EAST BAY — On Oct. 26, 12-year-old Victoria Sousa, a Bristol resident who attended St. Philomena School in Portsmouth, died suddenly after she had started experiencing flu-like symptoms the week before.

Many local residents’ worst fears were realized last week when tests confirmed that Victoria had been infected with H1N1, or swine flu. People are understandably anxious and are looking for answers about how serious a health threat H1N1 poses, and they want to know more about the vaccine being distributed in Rhode Island schools and elsewhere starting this week.

We hope to answer some of the more common questions people have about H1N1 in this article. Information was provided by the Rhode Island Department of Health (DOH), the Massachusetts Department of Public Health, the Centers for Disease Control (CDC), local nurses and doctors.

If you have any more questions, contact your local physician or visit www.health.ri.gov or www.mass.gov.

Now that a 12-year-old local girl who was infected with H1N1 has died, I’m very concerned about my own family. How dangerous is this type of influenza?

Although it’s a fast-spreading disease that can be fatal, the great majority of people who contract H1N1 will experience a few days of flu-like symptoms before recovering. One health official, in fact, said “less than 1 percent” of those who get the virus are becoming “significantly ill.” There are people all around us who either have H1N1 now, or have already recovered from the virus.

How widespread is this H1N1 outbreak expected to be?

About one third of Rhode Islanders are expected to come down with H1N1 this fall and over the winter.

Why is H1N1 getting so much more attention than the seasonal flu, which can also be deadly?

It’s true that seasonal influenza causes about 36,000 deaths and 120,000 hospitalizations in the United States each year. The difference is that H1N1 is a pandemic influenza; it’s a new virus, so people have little or no immunity to fight it, and no vaccine was previously available.

The word “pandemic” sounds scary. What does it mean?

“Pandemic” means we’re talking about a global outbreak of a disease occurring when a new influenza A virus appears in humans. It can spread easily from person to person worldwide, causing serious illness. There were only three similar types of influenza in the 20th century: The Spanish Flu (1918), Asian Flu (1957) and Hong Kong Flu (1968). Seasonal flu, on the other hand, occurs every year.

What else is different about H1N1?

Unlike the seasonal flu it appears to infect younger children at a higher rate than older people, who may already have existing immunity from previous infections and vaccinations.

What are the symptoms for H1N1?

They’re similar to those associated with seasonal flu: fever, coughing, sore throat, runny or stuffy nose, achy body and headaches, chills and fatigue. One difference is that about 25 percent of those with H1N1 also report vomiting and diarrhea — a higher rate than those with seasonal flu.

My young son is sneezing, has body aches and a slight fever, but I don’t know if he has H1N1 because doctors aren’t testing for the virus. How will I know if my child has the disease?

Health officials don’t want people to overrun doctors’ offices and emergency rooms because it will make caring for truly sick patients more difficult and could help the virus spread more rapidly. If you have flu-like symptoms, you should assume you have H1N1. However, most people with this virus have had only mild illness and do not need medical care or antiviral drugs. CDC recommends to stay home from work or school for at least 24 hours after the fever (defined as over 100 degrees) has gone away without the use of fever-reducing medications. Try to avoid contact with others as much as possible, too.

Are there certain people who should be more cautious if they get flu-like symptoms?

Yes. The following groups may need to be examined by a health care provider after experiencing flu symptoms. Check first with your doctor.

• children under 5 (especially those under 2)

• people 65 and older

• pregnant women

• people who have cancer, blood disorders, chronic lung disease (including asthma), diabetes, heart disease, kidney disorders, liver disorders, neurological disorders, neuromuscular disorders and weakened immune systems (including people with AIDS)

How do I know if a family member needs to see a doctor right away?

The emergency warning signs for children are:

• fast breathing or trouble breathing

• bluish skin color

• not drinking enough fluids

• not waking up or not interacting

• being so irritable that the child does not want to be held

• flu-like symptoms improve but then return with fever and worse cough

• fever with a rash

Adults should seek emergency care if they experience:

• difficulty breathing or shortness of breath

• pain or pressure in the chest or abdomen

• sudden dizziness

• confusion

• severe or persistent vomiting

CDC says the 2009 H1N1 vaccine — both injectable and intranasal — is available. Where?

Children ages 6 months to 5 years are now receiving the intranasal spray version from their pediatricians (some at-risk kids with underlying health issues, however, will receive the injection). The injectable version of the vaccine is being administered at school clinics throughout Rhode Island over the next six weeks, beginning this week. Pregnant and postpartum women are also receiving the vaccine now, while public clinics for all others will most likely start in December.

What’s the difference between the injectable vaccine and the nasal spray vaccine?

The injectable or inactivated vaccine contains a “dead” virus that your immune system learns to recognize and fights against if a live flu virus tries to infect you.

The nasal spray contains a live virus, but one that has been weakened so it doesn’t make healthy people sick. The nasal spray seems to be more effective in creating immunity against H1N1 for children who have never had the flu or a flu vaccine. You must be between the ages of 2 and 49 with no history of major health problems to receive the nasal mist, and it’s not recommended for pregnant women or people with chronic lung disease (including asthma).

Are these vaccines safe?

The National Institutes of Health conducted clinical trials which showed that the H1N1 vaccine is both safe and effective in either form. It is produced the same way the seasonal flu vaccine is manufactured every year. Like any vaccine, there’s always a chance of a severe allergic reaction. Health officials say, however, that the risk of any vaccine causing serious harm or death is extremely small.

Do the vaccines contain the preservative thimerosal, which some people believe is linked to autism?

There is a trace amount of thimerosal only in the multi-dose vials of the inactivated (injectable) vaccine, which health officials say is necessary to keep the medicine stable. In 2004 experts at the Institute of Medicine found no association between thimerosal and autism and subsequent studies have come to the same conclusion. Some nevertheless dispute those findings.

How many doses of the H1N1 vaccine do I need?

Children through age 9 should get two doses of the vaccine, at least 28 days apart. Everyone else requires only one dose.

Who should get the vaccine first?

Health officials are targeting the following groups first, since they are more susceptible to contracting H1N1:

• Pregnant women

• Persons ages 6 months to 24 years

• People who live with or provide care for infants (under 6 months)

• Health care workers and emergency medical personnel

• People ages 25-64 years who have pre-existing medical conditions that put them at a higher risk for influenza-related complications.

Then who?

As the vaccine becomes more available, it will be given to healthy people ages 24-64, and then to older people.

What about children who have severe ailments and are at higher risk of contracting the virus?

Last week vaccinations started at 12 schools attended by some of the most vulnerable children, including The Groden Center and Meeting Street School. Some patients at Hasbro Children’s Hospital will be getting the vaccine at the hospital and children who have had organ transplants may have started getting vaccinated at Hasbro this week.

After that, children with congenital heart disease, cancer or cystic fibrosis were to be vaccinated. Children with more common illnesses such as asthma will have to wait until their school clinic, however.

Is there any reason why I shouldn’t get the vaccine?

Yes — if you have a severe or life-threatening allergy to eggs or to any substance found in the vaccine. If you’ve had a life-threatening allergic reaction after a dose of seasonal vaccine, or if you suffer from Guillain Barré Syndrome, let the health care provider administering the vaccine know beforehand to help you decide whether you should get the medication. If you’re moderately or severely ill (not a mild cold, though), you may want to wait until you recover.

Why can’t doctors give the vaccine to school-aged children?

Pediatricians were not given the vaccine for this age group, only for those children ages 6 months to 5 years. Health officials believe the most effective way to distribute the vaccine and to help ward off the spread of the virus with older children is through their schools.

My family doesn’t even have a doctor. What about us?

Although everyone is urged to seek out a physician, Rhode Island hopes to schedule public vaccination clinics in the near future. As of press time, however, none had been set.

Is the vaccine expensive?

The vaccine was purchased by the federal government and is being provided to individuals at no charge. Insurance companies have agreed to pay for doctors or clinics to administer the medicine; you may have a co-pay, depending on your plan. The vaccine will be administered for free at the school clinics, and public clinics for those without insurance will be scheduled.

My son goes to Tiverton High School, which doesn’t have an H1N1 vaccination clinic scheduled until Dec. 15. Meanwhile, students at some schools started getting the vaccine this week. That doesn’t seem fair. How was the order of schools determined?

The schedule was developed using a randomized, computer-generated process. DOH officials say while the order in which the vaccine will be delivered to schools is fixed, the dates of clinics are subject to vaccine availability and may change slightly. Rhode Island children cannot receive this free vaccination in a school without a signed and dated consent form; visit www.health.ri.gov for more information.

Was every Rhode Island school considered when the list was generated? I didn’t see the East Bay MET Center, a charter high school in Newport, on the original list.

The exclusion of that school was an oversight; the DOH has since scheduled a clinic there for Nov. 23. If you don’t see your school listed, contact the DOH at 222-8022.

What about people in Seekonk or Westport, Mass.?

As of press time, no school H1N1 vaccine clinics had been set at Massachusetts schools. Early supplies have been earmarked for providers treating those who are at high risk for H1N1, including children. As vaccine supplies become more widely available, public H1N1 vaccination clinics will be scheduled, most likely in December.

Should I get the vaccine if I think I already have H1N1?

Yes — better safe than sorry. If your infection was confirmed by a medical professional to be the 2009 H1N1 virus, then you’ve most likely developed immunity and shouldn’t be infected again this fall or winter. However, the vaccine won’t harm you even if you’re already immune.

Once I get the H1N1 vaccine, how quickly does it work?

After receiving the vaccine, your immunity to H1N1 should begin within eight to 10 days.

Once you have H1N1, can it be treated?

It’s up to your own system’s antibodies to fight the actual virus. However, antiviral prescription drugs (such as Tamiflu) that are started within two days of the first symptoms of the flu may help those with the virus feel better faster, and may also help prevent serious complications. (Tamiflu is not to be confused with TheraFlu, an over-the-counter, or non-prescription, medication. Check with your pediatrician before you give your child TheraFlu, since it contains high doses of acetaminophen and may be unsuitable for children.

Will the H1N1 vaccine also immunize me from the seasonal flu?

No, you need to receive two separate vaccinations. It’s OK to get them at the same time.

We’ve already run out of the vaccine for the seasonal flu. Could the H1N1 vaccine supplies also dry up before all Rhode Island school students are immunized by mid-December?

Anything’s possible, but health officials believe enough vaccination is being produced on an ongoing basis to provide enough for everyone.

How is the virus spread?

Similar to the seasonal flu — mainly person to person through coughing or sneezing. You could also become infected if you touch something containing the H1N1 virus and then touch your nose, mouth or eyes. People infected with either the H1N1 or seasonal virus may be able to infect others from one day before getting sick to five to seven days after.

How long does H1N1 live on surfaces? Should I worry if someone recently sneezed on my computer keyboard?

The virus can live on surfaces and infect people for two to eight hours after it’s deposited. Disinfecting surfaces that are most touched by human hands — door handles, phones, toys, computer keyboards, etc. — can help lessen the spread of the virus.

What else can my family do to help ward off H1N1?

Besides getting the H1N1 vaccination, the most important thing to do is wash your hands with soap and water often (use an alcohol-based hand rub if soap and water is not available). Cover your mouth and nose with a tissue when coughing or sneezing, then put your used tissue in the wastebasket and clean your hands every time you cough or sneeze. Avoid touching your eyes, nose or mouth, and avoid close contact with sick people.

What are hospitals doing to prevent the spread of H1N1?

Hospitals are putting extra restrictions on visitors, such as not allowing people with flu-like symptoms or those 18 and under in unless there are extenuating circumstances (such as if a family member is dying). Patients with influenza-like illnesses are being masked in emergency rooms and/or admitting.

How long will we be dealing with this virus?

Since the virus is so new, it’s hard to say. Health officials say we may see a second and possibly third wave of the flu virus, extending to April 2010.