth to limit the spread of germs.
• To shield coughs and sneezing, use the crook of your arm rather than your hands or handkerchiefs because they carry moisture that spreads viruses.
• If you are sick, stay home from work or school.

The LFA noted that swine flu symptoms vary, according to the World Health Organization, but often are similar to those typical of influenza, including high fever, cough, and sore throat; some patients experience diarrhea and vomiting. The swine flu may progress rapidly to severe and unusual pneumonia.

Persons with lupus who have a confirmed diagnosis of the swine flu may receive treatment with appropriate antiviral agents, such as oseltamivir and zanamivir, according to the LFA. To date, no major drug interactions have been reported between commonly used lupus medications and antiviral agents effective in managing the swine flu, the organization added.

The LFA continues to monitor the outbreak of the swine flu and to consult with its National Medical-Scientific Advisory Council on the possible impact that this virus may have on persons with lupus. Notices from the LFA will be updated as additional details are received from the CDC.

To receive the latest information and guidelines on the swine flu, visit the CDC’s home page at http://www.cdc.gov/swineflu. For more information about the impact of the swine flu on persons with lupus and other aspects of lupus, visit the LFA Web site at http://www.lupus.org. Or, contact the organization at Lupus Foundation of America, Inc, National Office, 2000 L Street, NW, Suite 710, Washington, DC 20036; telephone: (202) 349-1155; information request line (toll-free): (800) 558-0121; fax: (202) 349-1156.