Swine Flu Q & A

Note: Guest blogger Matthew Hoffman, MD, has written for WebMD since 2006. He is currently a fellow in pulmonary and critical care medicine at Emory University, where he also completed medical school and residency.

As swine flu cases increase around the country, we are seeing some excellent questions from our readers about this disease. Here are answers to the most recent ones:

Anonymous said...
Is there any information on how long the H1N1 virus may live on hard surfaces? I believe that with HBV and HIV the lives of those viruses were seconds and weeks.

Dr. Hoffman: Great question. The H1N1 influenza virus is mainly transmitted through airborne droplets. Someone with the flu sneezes, coughs, or just talks, and someone else inhales the virus before the infected droplets settle to the ground.

Experts suspect that people also can catch swine flu (and seasonal flu) by touching surfaces contaminated with infected secretions (like shaking hands or touching a doorknob). Far fewer people catch flu this way, compared to airborne transmission.

Influenza viruses have been shown to survive on surfaces for 2 to 8 hours. However, that doesn’t mean they’re lurking on every countertop and faucet handle. Frequent hand washing, avoiding contact with sick people, and avoiding touching your nose, mouth and eyes are the best ways to avoid swine flu.

Anonymous said...
once diagnosed with swine flu and you have recovered can you contract the virus again?

Dr. Hoffman: No. Once you have had H1N1 influenza, your body develops antibodies against multiple parts of the virus. If you were then re-exposed to swine flu, your body would quickly destroy the virus and you would not become ill. (This assumes you have a normal immune system.)

Remember, though, that influenza viruses are constantly changing and combining with each other into new forms. (That’s why you need a new flu shot every year.) New seasonal flu viruses, and possibly swine flu viruses, will eventually develop. Immunity against the current H1N1 doesn’t necessarily provide immunity against any other form of influenza.


Anonymous said...
I want to know the answer to the second question. We think our college-age daughter had H1N1 this summer (all the symptoms--every one) but the initial rapid flu test had come back negative. Should she be getting vaccinated, since we're only 99% positive it was H1N1?

Dr. Hoffman: If your daughter is younger than 24, she should probably get vaccinated despite her previous illness. The Centers for Disease Control recommend vaccination against H1N1 influenza for anyone in these groups:

• Aged 6 months through 24 years old
• Pregnant women
• Regular close contacts of children younger than 6 months old
• Health care workers
• Anyone aged 25 to 64 with chronic illnesses

Rapid flu tests are only about 40-70% accurate at diagnosing influenza. In other words, a normal result still leaves about a 50-50 chance of having swine flu. Although your daughter may well have had swine flu earlier this year, you can’t be sure without a positive culture result.

Griph said...
I have been Diagnosed by my doctor with the Swine Flue, will I die?

Dr. Hoffman: It’s very unlikely that you will die from swine flu. In this country, the H1N1 influenza virus seems to be only slightly more dangerous than the regular seasonal flu.

People at higher risk of serious illness from swine flu include pregnant women and people with chronic illnesses. However, it’s true that unlike seasonal flu, swine flu has caused the deaths of a small number of otherwise healthy young people. I’m glad you were feeling well enough to write—most likely, that means you’re doing OK.

Our Family of 7 Got the Swine Flu

Note: WebMD employees are sharing stories about their experiences with swine flu as part of an occasional series: "WebMD Has Swine Flu."

By Donna Seigfried
Senior Editor

We have a full house: my husband, Keith (44), me (43), our four kids ranging from 2 to 15, and my mom (67). All of us got the flu, and we think we know how.

Friday night, August 21, was a big night in our community. The brand new high school had just opened for the first day of school on August 10, and on the 21st, the new football stadium was being dedicated. Athletes from all sports were being introduced, dads were making predictions about the new football team, little kids were running around playing ball, and moms were socializing.

There was plenty of hugging, hand shaking, and high-fiving going on that night between neighbors, teammates, and friends. Within 48 hours, many people in our neighborhood were suddenly sick, my 15-year-old son, Steven, and I included. Everyone else in our house followed within a few days.

While home sick from school, Steven’s friends were trading text messages about their symptoms. We all had the same thing: vomiting and/or diarrhea, sore throat, headache, fever of 101 to 103 for several days, body aches, and overwhelming fatigue.

Then the confirmations from other moms in our neighborhood started: “Patrick tested positive for flu.” “Michael was confirmed with H1N1.” “Marria has joined the club.” “Braedon has the swine flu and an ear infection.” Two people we knew had pneumonia. My friend Gail, a nurse, said her pediatrician’s office became so overwhelmed with patients that they stopped testing for flu type. If you tested positive for flu, the doctor was 98% sure it was swine flu.

So there we had it. With many around us being confirmed as swine flu cases and having the same symptoms we had, why go for a test and risk exposing others? We felt too horrible to leave the house anyway. We just stayed home and dealt with the flu in the usual way: sleeping and drinking fluids.

When I woke up on the Friday before Labor Day, my temperature was finally down around 99 and stayed slightly above normal all weekend. I had lost 10 pounds from the severe diarrhea and sweating. The Tuesday after Labor Day, I was diagnosed with bronchitis. I think we caught it just before it fully blossomed into pneumonia.

The directive from work was to stay out of the office until the symptoms were gone for 24 hours. Even though it felt strange to be home for so many days in a row, considering how fast this flu spread in our community, that was wise advice. Everyone in our house got over the flu, but altogether, it disrupted our lives for a little over two weeks.

Dr. Louise Chang, WebMD medical editor, comments on Donna's experience:
Donna's experience highlights how easy it really is for flu to spread. Experts estimate that spread of H1N1 swine flu will be greatest among school kids and households. In a recent news story, researchers estimate that an infected student will infect an average of 2.4 other students from school and the probability of an infected household member will infect someone else at home is 27%. If you are ill, following the CDC's recommendation to stay at home and infection control practices like covering coughs and hand-washing can prevent more people from getting sick.

My Son Had Swine Flu -- Maybe

Note: WebMD employees are sharing stories about their experiences with swine flu as part of an occasional series: "WebMD Has Swine Flu."

By Sean Swint
Executive Editor, WebMD

It was the Saturday morning after my 16-year-old son had three friends spend the night.

Two of them woke up that morning feeling bad, and one of them was my son.

At first, my wife and I took it in stride. Put four teenagers together in a downstairs man-cave with a gaming computer, guitars, a bass, two amps, a big TV and video game systems galore, and they generally get about two hours of sleep. At best, my son was usually groggy and grouchy the morning after such an event.

After a few hours though we realized this was a bit different.

Dylan could hardly get off the couch. He felt stuffed up, foggy-headed, and very, very tired. Then we found out he had a fever. So, we figured it was either a bad cold, or … well, I work for WebMD. Swine flu is with me every day as a concept, but now I had to face the possibility that it was about to hit home.

To be honest, I wasn't scared, but I was concerned. I knew from all our stories on WebMD, that despite the fact that swine flu is a "pandemic" and people are dying, in most cases, it's just another form of flu. But as a father, I hated to see my son feeling sick – and I knew swine flu wasn't an illness (if in fact that was what it was) to be trifled with.

My wife and I didn't see the need to take him to an emergency room, so she took him to a local clinic where he was examined by a nurse. The nurse hardly asked any medical questions, and she didn't ask Dylan anything at all, except, "what do you think you have?"

Then, she quickly looked in both ears and said he had a double-ear infection. Dylan hasn't had an ear infection since he was a baby, and then rarely. My wife asked the nurse, is there any way it could be the flu or swine flu?

The nurse said, "No, swine flu is abdominal." Then she prescribed antibiotics. We ignored the diagnosis, and didn't give Dylan the antibiotics.

We tended to Dylan over the weekend as best we could, and it wasn't until Monday afternoon that I could finally get Dylan into his pediatrician, during walk-in hours.

When we got there, we walked into pandemonium. The place was standing room only. This was not your average visit – something was up. I knew that the part of the U.S. that swine flu was hitting was the Southeast, and we live right outside Atlanta. I didn't need to be a scientist to know I was witnessing visual confirmation.

After more than an hour, our name was called, and we were escorted into a doctor's room. When the nurse came in the room about 10 minutes later, she asked all the requisite questions, then tested Dylan for strep (negative). She said since he didn't have a fever this day, she wouldn't test for flu. I knew swine flu doesn't always show up with fever, but I didn't speak up. I knew she'd been dealing with these cases for days now.

When our doctor came in, he did a thorough check-up and talked to us for about 10 minutes. He said it was definitely viral, maybe a bad cold, maybe a sinus infection. He eventually said, let's swab him for flu to see if it might be an "atypical seasonal virus." I thought that was an appropriately diplomatic way to avoid "swine flu." No need to scare people.

When the nurse came back in she said, the test was negative. Still, rapid flu tests are not always accurate. (By the way, the doc checked Dylan's ears. No infection.)

So, we went home with a prescription of rest and fluids, but no solid answer. Still, I was satisfied. I knew my son would be fine.

The bottom line: Even if the flu test came back positive, we would still never know what kind of flu it was, and that will be the case with many people this fall.

So, what did I learn? Three things. One, don't panic. Swine flu is a virus that most people will easily defeat with their own immune systems.

Two: Educate yourself! Know your, or your child's symptoms accurately, know the symptoms of flu or swine flu, and come armed with questions.

And finally, trust your instincts, especially after you've read up on the topics.

As for my son, he was back at his favorite climbing gym scaling a 30-degree incline wall like a teenage gecko several days later. He did say though that illness has hammered his high school, with multiple sick-outs.

And me? So far, I've been granted immunity.

Dr. Michael Smith comments on Sean's experience:
Even swine flu can be a learning experience. I work next to Sean every day and he has the benefit of being knee deep in swine flu and other health information. He probably knows more about swine flu that many doctors. That’s why he knew what to expect, the proper steps to take, and that there was no need to panic. Sean’s experience has probably brought up other questions for you about swine flu. Sean was prepared and you should be too. WebMD’s Swine Flu Center has what you need to know, from swine flu symptoms and the latest developments to whether it’s time to buy a mask. Stay tuned for more swine flu stories from other WebMD employees.

WebMD Has Swine Flu

Since the swine flu outbreak began, the writers, editors, and doctors at WebMD have made sure that you are on top of the latest swine flu developments.

But now swine flu has hit us in a different way. Like many other Americans, WebMD employees are coming down with swine flu symptoms.

Just in the past week, there have been several employees who have been home sick with swine flu symptoms, or home with sick kids.

Their experiences, which they will share over the next few days, will answer questions you have probably been wondering about.

What will the doctor do if you have swine flu symptoms? What should you do? Read their stories and learn all you can about swine flu in WebMD's Swine Flu Center.

Learn what to expect from others who have already gone through it. It might not be what you'd guess.

For example, if you had swine flu symptoms, you'd want to be tested to know for sure if you actually had swine flu, right? Well, you probably won't be. Unless you're very sick or have complications, which, thankfully, most people don't, your doctor won't likely test you for swine flu. And the truth is there is really no reason for the test in most of us. The test won't change treatment, it takes a long time (and by that time you're better anyway), and it's not very accurate.

It might be trite, but knowledge really is power when it comes to swine flu. You need to be prepared before you get sick.

Know when you should stay home, when you should go see the doctor, and what to expect if you do go see the doctor.

Even though some of us are home sick (which is where you should be if you think you may have swine flu!), WebMD is on top of the latest swine flu developments and recommendations, including "New Details on Swine Flu Deaths in Kids" and the latest CDC swine flu recommendations on day care advice.