Ninety-eight percent of the flu cases reported were determined to be the swine flu also known as the 2009 H1N1 Flu. The CDC does not publish a confirmed number of H1N1 cases, but there were 593 confirmed deaths due to H1N1 from April through the end of August.

While trying to control the pandemic, health officials are finding that compared with seasonal influenza, the 2009 H1N1 flu is unpredictable. For example, although about 36,000 people over 65 years of age die from seasonal flu each year that age group is rarely affected by the H1N1 virus, according to Kathleen Sebelius, U.S. Secretary of Health and Human Services, during a White House conference.

It has affected more people under the age of 65, including many pregnant women. Others considered at a high risk for H1N1 are the same as those at high risk for influenza. All high risk groups will receive vaccinations before the general population.

“Minority communities are no more or less at risk for H1N1 then any other communities,” said Sebelius.

African Americans and other minorities also have higher rates of chronic illness, such as asthma, heart disease, and diabetes– all underlying conditions that make it more likely that the flu can be very serious.

Dr. Mark Johnson, chair of the department of family medicine at the University of Medicine and Dentistry at the New Jersey Medical School in Newark, New Jersey, has not only encountered several cases of swine flu, but he teaches other doctors about how to diagnose and treat patients with it. BlackEnterprise.com talked with Johnson about the condition and its vaccine.

BlackEnterprise.com: What are the symptoms of swine flu?

Dr. Mark Johnson: There are certain signs or symptoms that you should consider emergency warning signs. In children, look for fast or troubled breathing, lethargy, irritability, unsocial interactions, or bluish skin color, which may indicate they are not getting enough oxygen due to respiratory problems.

In adults, the danger signs might be shortness of breath, chest pain, significant pain in the abdomen, confusion, dizziness, or severe and persistent vomiting.

If you experience these symptoms should you go to the emergency room?

No. Don’t go to the ER unless you have a very high fever or other dangerous symptom that you can’t control with Tylenol or ibuprofen. Going to the ER can actually be a dangerous thing because you are more likely to go to a place in which there will be a lot of people who do have the flu. If you are concerned you should call your physician.

How will the doctor know for sure someone has swine flu?

The doctor should assess the severity of your symptoms. Some offices are doing quick tests to see if they can confirm if this is H1N1, but the sensitivity of those tests are quite variable. Basically, the doctor will rely on his clinical judgment.

How do you protect yourself from getting the swine flu or prevent giving it to others?

Cover your mouth and nose when you cough and sneeze. The flu is transmitted primarily through sneezing and coughing, which produce respiratory droplets. You can pass the flu on to others if they breathe in those droplets or if you cough in your hand and touch something. The virus can stay alive on certain surfaces anywhere from 2-8 hours. That is why hand washing is so important.

If you have someone at home or work who you believe has the flu avoid being within six feet of them. At home, keep them isolated in their own room. Also, wash down surfaces, countertops, door knobs, and communal office equipment to prevent the spread of infection.

How is the swine flu different from the seasonal flu?

The vast majority of people with the swine flu have mild symptoms. They don’t need to see a doctor, they recover well and they go on with their life. For reasons we cannot predict some people have severe reactions and require hospitalization. More young than elderly people are becoming infected. A certain portion of the elderly population actually might have some immunity to H1N1 from previous infections.

Should people get vaccinated for both the seasonal flu and swine flu?

Yes. They are separate viruses and vaccination from one will not protect you from the other. You should get vaccinated for the seasonal flu vaccine first and then the H1N1. You might also consider that there are two antiviral drugs approved and available to fight H1N1 for individuals who have already contracted it. Doctors will try to limit antiviral drugs to people who are hospitalized with influenza and people with increased risk of influenza-related complications. The vaccinations increase your immunity to the disease, while the antiviral drugs work like an antibiotic and specifically attack the virus.

What business etiquette should people apply when they feel sick with the flu?

If you feel sick, now isn’t the proper time to be a hero. Don’t say, ‘I’m coming to work. I’m only a little sick.’ That is not going to be beneficial to your employees or coworkers. Let your supervisor know that you have flu symptoms, stay home, and continue to stay home until you have no fever for at least 24 hours. Limit outside activities to seeking medical care.

Should people refrain from shaking hands in a business setting?

Don’t feel awkward to forgo a handshake at business functions. If a handshake is unavoidable, refrain from touching your own mouth or facial area. Wash your hands immediately after leaving a business reception or use hand sanitizers frequently.

Why is there a gap in vaccination coverage for African Americans?

Vaccination is a problem in the African American community because there is an aura of mistrust of the healthcare system that goes back to slavery. In addition, there are other causes that reduce access to vaccinations, such as lack of insurance or lack of having a primary care provider.

Is there any truth to rumors that people should be afraid of taking a swine flu shot?

There was an outbreak of swine flu in 1976 and people who got vaccinated had a greater risk of getting Guillain-Barre syndrome, which caused nerve damage, muscle weakness, and sometimes paralysis. People still remember that, but it is actually very rare with only one or two cases per 100,000 a year. In addition, results from genetics on the swine flu virus show that this strain is significantly different from the one in 1976 and the vaccine is entirely different also.

Other points of interest from the Department of Health and Human Services:

–Swine flu vaccinations are free at all public health venues. Some providers may bill insurance for cost of administration, but the government encourages them to waive those fees.

–Although the government has ordered enough vaccines for everyone, it is still voluntary.

–The swine flu vaccination is currently being administered to five priority groups only including: health care workers, pregnant women, children and young adults between 6 months and 24 years of age, adults 25 to 64 with chronic health conditions and people living with or caring for babies under 6 months of age. Vaccinations for everyone else will be administered in late October.

–Infants younger than six months of age are too young to get the 2009 H1N1 and seasonal flu vaccines.

–Vaccines will be administered at public health departments, school venues, work sites, and community centers, among other places

–If you have mild illness your provider might make the decision that you can’t be vaccinated.

–People with an egg allergy should NOT be vaccinated with neither the flu shot nor the nasal spray flu vaccine since the vaccine is grown in eggs. Healthy people 2 to 49 years old can receive a nasal spray flu vaccine.

–The swine flu vaccine is made the same way as the seasonal flu vaccine; only a different strain of influenza is put into the swine flu vaccine.

Seeking to address the disparities, black, Latino and Asian lawmakers Tuesday introduced the Health Equity and Accountability Act of 2009, which outlines their priorities for healthcare reform—particularly the need to eliminate racial and ethnic disparities that exist under the current healthcare system.  The bill is designed to reduce racial and ethnic disparities and address a number of other issues important to communities of color while improving the national healthcare system for all Americans.

Both HHS and the Congressional TriCaucus – comprised of the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus — consider access to quality care as vital to health and wellness, and acknowledge that health insurance plays a key role. However, racial and ethnic minorities and low-income populations experience serious disparities in rates of insurance and access to healthcare.

Just under one in five African Americans – are uninsured. In comparison, only about one in eight Whites lacks health insurance, according to the HHS report, “Health Disparities: A Case for Closing the Gap.”

“Today over 47 million people lack health insurance in America and although racial and ethnic minorities account for about one third of U.S. population, they account for more than half of the uninsured,” said CBC Chair Rep. Barbara Lee of California. “The Congressional TriCaucus stands together and speaks with one voice to demand health care reform now, and to demand an end to the factors that perpetuate racial and ethnic health disparities in this country.”

Seven out of 10 African Americans between the ages 18 to 64 are obese or overweight, and African Americans are 15% more likely to suffer from obesity than whites, according to the report. African Americans are more likely to develop and die from cancer than any other racial or ethnic group.  African Americans also experience new HIV infections at seven times the rate of Whites, and Hispanics experience new HIV infections at two and a half times the rate of Whites.
With unemployment on the rise, the disparities already apparent among these groups will continue to increase, according the HHS.

The lawmakers’ bill would also strengthen the Office of Minority Health within the Department of Health and Human Services, expand racial and ethnic diversity in clinical trials, and integrate community-centric health efforts into health reform.

At a discussion of minority health issues at the White House, HHS Secretary Kathleen Sebelius said the Obama administration is committed to addressing the disparity in the delivery of quality healthcare, writes the Associated Press.

She notes that minorities are more likely to be uninsured and are less likely to have access to quality care when they need it. “We are here today,” she says, “because we all agree the system is broken, and we have to all work together to do something about it.”

Healthcare reform is a top priority of President Barack Obama’s administration. Congressional committees have already begun working on the overhaul, and the Senate Health Committee released a draft bill Tuesday. The Affordable Health Choices Act seeks to expand medical insurance coverage to all Americans, reduce healthcare costs, make health coverage affordable to the uninsured, and better coordinate healthcare.

“Healthcare reform cannot and must not wait,” said Sen. Christopher J. Dodd (D.-Conn.), who helped author the legislation. Today, we “introduce legislation that will strengthen what works and fix what doesn’t.”

However, the members of the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus warned Democratic leaders that any bill overhauling healthcare that didn’t correct the health gaps between whites and minorities would have a difficult time being passed.

The difference between the cardiovascular treatment received by whites and minorities is increasing. To combat the problem, some of the country’s leading physicians have joined forces to develop an initiative called Close the Gap, which raises awareness of the issue and ensures that eligible candidates receive the medical attention they deserve, regardless of background.

“These disparities exist even when we adjust for insurance, age, or income. Minorities continue to fall short in terms of less access,” says Leggett who serves as a member of the Close the Gap steering committee.

A collaborative effort between the medical company Boston Scientific and its partners, including the Association of Black Cardiologists and Black Coaches and Administrators, Close the Gap was launched in February with the goal of defining the disparity problem on a national level while simultaneously developing the necessary tools to provide local solutions.  “If you eliminated the disparities and brought the standard of healthcare in African American populations up to the standard of the Caucasian population, you would essentially save 900,000 lives,” says Dr. Charles Noble, an Ohio-based electrophysiologist who also serves on the steering committee.

With pilot projects in 10major cities, including, New York City; Atlanta; and St. Paul, Minnesota, the focus is on community education. Through seminars and brochures, Close the Gap reaches out to both patients and physicians, addressing the issues of healthcare awareness and cultural sensitivity.

Citing patient culture as one of the hurdles to be conquered, Leggett says it is necessary for minorities to not only familiarize themselves with diseases that plague their communities, but also to be open to and educated about the various treatment options available. “Sometimes the appropriate treatment could be recommended by the physician but refused by the patient,” says Leggett.

On the other hand, doctors cannot avoid the role physician bias plays in widening the gap that divides minority cardiovascular care from that of the white population. “We as doctors have to own up to being participants in this disparity,” says Leggett, who accepts that the bias may not be intentional on the part of most physicians, but a side effect of socialization that should not be ignored.

The doctors anticipate that soon there will be visible evidence of progress. Both Leggett and Noble are looking forward to a decline in the number of cardiovascular-related deaths among minorities and an increase in the number of patients receiving adequate treatment. In the end, they hope to completely eliminate all disparities in cardiovascular healthcare and reduce the number of minorities being affected by such diseases to the same level as white Americans.

“If we can achieve that goal, Close the Gap will not only be successful,” Leggett says, “but the country will be healthier, and people will get the treatment they deserve.” For more information on the initiative, visit www.heart-healthdisparities.
com.

THE FACTS ON BLACK AMERICANS AND HEART DISEASE

Based on data from the Census Bureau and Centers for Disease Control and Prevention, it is estimated that there are approximately 700,000 black Americans with heart failure in the United States, and this number is expected to grow to 900,000 by 2010.

Black Americans between the ages of 45 and 64 are 2.5 times more likely to die from heart failure than white Americans in the same age range.

Black Americans have almost twice the risk of first-ever stroke compared with whites.

Black Americans are 2 times more likely than white Americans to be diagnosed with diabetes and 1.5 times more likely to be diagnosed with hypertension—important risk factors for heart disease.

The prevalence for Peripheral Artery Disease (PAD) increases dramatically with age and disproportionately affects black Americans.

Black Americans are at greater risk for cardiovascular disease and stroke than white Americans.

The prevalence of hypertension in black Americans in the United States is among the highest in the world.

The annual rate of first heart attacks is higher for black Americans than for white Americans.

SOURCE: BOSTON SCIENTIFIC

GENERAL HEART DISEASE STATISTICS

More women than men die of heart disease, although more men have heart attacks.

As you age, your risk for heart disease increases.

At age 40, the lifetime risk for developing heart disease is 2 in 3 for men and more than 1 in 2 for women.

Heart disease causes more deaths in Americans of both genders and all racial and ethnic groups than any other disease.

Black Americans, American Indians, Alaskan Natives, Asian/Pacific Islanders, and Latino Americans die at earlier ages from heart disease.

This story originally appeared in the July 2008 issue of Black Enterprise magazine.

The Centers for Disease Control and Prevention implemented NBHAAD in 1999. Of the activities registered for NBHAAD, the marches are the most visible. Organizers in Los Angeles expect hundreds to attend their sixth annual AIDS rally in South Central. The rally will culminate to form a human billboard depicting an enormous AIDS ribbon. Although there will be AIDS awareness galas, plays, and conferences with appearances by high-profile individuals, including Colin Powell, Creflo Dollar, Sheryl Lee Ralph, and Tony Dungy, the majority of events are grassroots efforts that are centered around education, prevention, testing and treatment, and sponsored by local churches, community centers, and clinics. This year there are 400 more events than in 2007. On Feb. 8, Lamont Evans, chief executive officer for Healthy Black Communities Inc., one of the lead organizations for NBHAAD, and organizers will announce their plans to test 1 million individuals by 2009. According to Evans, testing is the catalyst that heightens awareness about prevention of HIV/AIDS.

“HIV/AIDS is affecting the African American community in a way like no other disease at present,” says Dr. Garth Graham, deputy assistant secretary for minority health at the Office of Minority Health within the U.S. Department of Health and Human Services.

Here are five reasons to make getting tested a priority:

1. It is simple and easy. “If you are scared of needles we have alternatives,” explains Graham. “Saliva can be tested now instead of blood.” Plus, no more waiting; results are available in 20 minutes. Sites such as www.hivtest.org will explain some of the less invasive tests available.
2. Knowing is half the battle. Getting tested doesn’t mean a death sentence, offers Graham. It means there is treatment available. “If you don’t know, there might be a time bomb ticking inside of you that can take you out at anytime,” says Evans.
3. Testing will heighten your awareness about prevention andtransmission. “We have to educate those who are living with HIV/AIDS,” says Evans. “And we have to work on the self-esteem of those who are willing to put the course of their lives at risk for a five minute thrill.”
4. Protect OUR future. “Young people are our biggest casualty right now,” says Evans. “More young people [in their 20s] are getting opportunistic infections and are in the hospital with pneumonia. In the beginning we lost a lot of black talent. We don’t know how those affected and dying could change the course for black America; and we will never know if we don’t stop this epidemic.”
5. Silence is not golden; it is deadly, says Graham. The faith-based community has started to fight the stigma behind HIV/AIDS. “If we can get the churches–the nucleus of the conscious of black communities–onboard to help promote prevention as power that will help turn this epidemic around,” Evans predicts.

To locate an event near you, visit www.blackaidsday.org and click on your state.

Don’t know where to get tested? Text your zip code to “KNOWIT” (566948) and you will receive a text containing information about a testing center near you. For other locations and questions call 800-232-4636. It is toll-free and available 24 hours.