Health Experts Answer Swine Flu Questions

April 28, 2009

With more outbreaks of the new strain of swine flu come outbreaks of misinformation and rumor. Below are 20 questions answered by infectious disease expert Charles Ericsson, M.D., professor of internal medicine and director of Travel Medicine at The University of Texas Medical School at Houston.

Also, Robert Emery, DrPH, vice president for Safety, Health, Environment & Risk Management at UT Health Science Center and associate professor in the UT School of Public Health explain common sense preparedness and prevention of illness.

1. How do symptoms of swine flu differ from other types of flu?

None, really, although this flu might include gastrointestinal symptoms (diarrhea and vomiting), as well as the usual respiratory symptoms. The basic symptoms for swine flu are similar to the seasonal flu we are vaccinated for each year, which may include:

*Fever (greater than 100°F or 37.8°C)
*Sore throat
*Cough
*Stuffy nose
*Chills
*Headache and body aches
*Fatigue

2. If I felt flu-like, how would I know if I had swine flu?

You wouldn't really, nor would your physician know for sure without a respiratory specimen taken within the first 4-5 days. The specimen would then be sent to the US Centers for Disease Control and Prevention (CDC).

The cases so far in the US have been relatively mild compared to the illness described in patients in Mexico. We do not yet know why the US cases have been milder.

The important point is to call your doctor if you think you have the flu. Prescription anti-viral drugs such as TamiFlu or Relenza can be called in by your doctor. Unless you are:

*exceptionally ill with flu-like symptoms
*are chronically ill
*immune-suppressed
*quite elderly
*or have a very young child, under age 2

It is best not to report to the hospital, clinic or doctor's office, where you could risk spreading the disease. Again, call your doctor first to get instructions as to what you need to do next.

3. How long are people contagious?

Adults are potentially contagious for the length of time one has symptoms, up to 7 days following the beginning of illness. The “shedding stage” of the virus is during the first 4-5 days of illness. Children can be considered contagious longer, up to 10 days. The initial incubation period is 24-48 hours.

4. Is there medication for this?

Yes, Tamiflu or Relenza have shown to be effective against these recently reported strains of swine flu. Altogether, there are four anti-viral drugs that we commonly use to treat various strains of flu.

5. Can I start taking medicine for it now, just in case I get it later?

That is not presently advised. Preventative medication might be advised for very special circumstances where a person had to expose themselves to potentially ill people during an epidemic (which we do not yet have here). Such people might include ER workers. An outbreak in a nursing home, for instance, might lead to protecting all the other residents with a drug like TamiFlu.

For the general public, the current answer is no to prophylactic (preventative) use with anti-viral medications. Its coverage time is limited.

Do not confuse over-the-counter “cold and flu” preparations for anti-flu medications that require a prescription.

6. Are the symptoms in children different from adult symptoms?

Though the basic symptoms are similar, the signs of potentially life-threatening complications differ.
The CDC advises those with these symptoms to seek emergency care immediately:

Emergency warning signs in children are:

*Fast breathing or trouble breathing
*Bluish skin color
*Not drinking enough fluids
*Not waking up or interacting
*Being very irritable
*Fever with a rash

Emergency warning signs in adults are:

*Difficulty breathing or shortness of breath
*Pain or pressure in the chest or abdomen
*Sudden dizziness
*Confusion
*Severe or persistent vomiting

7. Is there a vaccine?

Not yet, but the CDC has this current strain of virus and will consider whether to add it to next year’s flu vaccine as time goes on.

8. If I took the swine flu vaccine in the swine flu scare during the 70s, would that cover me? What about this year's flu shot I just took?

We don’t know yet. Previous vaccines could be expected to afford only partial, incomplete protection at best.

This new strain of the swine flu virus (H1N1) actually has a mixture of swine and avian components (not to be confused with the deadly avian flu of Southeast Asia).

9. Can I catch it from pigs?

No. This strain is one that is communicable through human-to-human contact. It is a mutated form of a swine virus.

10. Can I catch it from eating pork?

Absolutely not! Swine flu is not transmitted by food. It is not a so-called foodborne illness. Bacon, ham and other pork products are safe to eat, assuming they are prepared properly. An internal temperature of 160 degrees for cooked meat will kill any bacteria or virus.

Swine flu is transmitted by airborne droplets from an infected person’s sneeze or cough; or from germs on hands, or germ-laden surfaces. Eating pork will not give you swine flu any more than eating chicken will give you bird flu.

11. How does it cross from a pig to a human?

The swine virus mutates so that it can infect humans and be spread by humans.

12. Can it kill me?

Deaths have been reported from the Mexico City outbreak. So far the cases in the US have been mild and there have been no deaths as of this writing (Monday, April 27) We do not know all the factors geographically and demographically that may contribute to the mildness or severity of this flu.
But, like seasonal flu, there is the potential for serious outcomes.

13. Why the big concern if the regular flu kills 35,000 people a year, which is why we are all encouraged to get a flu shot?

This is a new flu strain that our bodies have not been exposed to before. The flu strains that the CDC creates a vaccine for each year all have the potential to cause great harm, especially in elderly, pediatric and chronically ill patients. This particular flu strain has struck seemingly healthy, young adults, with some resulting in death in Mexico. It also appears to be quite contagious. We will know more about this strain in the coming days.

14. How is it different from avian (bird) flu?

Avian flu so far has had difficulty infecting humans unless they are exposed intensely to birds, because the virus has not mutated in a way that makes it transmissible by humans to other humans. This virus has origins genetically from both pigs and birds, and the big difference from the avian flu is that this swine virus can be transmitted readily from human to human.

15. Is this just another scare that will go away like bird flu?

Bird flu is a theoretical threat and will need a mutation to be able to be transmitted among humans to become a serious threat. The present "swine/avian" virus clearly has already caused a major outbreak in Mexico City and San Luis Potosi, Mexico and has spread to places in the US (California, New York, Texas, Kansas and Ohio). What is not clear yet is whether this virus will result in a so-called pandemic—worldwide spread with major outbreaks--or whether it will fizzle out. But, even if it fizzles out, there is logical concern that it might re-emerge next flu season.

16. Should I cancel my vacation to Mexico?

At this writing, the situation is very fluid, changeable. I suggest checking frequently with the CDC Web site for possible Travel Alerts. I probably would not travel to Mexico City for a vacation that could easily be rescheduled, if for no other reason than the city has tried to limit access to crowded or public places where transmission might be facilitated. That does not sound like a very pleasant vacation to me!

Having said that, there are more than 4,000 flights to Mexico from the US and none have been cancelled as of this writing. However, some international airports in Europe and Asia are stepping up precautions and issuing alerts. Again, check the CDC’s Travel Alerts page.

17. What if I'm on a plane? Should I wear a mask?

Not necessary. The air on a plane is filtered. Transmission might occur if someone sitting close to you coughs or sneezes on you. The newer designs of aircraft airflow keep the air in a top-down flow, not forced air from front to back. However, if you do have a respiratory illness, it might be best not to travel.

18. How long does the germ live on surfaces, like on my desk if someone sneezes in my office?

Influenza virus survives only minutes on inanimate objects or hands, so these are very inefficient ways to spread the illness. Influenza is most easily spread by droplets that come into contact with our mucus membranes such as when someone coughs or sneezes in our faces. If we shake hands with an infected person who has just wiped their nose and then we rather quickly rub our nose or eyes with our own hand, then we could get the flu. So, good hand washing does play a role in diminishing the spread of the disease.

19. Other than hand washing and covering my mouth if I sneeze or cough, what can I do to take care of myself and others?

If you are ill, stay home. Control your sneezes and coughs. If you cough into your hand, remember the virus could be live on your hand at least for a few minutes, so wash your hands before touching anyone else. If you get symptoms suggesting the flu, call your doctor, who can call in a prescription for medication to treat the flu. Resist going to the doctor’s office or a hospital ER for influenza symptoms unless you are seriously ill. You do not want to spread the disease to others.

20. What else can I do?

Keep in touch with the most recent CDC messages through the following links:
http://www.cdc.gov/swineflu/investigation.htm
http://www.cdc.gov/swineflu/general_info.htm
http://www.cdc.gov/swineflu/whatsnew.htm

Go to the sources of verifiable information such as WHO (World Health Organization) or the CDC.

Most important, be alert, not panicked.

“There is a huge difference between preparedness and paranoia”, says Dr. Robert Emery, occupational health expert at the UT School of Public Health at Houston. “Although we’re dealing with a new strain of flu, a set of universally applicable preventive measures exist that can be employed right away by everyone to help stop the spread of this disease”

Proper hand hygiene:

There’s a right way and useless way to wash hands—and wash away—micro-organisms. The object is to break down the protective membranes of germs, dislodge them from your hands and let them go down the drain. Plain soap in the right hands is strong stuff.

*Lather well with a bar of soap or squirt a coin size of liquid soap in the palm of your hand.
*Vigorously rub your hands together, soap up between your fingers, AND your wrists, front and back for 15 seconds. Sing the first chorus of any song you know and that’ll take you through the 15 seconds.
*Rinse under warm, RUNNING water. Remember, the object is to dislodge germs. The force of water is key.
*Dry thoroughly your hands with a disposable towel or under the blower, again, rubbing your hands together.
*Discard the towel.
If you’re using alcohol-based gels as hand cleansers:

Put a dime-sized amount in one hand:

*Vigorously rub your hands together and in between your fingers until the GEL IS DRY—about 30 seconds.
*DO NOT touch your face!

Once your hands are clean, do not touch your face, nose, eyes or lips.
Rubbing your eyes and nose provides a freeway for micro-organisms and good breeding ground once they’ve arrived.
Cover your cough

If you must cough or sneeze, cover your mouth with a tissue, your sleeve or your hand.
Throw the tissue away in a waste basket. Do not leave discarded tissues on your desk or other surfaces.
Then, wash you hands thoroughly.
The throw-it-away part is essential.

Micro-organisms live a life span from a few seconds to days on inanimate surfaces such as desks, table tops, faucets…tissues. If your tissues are scattered on your coffee table, they then are in contact with community surfaces. Both the tissues and the surface it sits on can spread germs to the person who touches the coffee table.

If you begin to feel ill: feverish, achy, have a dry, painful cough, sore throat, go home from school or work and call your health care provider for further instructions.

If you feel sick with flu-like symptoms and you care for the very young or the very elderly or the chronically ill, inform your health care provider when you call their office.

If you have recently traveled to Mexico or to one of the areas worldwide that has reported a swine flu outbreak, inform your health care provider. He or she may prefer to treat you with prescription anti-viral medications from home, or may request that you come in for a visit. Follow instructions from your health care providers.

Comments

[Bo Thompson]

In 1918:

In large U.S cities, more than 10,000 deaths per week were attributed to the virus. It is estimated that as many as 50% of the population was infected, and ~1% died. To compare, in "normal" (interpandemic) years, it is estimated that between 10-20% of the population is infected, with a .008% mortality.

The fact the current 'swine flu' has shown to be contagious is alarming. So far the virus has shown to have a 6% to 6.3% mortality rate. It may not seem like much, but please consider the following: The deadly influenza panic in 1918 had a mortality rate of under 1%.

This virus went on to kill tens of thousands of healthy people a day in large cities and up to 100 million people world wide.

Viruses, like this strain of swine flu, kill their host by over-stimulating active immune systems that are robust and healthy. That is why the victims in Mexico were between the ages of 20 and 45.

Some have said that no one in the United States have died from the virus, so we need not worry. Experts say it is only a matter of time. The virus is not prevalent enough to reach statistical significance in the United States, with only a handful of confirmed cases. 93.7% of all Mexicans with the virus recovered.

More cause for worry: The 1918 virus started off 'mild' before it mutated into a raging storm. It also does not mean we will see millions of deaths. It is too early to draw sweeping conclusions. Nevertheless, there is potential for a disastrous pandemic. If 50% of Americans catch this flu in the next two years, and the mortality rate stays at 6.3%, we would witness 20+ million deaths.

This strain of virus is more potent and more deadly than the virus that hammered the world in 1918 and 1919. Viruses come in waves. There are striking similarities to this virus and the virus that killed up to 100 million people in 1918. The first wave is historically more mild than the later waves.

In addition to this virus becoming more severe, it is mutating faster than previous virus that we have seen. In addition, this virus is nothing like we have ever seen before because it combines features from viruses natural in different parts of the globe. We are in uncharted territory.

If it follows the same path as the 1918 flu, we will see very damaging results. However, we must remember we are a global society now and the virus can spread quicker than we have ever witnessed in history. This is very concerning especially since the drugs we have now seem resistant.

While there have been no deaths in America, it is shadowed by the fact the common variable among the deaths seem to be age. While most American cases have involved the very young and very old (under 10 and over 50) the Mexican cases that ended fatally involved the robust and healthy (over 20 and under 45).

This virus kills the host by over-stimulating the immune system. The term that is used when the immune system over reacts is called a Cytokine Storm. It is usually fatal. During this “Storm” over 150 inflammatory mediators are released. This would account for the high mortality rate in 1918-19.

http://tinyurl.com/d2te2f

[Jennifer Viegas]

Thank you for the additional information, Bo. Frightening to contemplate. The grandfather of a friend of mine lived through the 1918 flu, but was left with lasting health problems afterward as a result. I certainly hope this latest outbreak does not become a pandemic and does not approach (or as you suggest, possibly exceed) the threats experienced close to a century ago.

[vicang]

Why are the relatives of the students and faculty members of the NYC schools not being given prophylactic Tamiflu or better still kept at home? This will help contain the spread just like what they did in Taiwan during SARSA epidemic.

[TalkSwineFlu]

I think people need to stay calm about the Swine flu outbreak, When people get scare the virus itself could spread quickly

http://www.TalkSwineFlu.com

[Jennifer Viegas]

Good point, Vicang.

[Bailey]

I'm going to Houston, Texas soon and I'm severly scared of throwing up and getting dizzy!!!!! what are the chances of me getting the Swine flu there?!?! What are some ways to prevent getting it? Hand sanitizer?

[Jennifer Viegas]

Like all large cities, Houston is expecting to be hit by the swine flu, but there's a fair amount of cautious optimism in Texas. An interesting editorial in the Houston Chronicle today:
http://blogs.chron.com/sciguy/archives/2009/04/swine_flu_might.html

The hand sanitizer/hand washing advice mentioned by the experts is always good to keep in mind. Even before the swine flu scare hit, many other studies demonstrated how effective this simple act can be in preventing numerous illnesses. (A minor side effect of hand sanitizer goop is that it can dry out your skin. You might want to also bring along some hand lotion to use every so often too.)

And something else that has stuck in my mind after interviewing health authorities on this matter...What about them? And what about veterinarians who have to care for animals that can transmit influenza to humans? A few experts told me how they work hard to maintain good health, eat proper diets, exercise and so on. Often underlying health issues can leave individuals susceptible to flu and infectious disease. It's somewhat a mental game as well. Their belief in their strong immunity seems to help keep their bodies strong.

[L J]

What about mosquitoes? Can they pass the virus?

[Jennifer Viegas]

According to public health agencies, there is no evidence supporting that mosquitoes can transmit influenza. They are vectors for many other diseases, though.

[arthos]

Infectious Conditions Body Map
Find Specific Infectious Conditions

To learn more about a broad range of infectious conditions and alternative remedies to control infections, browse our resources for information that matches your specific questions. Select an option from the menus below to proceed.
I saw this over here: http http://www.guardian-silver-health-supplements.com/browsing-feature/

[arthos]

Here’s something that puts the whole swine flu thing in perspective: http://www.guardian-silver-health-supplements.com/viral-infections/swine-flu/

[Ray Stevens]

I too have been feeling ill recently and wasn't sure I should go see a doctor or not. It sounded kind of silly going to the doctors for a cough. I heard of the service called AmeriDoc where I was able to consult with a doctor by telephone or secure email and the doctor actually was able to provide me with a consult over the telephone and he was able to provide me with a prescription.. I feel way better now knowing and best part i didn't have to take off from work to see a doctor. I would urge anyone who is feeling symptoms to contact AmeriDoc and consult with one of their doctors by phone. It gave me a peace of mind.

Their website is www.ameridoc.com

Thanks
Ray, FL

[Steve]

The worldwide swine flu is tremendous. The world map on http://www.swinefluworldmap.com/ shows that this will probably lead to a global crisis.

[bob someone]

There was a case of Novel H1N1 flu in California as early as March 30.

Here is the link:http://www.ncbi.nlm.nih.gov/nuccore/FJ966955

The patient was 9 and Female in California and the collection date was March 30, 2009. I'm not a health care professional so I am not sure exactly what everything on this report means but the date to me is significant. If you can't see the link go to ncbi.nlm.gov forward slash nuccore forward slash FJ966955.

Can anyone tell us why we didn't hear about this case in the media reports? What does this report mean? Any comments would be helpful.

[Jennifer Viegas]

Interesting about the early date of the CA swine flu case, Bob. Thank you for sharing. Maybe others here will have additional thoughts on the matter. My initial reaction is that swine flu cases have been reported from time to time over the years both in the United States and elsewhere. I haven't read the full case report for this woman, but I wonder if she contracted the illness from another person, or if she was an agricultural worker. In general, victims outside of the U.S. seem to be contracting a less virulent virus than what's been seen in Mexico. Why is a mystery. I bet a lot of people have, or had, the virus and just thought they caught a regular flu bug. There's also another influenza circulating around China now, adding further confusion.

[Magerck]

Some eye awakening information is on the Pew Commission's website on Human Health and Industrial Factory Farm pratices, particularly Industrial Pig farming, http://www.saveantibiotics.org/

You are what you eat.

[arthos]

Condition by Condition: Natural, Safe and Effective Treatments
Are you looking for specific information about an alternative health treatment for an infectious condition? If so, this section of the website is for you.
http://www.guardian-silver-health-supplements.com/natural-alternative-health-treatments/

[arthos]

we can put swine flu in this Perceptive
http://www.guardian-silver-health-supplements.com/viral-infections/swine-flu/

[Nick Humphrey]

Swine flu hotline: 989-845-8045
I haven't seen it on the news much, but for relatives that don't have access to the Internet it can give up to the minute updates to help them sleep at night.

[John Kamphaus]

Just a few comments in a slightly contrary vein. To begin with, to declare that this virus is more potent and deadly than the 1918 epidemic is pure conjecture. The estimated Mexican mortality rate is little more than wheel spinning, at this point. No one knows how many people have died there from flu. The number of confirmed cases is a tiny number compared to the posted "probable" death rate. In addition, no one knows how many total cases there have been. If the total number is 2 or 3 times the estimated 2500, and the actual number of deaths is half (neither possibility is far fetched), then the mortality rate would be perhaps as low as 1 or 2 percent. It may be higher, but my point is no one knows. The estimate of a 50 percent infection rate and 6 percent death rate in the U.S. is almost certainly at the high end. The disease, thus far, is not expanding geometrically in the way a rapidly spreading flu epidemic would be expected to, given the lack of natural immunity. In addition, the WHO says the virus is looking essentially the same now as when first detected last week. It is not "rapidly mutating" - at least not yet. Perhaps we will still see this happen. Perhaps the virus will reemerge in the fall with a vengeance. Perhaps this will all look like hysteria in a year or two. We have cause for concern with this outbreak, but the idea that we are on the verge of a great catastrophe is premature, to say the very least.

[zapata]

what was distribution of illness form north to south continents.i.e.,is the virus light sensitive?,,,,greater daylight,less virulence,and the converse?

[Tim Longpre]

Hello All

Please share this video with all your contacts as we really need to get the word out. Everything including all Bars are reopen today and business as usual.

These 2 videos are so true and the real indication of what has been happening in Puerto Vallarta. Not at all what you have been seeing on the news.

http://pvrpvblog.blogspot.com/2009/05/bay-of-banderas-be-here-be-happy-be.html

http://pvrpvblog.blogspot.com/2009/05/swine-flu-in-puerto-vallarta-mexico.html

By you forwarding this email you will be helping everyone here in Vallarta.

Have a great day and any help would be great

Tim Longpre

[شات]

nice
thanks

[Risa Meyerson]

A recent email states that having the vaccine will result in Guillain-Barre syndrome. Is this true?

[Dick]

is there dangerous amounts of mercury in the flu shots?