By Robert Bazell Chief science and health correspondent
NBC News
updated 9/23/2009 2:47:00 PM ET 2009-09-23T18:47:00

As the swine flu outbreak continues its spread around the world , msnbc.com readers are concerned about the risks and what they can do to protect themselves from infection.

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Although many cases of swine flu in the United States have been mild , some are worried after the World Health Organization raised its pandemic alert to its second-highest level.

NBC Chief Science and Health Correspondent Robert Bazell answers your questions on this disturbing new virus.

What is swine flu?
How is it detected?
Should I be worried?
What can I do to keep from getting swine flu?
When should I seek medical treatment?
Can you just let the virus run its course?
What does a "pandemic" really mean?
Is it better to get swine flu now?

Should I change my travel plans?
Are children at greater risk?
Why are schools closing over unconfirmed cases?
Are there risks to pregnancy?
Are my pets at risk?
How does a virus get started from a specific species?
Can someone test negative for the swine flu and still be a carrier?

What is swine flu?
Influenza circulates regularly among humans and animals such as pigs and birds. Pigs are important because they are close genetically and physically to humans. Birds are important because they can transport viruses across great distances.

As the virus passes through these animals, it sometimes acquires different genetic characteristics that can make it more or less dangerous to human beings. Scientists have been warning for a long time that even though bird flu that’s been around in Asia for awhile is infecting mostly birds and occasionally infecting and killing human beings, there is always the possibility of a new virus that can cause serious disease. We have that now with swine flu.

People have no natural immunity to the new virus. If you’ve had flu shots in the past, it doesn’t matter. Nobody has had this virus before and that’s what makes it potentially so dangerous.

Things will keep popping up out of nature. We live in a global ecosystem that not only includes billions of other people, but hundreds of billions of animals. And we exchange viruses and new viruses do appear.

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How is it detected?
Labs provide clear ID on swine flu by a specific test that has been developed. One of the things that the Centers for Disease Control and Prevention is doing that should speed up the process of identifying cases is getting test kits out to the state health departments. Right now, it can only be done in Atlanta. That’s why it often takes several days from the time a cases is suspected to the time until it is positively identified.

If someone got sick in April and they recovered, they don’t have to worry if it was swine flu or not.

If you’re over it, just be happy you’re fine.

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Should I be worried?
The reason that we’re worried about swine flu is the people typically killed by flu are often the very old and frail, and sometimes the very young. Because of the deaths in Mexico, there are indications that swine flu might be able to strike and kill younger people — those in their 20s, 30s and 40s. In 1918, the ultimate pandemic we know about killed healthy young adults. That’s one of the reasons why this outbreak is potentially frightening. We still have to understand more.

The United States is already doing almost everything possible to track the spread of the virus, treat the victims and try to develop a vaccine.

Investigators from the World Health Organization and the Centers for Disease Control are investigating very actively, because a lot more needs to be understood about the deaths before we can understand the threat.

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What can I do to keep from getting swine flu?
The authorities have talked about it again and again: Wash your hands often and cover your mouth with your elbow when you cough or sneeze. That’s all really important in order to cut down the transmission of any infectious agent, particularly this one to which we have no natural immunity.

Antibacterial hand wash is excellent at eliminating the threat of flu and many other viruses and bacteria. These skin cleaners are basically just alcohol that has been put in an emulsifier to make it easier to apply and doesn’t dry your hands out. Health officials strongly recommend using it for swine flu. You can even use pure rubbing alcohol — it would have the same effect.

Masks sold over the counter provide minimal protection. Mostly they’re recommended for people working in hospitals or in laboratories. The virus can usually pass through them.

No previous flu shots provide any protection from this disease. No matter how many times in your life before that you’ve had the flu, that doesn’t provide any protection, either.

One reassuring thing is that we know now that many cases that have occurred in the U.S. have resulted in mild illness and people have recovered completely. Those who do are almost certainly immune to this virus in the future.

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When should I seek medical treatment?
You should seek medical attention if have a fever of 102 or higher, or if you feel very sick. Swine flu has flu-like symptoms of lethargy or muscle aches or pains. If you have been to Mexico or in contact with someone who has recently been to Mexico and you get sick, you might want to seek it sooner. Again and again, public health officials emphasize that people shouldn’t be going to get medical attention just for the sniffles . That would swamp medical facilities and make it more difficult for people who actually need medical care for all kinds of reasons, not just swine flu.

Tamiflu and Relenza are drugs that are known to be effective against swine flu.

Preventive doses of Tamiflu can be used when there’s an infected case. It can be given to family members and that has been done.

But Tamiflu is not advised for the general population at all. The reasons for that is, if a lot of people start taking a drug, it’s very much like antibiotics — a resistant strain could appear and make the situation far more dangerous than it is.

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Can you just let the virus run its course?
If someone is known to be infected, and they’re not feeling that bad, they can let it run its course. The advice we’ve gotten most consistently from public health officials about this is that people should go to the hospital, if they would normally go to the hospital. If they’re feeling so sick, then they should go because they can benefit from antiviral treatment. If they’re just feeling kind of crummy, they may or may not have swine flu.

Obviously, it’s a big problem that not everybody has a doctor. But reserve visits to emergency rooms for when you are really sick.  There are drugs to treat this, if you start to have a very high fever that’s the time to go.

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What does a "pandemic" really mean?
“Pandemic” is indeed a scary word. It means a global outbreak of an infection to which people have no resistance. Because of the raising of the phase level to 5, it would seem that we’re almost there. We have to keep in mind that it doesn’t say anything about the seriousness of the illness. There could be a pandemic of something that doesn’t cause a serious disease. We just don’t know yet the seriousness of this illness.

That’s why the raising of the phase level to 5 doesn’t affect the U.S. at all . It’s really a message to other countries to get ready because there is a very strong chance it will arrive on their shores. As the president said last night, we can’t stop it from coming here because it would be like closing the barn door after the horse is out. The virus is here already.

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Is it better to get swine flu now?
It’s better to never get the flu if you can possibly avoid it. Even though there is a theoretical possibility that it could work in the future, it may not, and it could make you very sick.  It’s not as if getting this is some picnic. You’re worried about a theoretical future of it being deadly and right now that’s just theoretical.

You wouldn’t want to get it on purpose, because you would further the chain of transmission and could pass it on to others.

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Should I change my travel plans?
I can’t advise you what to do, but the state department is issuing recommendations about this and so is the Centers for Disease Control. I would advise you to read them very carefully and pay attention.

If someone is coming back from Mexico and if they start to feel sick at all, they should stay home. But the odds of getting swine flu are very slim. It’s not as if everyone who’s been to Mexico or even a significant percentage of people who have visited Mexico have ended up getting sick.

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Are children at greater risk?
Every year during seasonal influenza in the U.S., a few children do die from the flu. Often they have underlying health conditions; sometimes they don’t. It’s usually not more than a handful each year, and it’s tragic when it does happen. But we don’t know yet whether this case is extraordinary or whether it’s something that’s going to bode badly for the future.

High fever, especially if it is increasing rapidly in a baby, is something you want to think about all the time. If your baby is sick enough to need medical attention in your opinion, you should take your baby to get medical attention and let the doctor worry about testing for swine flu.

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Why are schools closing over unconfirmed cases?
We really don’t know how much this flu is going to spread, whether it will continue throughout the summer or whether it will die out as flu viruses normally do. Different communities take different actions depending on the preferences of the local officials. One of the things that will be interesting will be to see whether the places that closed their schools will have less of an outbreak than the places that didn’t when they had similar numbers [of infections.] Scientists are happy that different communities are taking different actions because it’s sort of an experiment in real time. It’ll tell us how to handle it better if it does come back next year, or does continue for a long time.

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Are there risks to pregnancy?
Influenza can cause problems with pregnancy, and that’s something to speak about with your obstetrician. Although there’s no evidence yet that this swine flu presents more of a danger than regular influenza, you should talk to your doctor.

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Are my pets at risk?
There is no evidence whatsoever of any risk for animals that has come up. The main problem with this is that it’s a virus that seems to have originated in pigs and became capable of infecting human beings. There are flu viruses that preferentially affect cats and dogs, but that’s not what we’re talking about here.

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How does a virus get started from a specific species?
This is something that’s been studied a lot. One of the reasons the flu is such a trouble for the human population around the world is that it is a virus that mutates constantly and it passes between different animal species — mostly between pigs and different kinds of bird and humans. As it mutates, it picks up genes from the different animals, which causes it to be more or less dangerous to humans. Birds help viruses move around the world, as well as human-to-human contact.

It’s a part of nature and it’s been going on for a long time. It’s a part of nature that becomes more of a factor as human populations increase, as factory farming increases and the number of animals increases in small spaces. It is part of the ecology of our modern world.

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Can someone test negative for the swine flu and still be a carrier?
If someone was not showing symptoms, they would not be tested. But you can be a carrier and not know it.

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Still have questions about swine flu? Ask them here .  

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