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As the Novel A H1N1 flu begins a second wave this year with the regular flu strain expected to surge in February, no one seems to be able to explain beyond theory why flu seasons begin to peak then abate, says Jeanene Fowler.

Fowler, who is a public information spokesperson for the Maricopa County Department of Public Health, says that there is no seasonal flu and that there are no accurate answers to explain its ups and downs.

“We start to see it as blips,” she says. “The first blip of H1N1 was in April, but it has never gone away.”

She also says that 100 percent of the flu in Arizona right now is the H1N1 virus. The virus began its second wave last week.

There are two entirely different strains of flu virus for Arizonans to watch for, she says. There is H1N1 for which the vaccination is coming and the average flu strain for which current vaccinations are designed. Fowler says that typically Arizona sees the later virus as it begins in the Northeast then appears in Arizona beginning in February. H1N1 is unusual and in countries in the southern hemisphere, such as Australia, it took over the flu season but is now receding as climates change in temperature.

Why flu viruses fire up then disappear stumps experts.

“The flu season is one of the most predictable things in the world of infectious disease, yet there's no agreed upon explanation,” says Bob England, M.D. and medical director of the Maricopa County Department of Public Health. “Colder weather leads to more people jammed inside together... but not here (arguably, we're more likely to be outside in cooler weather). Yet we have our flu season at the same time as much colder climes.”

He adds that during pandemics such as the worldwide spread of H1N1 that none of the usual seasonality applies yet the virus remains essentially a flu. After a pandemic, mutated versions of the once new virus tend to circulate, seasonal flu strains that will once again obey the calendar and occur only in flu season, England says.

Meanwhile, area healthcare professionals prepare for the second surge of H1N1. Fowler says that the second surge is usually worst than the first, and if it were up to her, everyone would become vaccinated. She says there is a lot of apprehension by the public right now regarding vaccinations, but their fears are unfounded. People aren’t doing their homework, she says, and are relying on the Internet. Getting vaccinated will help contain the virus’ spread, so she hopes that those who avoid the vaccine do so based on well-educated decisions.

Some people are confused by having two strains of flu virus and two different vaccinations this year.

“You can go any number of places—supermarkets, drugstores, clinics—to get your seasonal flu immunization, but the H1N1 (aka swine) flu vaccine has not yet been released for most of Arizona,” says Susan Fuchs, senior media relations specialist at the not-for-profit John C. Lincoln Health Network. “We're still waiting for the initial delivery earmarked for our frontline health care providers such as doctors, nurses and therapists.”

From her perspective, vaccination needs to be a big deal, and the regular flu shot is a really good thing. The flu is everywhere.

Each year at about this time, John C. Lincoln Health Network posts notices restricting children age 12 and under from visiting the hospital, she says. Children are what the county health department calls spreaders because children cluster together more than adults at school and their activities, and they catch whatever viruses are out there: The children are the most likely to be contagious to others. They pose a special risk to the healthcare of those patients who have compromised immune systems, Fuchs explains. However, anyone adult or other who shows any signs of illness should avoid visiting patients.

Meanwhile, children are also especially vulnerable themselves this year because their systems have never been exposed to the type of flu strain circulating now. Symptoms include a fever but may include severe respiratory problems; any child who shows trouble breathing should be brought to an emergency room. Look at the child’s fingernails for any sign of bluish tint. Get to the emergency room as soon as possible and if possible to Mendy’s Place, says Fuchs. Mendy’s is the only pediatric emergency facility in the North Valley and is located at the John C. Lincoln Deer Valley Hospital on 27th Avenue south of the state Route 101.

No child or adult will be turned away from an emergency room under federal law. Patients have to get care first and be stabilized in an emergency situation then talk about payment later, says Fuchs.

Treatment for H1N1 is the same as for the annual flu strain. Anti-viral medication such as Tamiflu may be given, but it’s only effective if given within the first 24 to 48 hours and is expensive, Fuchs says.

There is not much point in being tested to determine which flu strain a person has. According to Fowler of the Maricopa County Department of Public Health, there is what’s called a rapid test, but it only has a 50 percent accuracy and a person will likely only be tested if hospitalized.

Fuchs seems to agree and says why pay for the test when treatment is based on symptoms?

To avoid becoming ill this season wash your hands frequently with anti-bacterial soap, advises Fuchs. She says to take your pick between singing the A,B, Cs or “Happy Birthday” as a quick rinse is not good enough. She also recommends using anti-bacterial hand gels and to look for gels that contain at least 65 to 70 percent alcohol content.

If you become ill, avoid the public. Send someone else to the store if possible, says Fuchs, who described a recent trip to the store with her children and being exposed to a young man in a crowd at the register who seemed to be buying soup and cold medicine.