Video: Bazell: Swine flu mimics typical influenza

NBC News
updated 4/30/2009 5:52:32 PM ET 2009-04-30T21:52:32

Many cases of swine flu in the United States may be mild , but at least one msnbc.com reader wondered how companies should respond if their employees get sick with the virus, or if the pandemic alert is raised to the top level. Others are unsure how the virus is identified or whether to go ahead and take antiviral medication — just in case.

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

How do labs examine swabs to provide clear swine flu ID? What is the time required and what is the certainty of their test?
—Jack Leppert, Crawfordville, Fla.

The 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. This dispersion of the tests will make it easier to identify at the state level. Also, some large cities could have some identification equipment for their own health departments.

What are the recommendations for employers if the threat level is raised? Should we be providing masks? Will we need to have people work from home?
—Anonymous

I think the government will start talking about this very soon. Every big employer should be thinking — not just for this one, but the general threat of a big outbreak of disease in this country — about what their plans are. How many people are capable of working from home to keep the organization going?

It’s very important that employers send out memos to their employees in these difficult economic times that they should stay home if they are feeling sick or have an ill child, and that they are not going to be penalized for doing it. It’s going to take some economic sacrifice for employers to say that. A very tiny minority of people will take advantage of it. But it’s so important because staying home when sick is a big part of infection control.

If people don’t have a sense that they can stay at home when sick, it could have serious consequences. Every employer large and small should starting thinking about if the outbreak in their area gets bad.

Should I take Tamiflu or Relenza before the chance of infection just in case?
—Anonymous

People should absolutely not be taking antiviral drugs if they are not sick and not diagnosed by a doctor. It could create resistance, just as bacteria can develop resistance to antibiotics, and it could make the situation more difficult for everyone on earth. It could also use up vital supplies that could be used to save the lives of other people.

I think "pandemic" is a very scary word because we don't really know what it means.  It sounds like "epidemic, only worse," and I don't think that is accurate. Could you please explain what "pandemic" means and how it compares to epidemic?  If just ONE person in every country showed up with this virus, would it be called a pandemic?
—Anonymous

“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.

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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.

How does the flu virus die out every year?  What is the time period before this virus is "out of flu season" like other flu strains?  Will it keep spreading even though it isn't technically "flu season" any longer?
—Anonymous

Influenza typically peaks in the Northern Hemisphere between November and May and in the Southern Hemisphere between May and November. Nobody knows why — it is one of the big unanswered questions of the flu.

The flu chief of the World Health Organization, Keiji Fukuda, says it is very important that the agency look at countries in the Southern Hemisphere because they are coming into their natural flu season to see if it takes hold even more there and becomes part of the natural seasonal flu outbreak. There’s no answer to that yet.

Nobody ever said you can’t get the flu in the summer, because you can. It’s spreading now because it’s new and we’re paying attention to it and looking for it.

Also, the World Health Organization said it was going to stop calling the illness swine flu, referring to it by its scientific name instead. Trying to call this H1N1 influenza A is one of the stupidest things I’ve ever heard and it’s totally driven both at the federal government level and by the U.S. government putting pressure on the WHO at the international level.

It turns out that one of the circulating seasonal influenzas this year, is AH1N1 — it’s a general category of flu viruses that is very wide and includes a lot of subtypes. This new one is one of the subtypes — the one that’s been circulating is a different one. We have immunity to one — it’s covered by the flu shot and it’s resistant to Tamiflu — whereas the new one has the opposite of both of those critical characteristics. The nomenclature is all to try to save the pork industry, even though we have said over and over again that there is no way you can get this virus from eating pork.

Traditionally, flu virus strains are named by the places where they are first identified. But if this were called Mexican flu like it was called Spanish flu in 1918, there would be an enormous amount of discrimination against Mexico and Mexicans. That’s why you give it a name like swine flu.

How are we meant to tell if our babies have swine flu or normal flu when they don’t talk enough to explain how they feel?
—Anonymous

This is about how you care for a baby. Nothing should be different now because of swine flu. High fever, especially if it is increasing rapidly in a baby, is something you want to think about all the time.

A parent will have an idea when to call the doctor or take a baby to the hospital, depending on how sick the baby is. If the 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 sending the sample off.

We keep hearing from the CDC to expect deaths here in the U.S. and I'm wondering why, if the early cases seem mild.
—Barbara Shelby, Salem, Ind.

There is a sensible response at the federal level of preparing for the worst and hoping for the best. That’s the way you should deal with this kind of situation. Even if this strain were to behave close to how normal seasonal flu behaves — if there are thousands of cases — there are going to be some deaths. Clearly, there can be mild cases because a lot of the high-school students in Queens have recovered and they’re going to be just fine. That’s good news. But it does causes deaths. It’s a question of what percentage of the cases cause deaths and we don’t know that yet.

According to the CDC, there are seven people hospitalized in the U.S. and one death in the case of the child who came from Mexico. But a lot of the cases are mild and the question is why.

It’s very hard without the proper lab equipment, which is just now arriving in Mexico in force, to know exactly what happened in that country. Were all those deaths really flu or were those deaths from something else at a time when this flu was circulating? Until those questions are answered, you just don’t know what that means.

The other possible thing is the virus mutated and gets less virulent as it travels down the chain of infection. But there’s no evidence of that yet. The molecular biology of the virus that’s found in the U.S. is the same that’s found in Mexico, even in the most serious cases.

I am so so worried about this swine flu but I would like someone to put my mind at rest because I haven’t stopped thinking about it. ... I’m really worried but I don’t know if there is any need for me to be.
—Kim Ronald

I would stay with the words of the President of the United States that it is a cause for concern, but not for alarm or panic. We just don’t know how this is going to play out yet. There are people who have gotten mild cases. It certainly isn’t a deadly virus like the one that was circulating at the height of the 1918 pandemic, and it seems more like some kind of flu that can occasionally cause problems, but not always certainly, and probably not very often.

Keep in mind that 100 people get killed in traffic accidents every day and some people still don’t wear seat belts. The simple things that everybody is talking about — washing your hands and covering your mouth when you cough or sneeze — may sound trivial, but they’re not. Worrying is not going to make it go away or change the situation.

Still have questions about swine flu? Ask them here .  

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