As New York City officials report that hundreds of children may be sickened with swine flu and U.S. health officials brace Americans for possible deaths, msnbc.com readers are understandably anxious about the fast-moving outbreak. While you’re not panicking yet, you have .
NBC Chief Science and Health Correspondent Robert Bazell provides some answers.
Do the masks that are sold over the counter and that we are seeing all over the news provide any protection?
The 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.
The mask can sometimes make people feel better — it seems like they’re doing something. But they can increase the level of fear among those around you, so health officials are not recommending use of the masks at all.
I have two elementary-school children whom I always send to school with antibacterial hand wash in their lunch boxes to use before eating lunch. Will using the antibacterial handwash be sufficient to kill the flu germ off their hands or do they need to use soap and water?
—Judith Deer, Livingston, N.J.
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.
It’s very easy because you can carry the little bottle around in your pocket and you don’t have go looking for soap and water if you want to wash your hands frequently.
Our company has several people who will be vacationing in Mexico. What should we do as a company to ensure that our employees have not contracted the swine flu and possibly spread it to other workers?
There is no recommendation from health officials right now about any kind of quarantine if you’re coming from Mexico. Certainly if someone is coming back from Mexico and if they start to feel sick at all, they should stay home. The odds of them getting it 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. It’s something to be aware of, but the idea of quarantining people has not been suggested. It seems like it would be counterproductive and an enormous waste of resources. That recommendation could change if enormous amounts of this disease were coming in, but that doesn’t seem to be happening at all.
Is there any possibility of this strain crossing into dogs, cats or other pets? If so, are small animals (puppies, kittens) more at risk than adult animals?
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.
I am scheduled for a hip replacement in three weeks. Are my chances of getting the swine flu higher in the hospital after my surgery? If so, what precautions will the hospital take to prevent me from getting the flu? Will I be more apt to get the flu after the surgery? (I am rather young for hip replacement — 49) Should I request that my family wear masks when visiting me? (I have a 14-year-old son.)
There have been no known outbreaks in hospitals so far. Hospitals in the U.S. have negative pressure rooms where people who are suspected of having infectious conditions are kept. There is, of course, a problem of all kinds of infections spreading in hospitals, but there’s been a lot of emphasis on trying to reduce the danger of that. But there has been no evidence that emerging swine flu outbreak is causing more of a problem than there has been before with other infections.
How will the government decide whether this virus strain should be included in the next vaccine? If they do decide to include it, will manufacturers be able to make enough vaccine for the whole U.S. population? If not, who gets priority? Does the fact that this atypical strain appears to affect young adults more than the usual elderly and very young change the distribution guidelines?
Whether to go ahead and produce a vaccine is a good question. The government is in intense negotiations with itself at the highest levels trying to do this. What’s happened so far is the Centers for Disease Control is taking what’s called a seed stock. The agency took a virus known to be this swine flu and is growing large quantities of it. So far it’s just at the CDC, but at any time the decision is made, that could be turned over to manufacturers to start making a vaccine. It could take several months before a vaccine is available but it’s something government officials are considering very seriously.
Whether they would include it in the seasonal vaccine is very difficult to answer. It will become part of the process — whether it will become part of the seasonal vaccine or additional vaccine and you could get two shots. All those things are under discussion. It would be technically possible to put it in the seasonal flu vaccine. It depends how far along in the manufacturing process of the seasonal vaccine. It could be separate or part of it.
Exactly what part of this flu is killing people? And at what point should a person actually seek medical attention?
That remains the biggest question. Why have there been deaths in Mexico and not in the United States? Nobody knows why those people died. It’s not even clear that everybody who has died in Mexico died of this flu. Certainly some of them have because it’s been confirmed by tests of the virus at the CDC. But there may be other deaths in Mexico attributed to this, but until the autopsy specimens are worked up thoroughly with very good lab equipment, we don’t know. That’s one of the big questions that the CDC and others are putting a lot of effort into trying to find out. The deaths in Mexico remain the big question.
It’s important to note that there have not been any deaths in U.S. But Tuesday the CDC said there were five more cases of hospitalizations in California and Texas, and the New York City health commissioner said about two were hospitalized in N.Y. As predicted all along, we are starting to see some severe cases of swine flu in the U.S. Health officials say over and over that they would not be surprised to see some deaths.
It’s too soon to know what the case fatality rate is for the disease. It is a huge issue. It could be that an enormous percentage of the population of Mexico was infected with this virus and that the number of people who died was only a small percentage of that. Or it could be that there is this very dangerous virus out there. You have to do an enormous amount of sampling randomly of people on the street who didn’t get sick at all, as well of people who got sick. There’s a lot of shoe leather and lab work involved in that. It’s the answer everyone wants.
You should seek medical attention if have a fever of 102 or if you feel very sick. Swine flu has flu-like symptoms of lethargy or muscle aches or pains. Or if you have been to Mexico or in contact with someone from 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, no just swine flu.
How do we tell if it’s swine flu or just a regular flu? My family had the symptoms of fever, cough, sniffles, headache, muscle ache, vomiting and diarrhea. This was the third week April. We have all since recovered. Is there a specific indicator that it’s swine flu?
There is absolutely no difference. There is no specific indicator. 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. Having had it — and most people in the U.S. have had mild cases — it doesn’t change your life at all.
Annually, the U.S. inoculates millions against the predicted strain of influenza for that year. Since all flu viruses are similar, does getting the various flu shots over the past several years offer any collateral immunity benefits — such as less severe symptoms?
All flu viruses are similar in many ways, but they’re not so similar that they cause the same anagenic response. That’s why we need a new flu shot every year. But this one is completely different from what we’ve seen before.
So, 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.
That’s one of the many reasons everyone is so concerned about this strain.
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