The Public Health Agency of Canada says that, as of the week ending Nov. 14, the number of outbreaks at schools and hospitals, the prevalence of flu-related doctor visits and the number of flu cases for testing across the country declined.

In Ottawa, the number of flu cases fell far enough for local health authorities to closed all but one of the city’s flu assessment clinics. In Vancouver, a flu clinic at the B.C. Children’s hospital also shut down this week as the number of patients eased.

“This is an outbreak that rose for the first four weeks, peaked three weeks ago and is now in freefall,” said Dr. Richard Schabas, Ontario’s former chief medical officer.

South of the border, fewer Americans are visiting their doctor because of swine flu, according to the Centers for Disease Control in Atlanta. Absentee rates at U.S. schools have returned to normal as well.

The evidence suggests that the virus is spreading more slowly than it was in September and October, and the number of lab samples testing positive for H1N1 is dropping.

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“Nationwide we’re off the charts right now,” Ms. Baisley says of the H1N1 infection, which is now in all 50 states and D.C. “This can be very dangerous. It’s a novel virus, we have no immunity to it and it’s spreading like wildfire.”

Last week the Centers for Disease Control released new estimates that paint a fresh picture of how the disease has been spreading. In the past six months, the report says, 22 million Americans have come down with H1N1 flu and 3,900 have died, with about 540 of those deaths pediatric.

The numbers tracking the spread in the Connecticut area, Ms. Baisley said, are fluid, a moving target. The first wave, which lasted from April 1 to Aug. 30, saw 1,996 people come down with the virus in Connecticut.

As of Nov. 10, just three months into the second wave, which will last through the spring, there are already 440 confirmed cases, with Hartford County leading the way at 146, New Haven County 112, and Fairfield running third with 87.

The age range is from 1 to 81, but the mean is 18, evenly split between male and female.

One reason the pandemic may be affecting more younger people than older ones, Ms. Baisley said, is that anyone born before 1957 may have gotten vaccinated during the swine flu epidemic of 1976, or have been exposed to it, thus giving them a slight edge. That virus had components similar enough to today’s H1N1 that it could be acting like a vaccine from the past.

“Scientifically, it makes sense,” says Ms. Baisley. It could also explain why older people are much more vulnerable to the regular seasonal flu. Were it not for this imbalance, things could get bad.

And they are bad enough. “We anticipate there will be many more hospitalizations,” she said. Nationwide, there are 200,000 hospitalizations in a cycle of seasonal flu, with 37,000 deaths. “What will those numbers be when these two viruses collide?”

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Since the onset of H1N1 in April 2009 nearly 3,900 people, including about 540 children, are believed to have died from the H1N1 flu, the Centers for Disease Control and Prevention said Thursday.  For the first time in over 50 years there is a vaccine against a pandemic strain of influenza before the beginning of winter, when low temperatures and humidity permit the H1N1 virus to spread more readily.  Before you believe what you read on the internet, including the information on this web site, you should speak with a qualified health care professional to understand the truths, myths and risks involved with taking the H1N1 vaccine.

Here are some facts about the vaccine that should help you decide if the vaccine is the correct answer for you and your loved ones:

• The seasonal flu vaccine will not protect you against 2009 H1N1 flu.
• This vaccine is produced using the same processes and facilities that are used to make the currently licensed seasonal influenza vaccines.
• Inactivated 2009 H1N1 vaccine can be administered at the same visit as any other vaccine, including pneumococcal polysaccharide vaccine. Live 2009 H1N1 vaccine can be administered at the same visit as any other live or inactivated vaccine EXCEPT seasonal live attenuated influenza vaccine.
• Children through 9 years of age should get two doses of vaccine, about a month apart. Older children and adults need only one dose.
• CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that certain groups of the population receive the 2009 H1N1 vaccine first. These target groups include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems.
• The U.S. Food and Drug Administration (FDA) has approved the use of one dose of 2009 H1N1 flu vaccine for persons 10 years of age and older. This is slightly different from CDC’s recommendations for seasonal influenza vaccination which states that children younger than 9 who are being vaccinated against influenza for the first time need to receive two doses. Infants younger than 6 months of age are too young to get the 2009 H1N1 and seasonal flu vaccines.
• The 1976 swine flu virus and the 2009 H1N1 virus are different enough that it’s unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1. People vaccinated in 1976 should still be given the 2009 H1N1 vaccine.
• People who are allergic to eggs might be at risk for allergic reactions from receiving influenza vaccines, including the 2009 H1N1 vaccine.
• The H1N1 flu vaccine will not prevent “influenza-like” illnesses caused by other viruses.
• In 1976, an earlier type of swine flu vaccine was associated with cases of Guillain-Barré Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS.

If you experience a severe reaction to the vaccine such as a high fever, behavioral changes, difficulty breathing, hives, paleness, dizziness or a fast heartbeat you should go to health care facility immediately.  Be sure inform the doctor of what happened, when it happened and when the vaccine was administered.  Ask your health care provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS).

In summary, educate yourself on the pros and cons of receiving the H1N1 vaccine and make an educated determination only after discussing with your health care provider.  Be Healthy!

1. MYTH: You can catch H1N1 flu from eating pork.  FACT: Absolutely false.  There is no way to contract H1N1 flu from eating bacon, pork chops or other food containing pork.
2. MYTH: You can get flu from drinking water or swimming pools.  FACT: Chlorinated tap water and swimming pool water does not put you at risk for flu.  To date, there has not been any incidence of anyone who has acquired flu from drinking water or from a swimming pool.
3. MYTH: This new vaccine is not safe and is untested.  FACT: Clinical trials conducted by the National Institutes of Health and the vaccine manufacturers have shown that the new H1N1 vaccine is both safe and effective.  The FDA has licensed it.  There have been no safety shortcuts.
4. MYTH: It costs too much money to get an H1N1 vaccine.  FACT: The federal government has purchased the H1N1 vaccine and is providing it to the states free of charge.  This is different in many places from the seasonal flu vaccine.
5. MYTH: Taking precautions is a waste of time. You’ll get the flu anyway. FACT: According to the CDC, precautions such as washing hands, covering cough/sneezes, avoiding sick people, and staying home if ill, help to prevent the flu and to stop it from spreading. Remain vigilant and follow these precautions. If an ill or well person isn’t following these precautions, say something.
6. MYTH: Everybody who has the flu needs to see a doctor.  FACT: People who are in a high-risk group or who are experiencing severe symptoms should see a doctor right away. For most people without risk factors, a regimen of rest, fluids, medications (such as Tylenol, Advil, or Aleve), and (if necessary) decongestants will be adequate. The CDC currently recommends Tamiflu only for those who are hospitalized or who have high-risk conditions.
7. MYTH: I have a cough and a runny nose. I must have H1N1.  FACT: H1N1 symptoms almost always include fever (temp over 100 degrees) with a cough or sore throat.
8. MYTH: If I have the flu but don’t feel too bad, there’s no reason to confine myself.  FACT: Although the H1N1 influenza illness may be mild in some people, it can be serious in others. Some people staff have risk factors such as heart disease, diabetes, and pregnancy — making them more susceptible to complications. Be responsible and protect others — stay at home if you are sick.
9. MYTH: The seasonal influenza vaccine protects you from getting the H1N1 flu.  FACT: The seasonal flu vaccine does not protect against the 2009 H1N1 flu. The seasonal flu vaccine protects against three different influenza viruses that are expected to be around in the fall and winter. The H1N1 vaccine provides protection against only the novel H1N1 virus.
10. Myth: The influenza vaccine will give you the virus.  FACT: Injected flu vaccines only contain parts of dead virus, and therefore cannot infect you. The nasal spray flu vaccine does contain a live a virus, but the virus in the vaccine is specially engineered to remove the parts that make people sick. Despite the scientific impossibility of getting the flu from a flu vaccine, many people often confuse the side effects some experience from  the vaccine with having contracted the flu itself; or receive the vaccine, and within a few days are stricken with a cold or respiratory illness not associated with the flu.