Arthritis and H1N1
If you have arthritis, you may have questions and concerns about the H1N1 virus. The following frequently asked questions, along with consultation with your physician, can help you determine the precautions and steps that you should take.
Frequently Asked Questions?
How does arthritis affect how I respond to the flu?
What are the symptoms of the flu?
How can I avoid getting the flu?
Do I need to get a flu shot?
What should I do when I am sick?
Where can I learn more?
How does arthritis affect how I respond to the flu?
People with certain types of arthritis, called inflammatory or systemic arthritis or autoimmune rheumatic disease, have a higher risk of getting an infection including the flu. Also, when they get the flu, they often have more severe disease and complications such as hospitalization. Rheumatoid arthritis and lupus are the most common types of inflammatory arthritis. Many people with inflammatory arthritis are on medications that can also weaken their immune system (see list below) making them more at risk to get the flu.
People with osteoarthritis (also called degenerative arthritis) are not at increased risk of the flu unless they also have another chronic disease such as asthma, diabetes, heart disease, or cancer.
If you have one of these types of arthritis, you may be at high risk for getting the flu or complications from the flu.
Types of Inflammatory Arthritis
- Rheumatoid arthritis (RA)
- Systemic lupus erythematosus (SLE)
- Psoriatic arthritis
- Anti-phospholipid syndrome
- Polymyalgia rheumatica
- Systemic sclerosis/scleroderma
- Spondyloarthropathies
- Sjögren’s syndrome
- Polymyositis/dermatomyositis
- Vasculitis (e.g giant cell arteritis)
- Necrotising arteritis
- Sarcoidosis
- Polyarteritis nodosa
If you are taking one or more of these medications for your arthritis, you may be at high risk for getting the flu or complications from the flu.
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Steroids (corticosteroids)
- prednisone (Deltasone, Orasone, Prednicin-M, Sterapred))
- prednisolone (Prelone)
- methlyprednisone (Medrol)
- hydrocortisone (Cortef, Hydrocortone)
- dexamethasone (Decadron, Hexadrol))
- cortisone acetate (Cortone)
- betamethasone (Celestone)
DMARDs (disease-modifying antirheumatic drugs)
- methotrexate (Rheumatrex, Trexall)
- azathioprine (Imuran, Azasan)
- hydroxychloroquine (Plaquenil)
- leflunomide (Arava)
- sulfasalazine (Azulfidine)
- minocycline (Minocin, Dynacin)
- cyclosporine (Sandimmune, Neoral, Gengraf)
- mycophenolate mofetil (Cellcept)
- gold (Auranofin, Ridaura, Myochrysine)
- chlorambucil (Leukeran)
- cyclcophosphamide (Cytoxan)
Biological response modifiers (biologics)
- etanercept (Enbrel)
- infliximab (Remicade)
- adalimumab (Humira)
- anakinra (Kineret)
- abatacept (Orencia)
- rituximab (Rituxan)
- tacrolimus (Prograf, FK-506, fujimycin)
What are the symptoms of the flu?
The symptoms of novel H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with novel H1N1 flu virus also have reported diarrhea and vomiting.
How can I avoid getting the flu?
The flu is spread from person-to-person by coughing or sneezing. You can take simple actions to prevent getting the flu:
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread this way.
- Try to avoid close contact with sick people.
- If you are sick with flu-like illness, seek medical care early. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
- Get a seasonal flu shot now and the new H1N1 flu shot when it becomes available.
Do I need to get a flu shot?
Yes, CDC recommends persons with weakened immune systems,such as people with inflammatory arthritis, should get flu shots. People with inflammatory arthritis should get:
- A seasonal flu shot every year. People with inflammatory arthritis should NOT get a flu vaccine given as a nose spray (e.g. FluMist).
- The new H1N1 flu shot when it becomes available in mid-October 2009. People with inflammatory arthritis should NOT get an H1N1 flu vaccine given as a nose spray.
What should I do when I'm sick?
- Avoid contact with others. You should stay home and avoid travel until at least 24 hours after your fever is gone except to get medical care or necessities. (Your fever should be gone without using fever-reducing medications).
- If you leave the house to seek medical care, wear a facemask, if available and tolerable, and cover your coughs and sneezes with a tissue.
- Do not stop taking any medicine you take for your arthritis unless told to do so by your physician.
- Seek medical attention early if you develop symptoms of the flu. Treatment is available for persons with severe disease and those at high risk for complications.
- If you are exposed to someone who has flu, consult your health care provider. They may prescribe medication to help prevent you from getting the flu or watch you closely to see if you develop flu symptoms.
Where can I learn more?
H1N1 Flu: General information
What You Need to Know About H1N1 and Seasonal Flu
H1N1 Advisory for People with Lupus
Lupus and Influenza Vaccines
For more informtion from the CDC:
