Nasal spray no cure-all

If you don’t like getting a flu shot, you might think the new FluMist nasal spray available for the first time this year might be a good option.

But it’s not for everyone.

FluMist is only recommended for healthy children ages 5 to 17 and healthy adults ages 18 to 49. It is not recommended for anyone younger than 5 or older than 50.

And it is not recommended for health care workers, because the mist itself potentially can spread the disease.

Anyone who has contact with the elderly, cancer patients and others with weakened immune systems should get a shot instead, said Dr. Yuan-Po Tu, a physician at The Everett Clinic, citing recommendations from the federal Centers for Disease Control and Prevention.

"The thing that’s not very well publicized or understood is that the FluMist vaccine is a live virus," Tu said. "When you squirt it up someone’s nose, it can shed the (flu) virus for up to 21 days."

That means that someone who has received the anti-flu vaccine via the nose spray potentially could infect someone with flu, he said.

"That’s a concern from us in the medical community if you’re hanging around" someone who has cancer, has immune system problems or is really sick, he said, whether they’re family members or fellow workers.

"They can potentially spread the FluMist flu … and make them sick," Tu said. "That’s the major difference between the FluMist and the flu shot," because the shot uses killed flu viruses.

Since this is the first year that the anti-flu nasal spray has been available, no one knows how commonly flu might accidentally be spread in this way, Tu said.

"The FluMist is only meant for healthy individuals, with the caveat that you’re not living or working around anyone who is sick," he added.

The Everett Clinic is not offering FluMist to its patients. But Visiting Nurse Service of the Northwest, some local pharmacies such as those at QFC and Bartell, and some clinics are. The nasal mist costs about $60. Flu shots are $15 to $20.

The potential for the spread of the flu is the reason area hospitals are asking employees with direct patient contact not to use FluMist instead of getting a shot. Snohomish County hospitals in Everett, Edmonds, Monroe and Arlington have joined Group Health Cooperative and the University of Washington Medical Center in the move. All are making flu shots available to employees.

Cascade Valley Hospital in Arlington is asking any employee who used the nasal spray to report it.

"We don’t want them to take care of patients" with immune system problems, hospital co-administrator Clark Jones said.

The possibility of the flu being transmitted from a person who has received the nose spray to a person with a suppressed immune system "is potentially dangerous," Dr. Estella Whimbey, associate medical director at the University of Washington Medical Center, said in an e-mail this month to hospital employees.

For that reason, workers with direct patient contact are being urged to get a shot or refrain from direct patient contact for three weeks.

"I think we’re all trained to go get the flu shot," spokesman Walter Neary said.

At Stevens Hospital in Edmonds, a memo was sent out Monday by the hospital’s director of infection control.

"We’re advising them that we prefer that they not" get FluMist, spokeswoman Beth Engel said. If they do use the nasal flu medication, they must tell the hospital, and they will not be able to work for three weeks, she added.

Group Health will distribute an advisory to staff dealing with patients this week "asking that they not use FluMist," spokeswoman Laura Query said.

A similar request is being made to employees of Providence Everett Medical Center and its sister organization, Medalia Medical Group, which operates clinics in Snohomish County.

Cascade Valley Hospital in Monroe has asked employees to hold off, too.

"The chance of infecting someone is small, but the impact is great. Why put others at risk?" hospital spokeswoman Martha Dankers said.

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.