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Q&A: What does ‘pandemic’ mean to me?

Is swine flu deadlier than regular seasonal flu? Are children more at risk? And is the media being too hysterical reporting on the outbreak? NBC's Robert Bazell answers your questions.
/ Source: NBC News

As the swine flu outbreak continues its rapid spread around the world and the United States reported its first death from the virus, there is still considerable confusion over the new strain.

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

I heard the WHO just raised the swine flu pandemic alert to level 5. What does that mean to me? Am I supposed to be more scared than yesterday? Should I be doing anything differently?

The change to a level 5 alert has little meaning for people living in the U.S. This country is already doing almost everything possible to track the spread of the virus, treat the victims and try to develop a vaccine. This is much more of an alert to other countries to start their own preparations for when the virus arrives.

I am currently 26 weeks pregnant.  Is it known if the swine flu presents any increased risk to the developing fetus?  Should I be taking any extra precautions to prevent contracting it?  (i.e., wearing a mask in public, calling in sick to work, etc.)

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.

I was wanting to know what in the swine flu is causing people to die? Are there steps we can take if it we get it, that will prevent it going to that extreme? The people who have died, did they just not seek medical help in time? Or is it just some people get it worse than others and it doesn’t matter what you do?
—Dawn Davis, Salem, Ore.

Nobody knows what’s in swine flu that’s causing people to die. That remains a huge question: Is this behaving like normal flu, which kills mostly older sick people and young children every year? That’s still under investigation. Nobody understands yet.

It does matter what you do. 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.

We don’t know yet what the death rate from this particular virus is. We don’t know whether the victims in Mexico who died didn’t seek medical help in time. Unfortunately, there’s no simple answer.

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.

At least so far among the people in the U.S. it’s not the kind of virus like that of 1918, where a 20-year-old would be healthy one day and dead the next day. That happened to portions of entire towns. That is not happening here.

A lot of people are getting the flu and recovering. So that is one piece of very good news. What the virus will do in the future remains unknown, but, for now, it’s reassuring.

Should we be more concerned with children getting it due to the first death in U.S. being a 23-month-old?

It’s too early to know yet. We don’t how many deaths have been among children. 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.

I’m sorry to keep saying there are things we don’t yet. But a lot of people are working on these questions.

It has been said that approximately 35,000 deaths are attributed to influenza each year in the USA.  Why should we be worried about the swine flu that hasn’t even come close to that volume?

The reason that we’re worried about swine flu is the people typically killed by flu are often older people with underlying health conditions which are pushed over the edge by getting infected with influenza. Because of the deaths in Mexico, there are indications that it may be able to strike and kill younger people.

If you contract this flu and survive will it be possible to get it more than once or will the body produce antibodies?
—Brad Davis, Minn.

You will almost certainly not get it again. There are a few dozen people who have recovered in the U.S. They are almost certainly immune to it in the future.

First the bird flu now swine flu, what next? How do these diseases keep popping up?

This is an important question. Influenza circulates regularly between animals such as pigs and birds and humans beings. Pigs are important because they are close genetically and physically to humans. Birds are important because they can transport viruses across great distances.

The point is, 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.

That’s the key — 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 the 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.

My concerns on the swine flu are the imposed hysteria being flashed on television sets around the world.  Should we be concerned? Mildly. Should we take precautions? Possibly, but no more than usual. Should it be dominating the news? Should it be portrayed as the beginning of the end? Ah, NO!  Don't get me wrong, I have [empathy] for the families who have lost someone. But really, the sky is not falling, for shame.

The sky is not falling. President Barack Obama and officials at all levels of government have tried to strike a balance. We need to be concerned because it is a potential threat, but it is not an actual threat yet. It is something they have been talking about and making plans for, for a long time.

I hope we at NBC News and are not being hysterical.  We try not to be and try to strike the same balance. It’s a case of being concerned, but not alarmed, because personal panic doesn’t do anything.

But think about what you need to do to protect your family from transmission of disease. That includes things like hand washing, staying home if you’re sick and not sending your kids to school if they’re sick. If you are sick and getting sicker, go to the doctor because there are drugs for this.

It doesn’t seem to be more easily transmitted than regular flu. The cases in New York City, for example, involve a few schools. It started in one school with kids who went to Cancun, Mexico, for vacation. And then spread to other students, some teachers and staff and their families.  That looks like garden variety flu spread. The instantaneous spread was SARS in 2003. That spread very quickly.

How is swine flu treated in individuals who cannot (because they are immunosuppressed) use "live" viruses like Tamiflu ?

There is no reason to think immune-suppressed individuals can’t take Tamiflu or Relenza, the two drugs known to treat this virus. They do not contain viruses, either killed or live. They are medications that have very few side effects.

Still have questions about swine flu? .