WebMD News Watch

Acetaminophen and Liver Injury

2009-06-30T11:06:00.001-04:00

Three FDA advisory committees are meeting today to discuss possible ways to try to cut the risk of liver injury from acetaminophen in over-the-counter and prescription products.

You might not know "acetaminophen," because that's the drug's generic name. It's found in many over-the-counter products -- including Tylenol, aspirin-free Anacin, Excedrin, and numerous cold medicines. It's also found in many prescription drugs.

The FDA says acetaminophen is generally considered safe when taken according to the directions on product labels. But taking too much acetaminophen -- even a little too much taken by accident -- can lead to liver injury.

Products containing acetaminophen already note that risk. But today's FDA meeting is happening because some people still take too much acetaminophen.

Today, the three FDA advisory committees will vote on various options, ranging from additional warnings to limiting doses to banning over-the-counter acetaminophen products. The FDA isn't required to follow the advice of its advisory committees.

Makers of acetaminophen products and the Consumer Healthcare Products Association (CHPA), a trade group for the over-the-counter drug industry, have stressed the safety of acetaminophen when used properly and argued for keeping the products on the market, according to media reports.

As the FDA advisory committees weigh their options, here are steps the FDA wants people to take when using acetaminophen to reduce the chance of liver injury:

• Follow dosing directions and never take more than the recommended dose of acetaminophen.
• Do not mix acetaminophen-containing products. For instance, acetaminophen could be in a headache medicine and in a cold medicine; if you take both, you may wind up getting too much acetaminophen.
• Talk to your doctor about acetaminophen if you drink alcohol or have liver disease.
• Be aware that acetaminophen comes in many forms, including drops, syrups, capsules, and pills.
• Check drug labels to see if it contains acetaminophen. If you're taking a nonprescription (over-the-counter) product, check the "Active Ingredients" section of the "Drug Facts" label.
• Know that acetaminophen may be abbreviated as "APAP" on prescription drug labels.
• Don't take acetaminophen for more days than directed.

The FDA notes that acetaminophen can be given to infants, children, and teens, but the FDA reminds parents and caregivers to take these steps, posted on the FDA's web site, for safety's sake:

• Check the active ingredients list on drug labels. Your child should never take more than one medicine containing acetaminophen, whether it's an over-the-counter drug or a prescription drug.
• Read and follow all the directions given by your child's doctor and on product labels.
• Choose the right medicine based on the child's weight and age. Check the "Directions" section of the "Drug Facts" label on over-the-counter products to see if the medicine is right for your child, how much medicine to give, how many hours to wait before giving another dose, and when to stop giving acetaminophen and ask a doctor for help.
• Use measuring tools that come with the medicine. Don't use a spoon that's meant to be used for cooking or eating. If you don't have the measuring tool that came with the medicine, ask your pharmacist for one.
• Keep a record of what doses you gave the child and when.
• Keep all medicines where they can't be seen or reached by children -- a locked box, cabinet, or closet is best.

If you or someone else takes too much acetaminophen, the FDA recommends calling 911 or Poison Control (800-222-1222) right away to find out what to do. Liver injury symptoms may not appear for hours or even days -- and by then, the damage may be severe and could lead to death.

Of course, any medication should be taken as directed. That includes other types of pain relievers besides acetaminophen. For more FDA tips on pain medicines, read A Guide to Safe Use of Pain Medicine.

And tell us, how careful are you when you take acetaminophen? How strictly do you follow the directions on the label -- even when you're, say, hung over or feeling sick?

Michael Jackson Dies from Cardiac Arrest

2009-06-25T18:27:00.011-04:00

Michael Jackson, age 50, has died from reported cardiac arrest.

The main cause of cardiac arrest, which means the heart has stopped, is a heart attack.

Although not denying that Jackson died of cardiac arrest, Los Angeles County Coroner spokesman Craig Harvey, after the initial autopsy on Friday, says the cause of death will be deferred until further toxicology tests can be conducted. He anticipates final results in four to six weeks.

Many people confuse cardiac arrest and heart attack. A heart attack is caused when a clogged artery stops blood flow to part of the heart muscle.

Cardiac arrest is different.

While a heart attack is a plumbing problem, cardiac arrest is electrical. The heart is triggered to beat with regular electrical impulses. But if these electrical impulses become erratic — causing an irregular heartbeat called an arrhythmia — the pump may not work.

When you see heroic TV doctors shouting “Clear!” and shocking a flat-lining patient with paddles, they’re dealing with cardiac arrest. They’re trying to electrically jolt the heart back into the correct rhythm.

According to the American Heart Association (AHA), it's estimated that more than 95% of cardiac arrest victims die before reaching the hospital. The treatment is defibrillation, trying to shock the heart back to a normal rhythm.

However, the AHA says that a victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation. Few attempts at resuscitation succeed after 10 minutes.

Farrah Fawcett Dies

2009-06-25T14:25:00.001-04:00

Actress Farrah Fawcett died today at age 62, having fought anal cancer since 2006.

People reports that Fawcett died at St. John's Health Center in Santa Monica, Calif., where she was being treated for complications from anal cancer. Her partner, Ryan O'Neal, was among those with her when she died.

Fawcett went public with her struggle against anal cancer in a documentary that aired on NBC in May.

In that documentary, Farrah said, "Cancer is a disease that is mysterious, headstrong, and makes its own rules, and mine to this date is incurable. I know that everyone will die eventually, but I do not want to die of this disease. I want to stay alive."

Feel free to leave your comments, thoughts, and feelings about Fawcett here.

Generic Plan B Pill for Women 17 and Younger

2009-06-25T10:12:00.000-04:00

The FDA has approved the first generic version of the emergency contraceptive Plan B (levonorgestrel). It will be available by prescription only for women aged 17 and younger.

Plan B -- the brand-name drug -- is already available without a prescription to women aged 18 and older. In April, a federal judge ordered the FDA to lower the age limit for Plan B to age 17, and the FDA said it would not appeal that ruling, but that Plan B's maker, the drug company Duramed Pharmaceuticals, Inc. -- would need to file an application first.

But the new generic levonorgestrel product requires a prescription, and it's specifically approved only for women aged 17 and younger.

A woman aged 18 and older could get a prescription for the generic product, but that would be an "off-label" use, because the generic product specifies the age range of the patients for whom it's approved.

Why not just make the generic product available without a prescription?

Because Duramed Pharmaceuticals has a patent on Plan B's nonprescription sales until Aug. 24, 2009. The new generic product is made by a different company, Watson Laboratories Inc., and even after Duramed's patent expires, the generic product won't automatically become available without a prescription -- Watson Laboratories would have to seek FDA approval for that. The FDA won't say whether such an application has been filed.

As for brand-name Plan B, it's a nonprescription drug now, and is no longer approved as a prescription drug for women 18 years and older.

Nonprescription drugs are often called "over-the-counter" drugs, but Plan B isn't out on store shelves; it's stocked behind pharmacy counters.

There is no age limit on how young is too young for the new generic, prescription-only levonorgestrel product. But a doctor would have to prescribe it; young women or girls can't get it otherwise.

Levonorgestrel can prevent pregnancy after unprotected intercourse or a known or suspected contraceptive failure. "It is not effective in terminating an existing pregnancy and does not protect against sexually transmitted diseases, including HIV infection," states an FDA news release.

What's Your Molecular Age?

2009-06-18T17:13:00.000-04:00

Researchers report the development of a new blood test that they say may show your "molecular age," as opposed to your chronological age.

That test measures levels of a protein called p16. A new study shows that p16 levels rise as people age, that smokers have higher levels of p16 than nonsmokers, and that people who exercise have lower levels of p16.

The test isn't available to the public yet. But if it was, would you want to know your "molecular age"?

Let's say you took the test and found out your molecular age was greater than your chronological age, suggesting that your aging process is on the fast track. Or maybe you'd find out that the opposite is true, that your clock isn't ticking quite as fast as you thought.

What would you do with that information? Would it spur you to make lifestyle changes to try to stave off aging, or would you be looking for reassurance that your healthy habits are paying off?

The U.S. population is getting older. Nearly one in five U.S. residents will be at least 65 years old in 2030, and the number of people age 85 and older is expected to triple between 2008 and 2050, according to the U.S. Census Bureau's predictions.

How are do you feel about aging? Is it something that bugs you, something you accept, or a little bit of both? Or is age just a number to you? If you're doing something that you believe will help you age well, tell us.

Personal Health Care Reform

2009-06-16T15:28:00.002-04:00

Health care reform is a hot topic this year, and President Obama outlined his vision for health care reform yesterday in Chicago at the annual meeting of the American Medical Association (AMA).

In his speech to the AMA, Obama made these main points: health care reform is an economic must, people will be able to keep their doctors and current health insurance plans, the government won't tell doctors how to practice, and all Americans must be able to get affordable health insurance.

Acknowledging that reforming health care will be "difficult," Obama said that "there's probably healthy debate within the AMA" about how it should be done.

Obama drew some boos when he said he didn't support caps on malpractice awards, explaining that he felt such caps "can be unfair to people who've been wrongly harmed." But he also said that it would be hard to make certain changes in health care "if doctors feel like they're constantly looking over their shoulders for fear of lawsuits."

The AMA later released a statement responding to Obama's speech.

"The AMA is committed to achieving reform this year so that all American have affordable, high-quality health coverage," AMA President Nancy Nielsen, MD, said in the statement.

Nielsen said the AMA is "very pleased that President Obama has expressed an openness to medical liability reform as part of comprehensive health reform."

She didn't mention his stance on malpractice caps, and the AMA statement didn't endorse or criticize Obama's approach to health care reform.

The AMA noted that Obama got a standing ovation when he told the hall full of doctors that "you did not enter this profession to be bean counters and paper pushers. You entered this profession to be healers -- and that's what our health care system should let you be."

Obama also emphasized preventive care.

"That starts with each of us taking more responsibility for our health and for the health of our children. It means quitting smoking. It means going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside ... [and] cutting down on junk food," Obama said.

A transcript of Obama's AMA speech is posted on the White House's web site.

What are your hopes and fears for health care reform? Do you think personal lifestyle choices have a place in the debate? If so, how far would you push the "responsibility" issue?

Swine Flu Pandemic: Panic Now, Avoid the Rush?

2009-06-11T17:03:00.008-04:00

Obviously, the answer is no.

Believe me, I'm definitely not making light of swine flu. Yes, it's a serious problem. People have died. But keep in mind that about 36,000 people die every year from garden-variety flu. Do you panic each fall when flu season starts?

The fact that swine flu is now officially a pandemic doesn't mean you should do anything differently -- as long as you were already doing the right things.

It also doesn't mean swine flu has become more deadly. A pandemic means that the infection has spread around the world. But we know that swine flu rarely causes serious illness, with about 13,000 cases and 27 deaths in the U.S.

Don't panic. But take action.

Hopefully, when swine flu surfaced a couple of months ago, you started doing all the right things, if you weren't already. If you stopped, I hope the fact that we have an official swine flu pandemic will spark you to start again. And don't stop this time!

Flu prevention -- both for swine flu and garden-variety flu -- should be a lifestyle and not a reaction to an outbreak. Get in the habit of doing what we know helps prevent spread of swine flu and other respiratory infections.

Wash your hands regularly with soap and water, especially after coughing or sneezing. Or, use an alcohol-based hand cleaner if soap and water are not available.
Avoid close contact -- that is, being within six feet -- with people who have flu-like symptoms.
Avoid touching your mouth, nose, or eyes. That's not easy to do, so keep those hands clean.
If you have flu-like symptoms -- fever plus at least cough or sore throat or other flu symptoms -- stay home for seven days after symptoms begin or until you've been symptom-free for 24 hours -- whichever is longer.
The CDC does not recommend using a face mask or respirator in community or home settings. However, the CDC says that people at increased risk of severe flu illness may consider wearing a N-95 respirator or face mask in crowded settings in communities where swine flu is circulating or when taking care of a person with flu-like illness. It's not known whether face masks actually protect against flu transmission.
People who have or are suspected of having swine flu should wear a face mask, if available and tolerable, when sharing common spaces with other household members, when outside the home, or when breastfeeding.

Now that there's an official swine flu pandemic, are you going to take extra precautions to avoid getting infected?

Parental Depression a Family Affair

2009-06-10T17:27:00.003-04:00

When a parent gets depressed, it can cast a cloud over the whole family, and the whole family should be addressed in treating parental depression.

That's the bottom line from a new report, released today by the National Research Council and the Institute of Medicine.

The report is full of policy and research recommendations. But on a very practical level, the report makes it clear that parental depression affects children -- and that depression can be treated.

The sooner depression treatment starts, the better, notes William Beardslee, MD, of the psychiatry department at Children's Hospital in Boston.

"We really think getting treatment early is important," Beardslee says.

Beardslee says during one of the parental depression studies he worked on, a mother told him that when she was depressed, her after-school routine with her young son nosedived.

When that mother wasn't depressed, she would help her son with homework, play with him, and give him a snack. "She said, 'When I get depressed, all that just goes out the window and I plop him down in front of the TV set," the mother told Beardslee. "Our work with her was around how she could, despite depression, keep in place the structures that really helped this boy."

"The fundamental point," says Beardslee, "is that we need to view parents who are depressed as parents first and help them with that," besides treating their illness.

Another committee member, Mareasa Isaacs, PhD, executive director of the nonprofit National Alliance of Multi-Ethnic Behavioral Health Associations, says she's heard depression myths from parents that hinder them from seeking help.

"We know parents often feel they're going to lose their children," Isaacs says. "There are a lot of stigma-related messages that need to be changed for everyone to feel safe and comfortable in getting treatment."

Warning signs of parental depression are just like the warning signs of depression in people without kids. Symptoms of major depression include:

• Persistent sadness, pessimism
• Feelings of guilt, worthlessness, helplessness, or hopelessness
• Loss of interest or pleasure in usual activities, including sex
• Difficulty concentrating and complaints of poor memory
• Insomnia or oversleeping
• Weight gain or loss
• Fatigue, lack of energy
• Anxiety, agitation, irritability
• Thoughts of suicide or death
• Slow speech; slow movements
• Headache, stomachache, and digestive problems

Symptoms of dysthymia (milder, but long-term depression) are less intense and fewer in number, but long-lasting -- and of course, deserve treatment.

Have you or someone you know faced parental depression? If so, what was the toughest part -- figuring out that it was depression, finding help, or just getting through the day? Or is the depression going untreated?

New Pharma Rules May Backfire

2009-06-04T17:21:00.003-04:00

(Orlando) – Doctors seemed a little taller at this year’s annual meeting of the American Society of Clinical Oncology (ASCO), which started Saturday and ended Tuesday.

The reason: The drug company industry's ban on logo-laden pens, mugs and other giveaways to doctors.

In years past, attendees swarmed the enormous exhibits hall, rushing from booth to booth, trick or treating for tchotchkes ranging from personalized ballpoint pens to MP3 players.

Weighed down by overstuffed bags stamped with the logo of one drug company or another, their gaits unsteady as they struggled to balance their new toys, the doctors appeared – well, shorter.

Fast forward to 2009. Under a voluntary code of conduct from PhRMA, the drug-industry trade group, drugmakers are to abstain from noneducational freebies, such as pens or mouse pads. The policy, which went into effect at the beginning of the year, came amid criticism that nominal gifts influence -- or appear to influence -- physicians’ prescribing patterns.

Excuse my cynicism, but I find it hard to believe that my doctor would prescribe me one drug over another simply because he has a promotional keychain.

What did happen is that exhibit areas – not just at ASCO, but at all the major medical meetings – have become ghost towns. Doctors’ conference bags have become lighter. They seem taller.

There is also an unintended consequence of the new regulations, says Len Lichtenfeld, MD, deputy medical director of the American Cancer Society (ACS).

Traffic is down not only at drug companies’ booths, but at those of nonprofits like ACS that aim to stamp out cancer and patient advocacy groups as well. He’s worried the regulations will have a backlash on groups like his.

Meanwhile, through a loophole in the policy, drugmakers continue to fund lavish all-you-can-eat dinners for attendees. (The policy reads: “A [drug] company should not provide meals directly at continuing medical education [CME] events, except that a CME provider at its own discretion may apply the financial support provided by a [drug] company for a CME event to provide meals for all participants.”)

And drugmakers continue to pay doctors huge sums for research and consulting. The list of conflicts-of-interest (COI) – meaning the authors have a financial stake in the company that makes the study drug -- on some clinical trials runs a full page. And just like the fine print on advertisements, the COI list often goes unnoticed.

“They’re worried about me taking a pen and these people are taking in hundreds of thousands of dollars for research,” Lichtenfeld told me at dinner the other night (yes, I paid my own way).

Maybe PhRMA should consider refining the rules – so that doctors and drugmakers can truly stand taller.

Charlene Laino
WebMD Guest Blogger

Related Topics:

Rethinking Pregnancy Weight in Obesity

2009-06-02T15:39:00.000-04:00

Pregnancy weight gain may not be necessary for obese women, provided they get solid nutritional advice throughout their pregnancy.

That's according to researchers including Yvonne S. Thornton, MD, MPH, clinical professor of obstetrics and gynecology at New York Medical College in Valhalla, N.Y.

Thornton and colleagues have just published a study about pregnancy weight gain in obese women.

It's a topic Thornton knows personally, not just professionally. Her own struggles with weight inspired the study.

"I've had a lifelong battle of being overweight," Thornton tells WebMD.

Thirty years ago, during her first pregnancy, Thornton says her doctor gave her prenatal nutrition advice. But Thornton, herself a doctor specializing in maternal-fetal medicine, says she set that advice aside.

"I was so happy to get pregnant. I just ate everything," she recalls. "I need protein; let me get some spare ribs and barbeque sauce. I need dairy products; let me get some Haagen-Dazs.' You know? And I gained 67 pounds."

After her son was born, Thornton joined Weight Watchers, and she lost some weight, but she was still overweight when she learned she was pregnant again.

"I said, 'I'll be danged if I'm going to gain another 67 pounds,'" Thornton says. She decided to focus on eating healthfully, and she kept her weight steady during her pregnancy.

"I didn't gain; I didn't lose any weight," Thornton says. "I stayed 200 pounds the entire pregnancy. At the end, just before my daughter was born, I gained a half a pound." She says her daughter, who was born healthy, is now a Stanford University graduate.

"I said to myself, 'It worked for me. Why can't it work for other patients?' And that planted the seed of doing this randomized clinical trial," says Thornton, cautioning that her approach is geared only to women who are obese when they become pregnant.

In Thornton's study, obese women still gained weight while pregnant, but not as much when they followed personalized eating plans and kept food diaries that got reviewed at each prenatal checkup.

But overeating during pregnancy is "ingrained" in society, Thornton says.

"It's the only time in a woman's life when society will give her the license to be looking like Frosty the Snowman," says Thornton. "How many times can we take the opportunity to do that? And so, many women do. But I still profess that it is not the time to overeat."

Still, the new guidelines from the Institute of Medicine (IOM) recommend that obese women gain 11-20 pounds while pregnant.

Where do you stand? Should obese women just focus on eating healthfully, instead of the numbers on the scale? Or does it help to have a specific weight range as a benchmark?

Pregnancy Weight Gain

2009-05-28T16:06:00.000-04:00

The Institute of Medicine (IOM) today issued new guidelines on how much weight to gain during pregnancy. But actually, those guidelines begin before pregnancy.

The IOM wants women of childbearing age at a healthy weight before getting pregnant, for the sake of the health of mother and baby alike. And the IOM wants women to be offered preconception counseling about weight, diet, physical activity -- and contraception, if they're overweight or obese, so that they can lose extra weight before pregnancy.

Then, once a woman gets pregnant, she's supposed to keep her weight gain within certain limits, based on her BMI (body mass index) before pregnancy.

Here are the IOM's weight gain allowances for a woman carrying one child: If she's underweight, she should gain 28-40 pounds. If she's at a normal weight, she should gain 25-35 pounds. If she's overweight, she should gain 15-25 pounds. And if she's obese, she should gain 11-20 pounds.

Does that sound doable to you? Or did you figure that since you're "eating for two," you can double your calories -- especially if you're having cravings or feeling hormonal?

Don't go there, says Melissa Goist, MD, a clinical assistant professor of obstetrics and gynecology at the Ohio State University Medical Center.

A normal-weight woman would need only 300 extra calories per day to maintain a healthy pregnancy with one baby -- that's one-sixth of her prepregnancy calorie budget and roughly the amount of calories in a Snickers bar, Goist says.

Of course, Goist isn't recommending that pregnant women get their extra pregnancy calories from candy bars -- a healthy, balanced diet is the way to go.

Goist says it can be tough to talk to pregnant patients about weight, like her patient who was 8 pounds heavier each month that Goist saw her. Keeping that pace for nine months would put her way over the IOM's recommended weight gain. Plus, Goist says that patient wasn't following her dietary advice -- she was feasting on carbohydrates.

Goist, and the experts who wrote the IOM's new guidelines, say the public hasn't gotten the message that pregnancy isn't a time to ignore weight or eat with abandon.

What do you say? If you've been pregnant, how much weight did you gain, and did your doctor talk to you about it? How hard was it to lose the weight after the baby was born, and would you gain more or less weight if you had to do it all over again?

Summer Begins -- Swine Flu Ends?

2009-05-22T15:41:00.009-04:00

Memorial Day is the unofficial start of summer, so does that mean the official end of swine flu?

Attention to swine flu has waned, but swine flu hasn't. It looks like swine flu is here to stay -- for how long we don't know. While flu is unusual in the warm, summer months, swine flu is still swirling around. CDC officials say the entire U.S. is likely affected, and they continue to see more people with swine flu. Officials aren't sure what will happen when the fall flu season arrives.

So as school comes to a close, is the threat of swine flu going to affect your summer plans? Should you be concerned about exposing your child to a crowded group of kids at summer camp?

The CDC says there is no reason to keep your kid out of school unless he/she is sick. The same holds true for summer camp or any other summer activity.

Yes, the risk of swine flu is out there. But thankfully, very few people are developing serious illness. It appears we have no more reason to be concerned than during the normal flu season.

While you don't need to let swine flu get in the way of a fun summer for you and your family, hopefully the attention that swine flu has received will help all of us remember how to stop the flu. And no time like the present to teach your kids a few simple tricks.

Lead by example. It's tough to get kids to wash their hands -- much less for the recommended 20 seconds (a good rule of thumb is to sing Happy Birthday twice). Most of us aren't so good at that either.

Your kids have likely heard about swine flu, so take the time to explain to your kids why frequent hand washing is so important. It'll go a long way to not only preventing the very contagious swine flu but also other respiratory viruses, such as colds, and even stomach bugs.

And come fall, most of us have no reason not to get the flu vaccine. The CDC has found that people born before 1957 may have a bit more immunity to the swine flu virus than younger people. This is likely due to their exposure to previous flu viruses and possibly having received flu vaccines in past years.

Are you going on about your normal business or has swine flu caused you to change your summer plans?

Pneumonia Vaccine for Swine Flu?

2009-05-19T14:28:00.006-04:00

Kudos to the reader that asked this question. It's very insightful and shows you're thinking about this swine flu outbreak logically.

"Dr. Smith, Since a complication of swine flu (and other flu) is pneumonia, shouldn't we all be getting the pneumonia vaccine? Wouldn't having protection from pneumococcal pneumonia help you if you did contract the swine flu? Is this type of pneumonia what is killing some swine flu victims?"

You're right in that bacterial pneumonia is often one of the main things that kills people who have the flu (about 36,000 people die from the flu every year). Sometimes that bacteria is pneumococcus. Sometimes it's other bacteria, like staphylococcus. The pneumococcal pneumonia vaccine (more commonly known as just the pneumonia vaccine) would help if it's pneumococcus.

However, many of those that have died from swine flu have died from viral pneumonia. This means that the swine flu virus itself is causing the lung infection and inflammation. Unfortunately, a pneumococcal vaccine wouldn't have helped in these instances.

Those of you who have kept up with my blog know that I'm a very big proponent of the flu vaccine. Same is true for the pneumonia vaccine. Both save lives.

So who should get the pneumonia vaccine?

Currently, it is recommended for:

All adults 65 or older
Everyone 2 and older with chronic medical conditions such as diabetes , chronic lung, heart, kidney or liver disease, or alcoholism
People over 2 whose immune systems have been weakened by such conditions as cancer or HIV infection
People without a functioning spleen
People with sickle cell disease

In October, a CDC panel also recommended that people with asthma or those who smoke should receive the pneumonia vaccine. It's not an official recommendation at this point but if you have asthma or you smoke, ask your doctor if the pneumonia vaccine is right for you.

Something Good Out of Swine Flu

2009-05-11T10:51:00.010-04:00

It's tough to think of something good that could possibly come out of the swine flu outbreak that has killed 3 people as of today, but I'm keeping my fingers crossed.

During the normal flu season, I have to practically beg and plead some people to get a flu shot -- including my parents! But that's because most people go through the flu season with a "not me" attitude. I thought we grew out of that when we were teenagers.

Even though this swine flu outbreak has been mild so far -- and that could change -- I hope it's at least made an impact on people. I'm hoping that, come November, more people will be rushing to get their flu vaccine. After all, the normal flu kills 36,000 people every year!

It's unclear at this point if a swine flu vaccine will be included in the recommendations this year (or if one will even be developed in time) ... but we know that the annual flu vaccine stands to save thousands of lives.

The flu vaccine is the #1 best way to prevent the flu and prevent flu complications, such as pneumonia and even death.

Let's learn something from this swine flu outbreak.

If you can significantly lessen the likelihood of getting the flu and flu complications, why not? A few minutes, and a tiny needle stick, just might save your life -- or the life of a loved one.

Do you always get a flu shot or do you think the swine flu outbreak will finally convince you to get a flu vaccine?

Swine Flu: One Extreme to the Other

2009-05-08T14:16:00.011-04:00

It almost seems like we've gone from one extreme to the other with the swine flu outbreak.

When swine flu first hit the scene about 3 weeks ago, you might have thought the world was coming to an end. Actually, a few comments to some of my early blog posts did feel a bit chicken littleish.

I think we've learned at this point that the world will continue to exist -- for at least a little while longer. But now it seems that people already have flu fatigue and are going to go back to their old ways until some other flu virus -- or some other germ -- rears its ugly head.

Now is not the time to slack off. The truth is that what we do today -- and for the next few months -- could have a significant impact on the fall & winter flu season.

Since the swine flu scare, I've noticed definite improvement in the steps people are taking to prevent spread of infection. Better hand washing ... more use of alcohol-based gels to kill germs ... and limiting touching of public areas (or at least wiping your hands down afterward if you do).

If we can just keep up the good work through the summer and into the fall and winter, we can help prevent spread of swine flu -- or any other type of flu that may come up in the future.

So far, this swine flu has been milder than we originally feared. But we continue to see more cases and there's a good chance that this swine flu strain could come back in the fall -- when the normal flu virus also gets ramped up.

Have you stepped up your germ-killing efforts or already feel yourself reverting back to your old ways?

You Have Swine Flu -- Now What?

2009-05-07T13:00:00.005-04:00

I've probably hit you over the head enough about not worrying too much about getting swine flu. But what happens if you actually do get it?

Earlier this week, someone asked "If your child gets sick with symptoms of the flu, do you go to the pediatricians office, hospital, where? Is there a test for this flu strain? How are people being treated that suspect they may have it?"

But what about for older adults -- "Hi Doc, I am 67 years old and I could tell you when the last time I had any type of flu. Should I be worried? Also I have not heard anybody say what to do if you get it, like take aspirin, drink lots of fluids, bed rest or what?"

I bet many people wonder what it would feel like to get the swine flu. You probably wouldn't be able to tell the difference between swine flu and the normal flu that you've likely had a time or two.

Swine flu symptoms, and regular flu symptoms, are fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. The difference is that more people with swine flu seem to have diarrhea and vomiting, which we don't usually see with the regular flu.

For most people, the only treatment that would be needed for swine flu is also the same as regular flu treatment. Make sure you get plenty of fluids so you don't become dehydrated, take over-the-counter medications to help relieve symptoms, such as congestion and coughing, and get plenty of rest.

For children, particularly young children, you need to watch them closely to make sure they're not getting dehydrated, not overly lethargic, and not having any breathing difficulty. If you're concerned about these or any other symptom, it's always best to call or see your pediatrician.

Some people might benefit from taking antiviral drugs. The good news is that the flu drugs Relenza and Tamiflu are effective against the swine flu virus. However, the trick is to take them very early -- within 48 hours of developing symptoms. They can help lessen the severity of the flu, help you recover more quickly, and may help prevent serious complications from the flu.

While anyone can take an antiviral drug if your doctor feels it's right for you, those at high risk from swine flu complications, such as the very young, the very old, pregnant women, or those with a heart or lung problem, would benefit the most.

If your doctor does suspect you may have swine flu, there is a simple swab test that can confirm the infection. It takes a few days to get the results back so you would be treated while waiting on the results.

And lastly, keep in mind that even if you get the swine flu, chances are very great that you will recover just fine in just a few days.

Keep the great questions coming!

Are You Hankering for a Swine Flu Vaccine?

2009-05-06T13:00:00.007-04:00

Within days of hearing about the swine flu outbreak, people started asking, "What about a swine flu vaccine?" And I'd bet that many Americans were ready to take the shot right then and there.

I wish people were so eager during the regular flu season. If they were, maybe fewer people would get infected -- and we'd see fewer deaths from the seasonal flu. As it is, about 36,000 people die every year from the flu.

And before you get ready to stand in line next week for the swine flu vaccine, the CDC says a swine flu vaccine won't be ready for about 6 months -- and that's if they decide to ask manufacturers to develop a vaccine against this strain. It's really going to depend on how this outbreak plays out.

The 1976 swine flu outbreak is good evidence why we shouldn't try to speed up the process. Our lives may just be at risk.

In that swine flu outbreak, one person died from the actual swine flu. However, 32 people died from the quickly-developed vaccine and another 500 people developed paralysis from Guillain-Barre syndrome, a usually very rare complication of the flu vaccine.

Regardless of what happens with the current swine flu outbreak, a vaccine isn't going to have any impact for at least several months. So, don't ease up on your flu prevention efforts.

The good news is that the outbreak seems to be calming down a bit -- or maybe it's just the hysteria that is easing off. No, we're not out of the woods completely, but time appears to be telling us that this swine flu outbreak is not likely to be one to kill scores of people. As of yesterday, there were 2 swine flu deaths in the U.S.

If a swine flu vaccine were available today, would you be first in line?

Swine Flu Supplements: Magic Pill?

2009-05-05T12:09:00.013-04:00

Since people are always looking for that magic cure pill, it's inevitable that I've been getting questions about supplements for swine flu.

It's of no surprise that some companies have jumped at the opportunity to sell supplements that supposedly combat swine flu. And it's no surprise that there is so much interest.

People are very concerned -- honestly, far more concerned than they probably should be -- about getting sick from swine flu.

There are absolutely no supplements that are known to help fight swine flu. Last week, the FDA and the FTC alerted the public to be wary of any product that claims to diagnose, prevent, treat, or cure the H1N1 swine flu.

A group of supplement industry associations have joined together to come out against swine flu supplements, pointing out that they are "unaware of any scientific data supporting the use of dietary supplements to treat swine flu. Furthermore, federal law does not allow dietary supplements to claim to treat any diseases, including swine flu."

What concerns me even more is why people feel they need swine flu supplements.

At the risk of repeating myself, let me bring up a couple of quick stats about the regular flu season that we see every year. On average, 200,000 people are hospitalized with the seasonal flu just in the U.S. and 36,000 people die in this country. But I'd guess that not many of us think much about the risk of this garden-variety flu -- much less taking supplements to treat this flu.

Compare that to what we've seen thus far with the swine flu. As of yesterday, there has been one swine flu death. I'm certainly not making light of that death as it's very tragic. I'm making the point that relative to what we normally see with the flu, the swine flu thankfully has been very mild so far.

To date, very few swine flu infections have been serious and almost everyone has fully recovered.

Your risk of getting serious flu infection, and even dying, is far greater with the regular flu than it is, thus far, with the swine flu. And while officials are being cautious, there is nothing to suggest that this swine flu outbreak will all of a sudden cause more serious infections.

Don't take this as an excuse to lighten up on your flu prevention -- you should still wash your hands regularly and frequently, avoid close contact with sick people, avoid touching your mouth, nose, and eyes, and stay home if you feel ill.

You can stay on top of the latest swine flu news with WebMD's Swine Flu Guide.

And let us know what's on your mind. Are you feeling better about the swine flu outbreak? Still worried sick?

Swine Flu or Allergies: How Do You Tell the Difference?

2009-05-04T10:55:00.008-04:00

Given that allergy season is upon us, people are wondering how to tell the difference between allergy and swine flu symptoms?"

Ev345 asks, "My question is how do you differentiate between swine flu and seasonal as well as indoor(to cats/dogs/dust mite etc.) allergies?

It's actually pretty easy.

Symptoms of swine flu are like regular flu symptoms and include fever, cough, sore throat, body aches, headache, chills, and fatigue.

There are 2 symptoms that are always present with the swine flu that you don't get with allergies.

While allergies can make you feel awful, allergies do not cause fever. Without fever, you don't have the swine flu. Another symptom that almost everyone with the flu will have is body aches. This is also very unusual with seasonal allergies or allergies to dogs or cats.

A runny nose and congested sinuses, even if combined with coughing, are not signs of swine flu. If these are your symptoms, you likely have either allergies or possibly a sinus infection. Not so pleasant either, but certainly not swine flu.

Still worried about the swine flu? The WebMD news team did a great piece on 7 reasons why you don't need to worry.

And in case you didn't keep up with the latest swine flu news over the weekend (we're all allowed a break), today's story "H1N1 Swine Flu: No State Is Immune" will bring you up to speed.

Let us know what's on your mind. Have a question? We'll put our team of writers, editors, and doctors to work and try to find out for you.

Swine Flu: What's in a Name?

2009-05-01T09:31:00.012-04:00

You thought swine flu sounded strange. Well, try H1N1 influenza A virus on for size!

It appears that the use of the term "swine flu" has had quite an impact.

The pork people say it's hurting their industry because it's misleading people into thinking that pork is bad. They have a point. You absolutely cannot get this virus (goodness, I don't even know what to call it anymore) from eating pork. Someone should tell the Russian and Chinese governments that. They're banning pork imports from Mexico and parts of the U.S. If government officials are taking such misleading action, what's the public to think?

But the damage has been done. Pork sales have apparently fallen by 80%. It bears repeating -- you CANNOT get this virus from eating any type of pork.

This is not the only flu myth floating around. Check out WebMD's "Top 14 Flu Myths" to get up to speed.

The Israeli government has also said they would abandon the use of "swine flu," so Jews would not have to use the term.

Then, the World Health Organization has said it will use "North American influenza" to note, as they have done in the past, the location of origin of a potential pandemic. And then you have the Mexican government saying that the virus actually got into their country from someone visiting from Asia, where most flu viruses typically originate.

By the way, the U.S. government has also jumped on the "be kind to pigs" bandwagon and also abandoning "swine." As of today, both WHO and the CDC sites are still using "swine flu" on their websites -- guess they have a few things going on right now.

Got all that?

There is potentially a scientific reason to change the name. The name was originally used because this virus is one that generally stems from pigs. However, the virus has yet to be isolated from a pig, leaving some to wonder if it's actually a pig virus. Then, there have also been reports that the virus contains part of bird flu viruses as well.

But a report I read today says that 80% of the virus is derived from swine, with the remaining 20% being a mixture of bird and human flu viruses. Many scientists say that this is a swine flu virus.

So where does that leave us? I certainly don't want to offend anyone or mislead people into thinking things that aren't true. But at least come up with a name that people can remember -- and try to come up with something that makes sense. I'm just glad I'm not a government official that needs to worry about all the concerns of the world and come up with a name for a microscopic virus!

What do you think we should call this virus?

Dr. Smith's Swine Flu Q&A

2009-04-30T11:43:00.010-04:00

First, let me thank you for all the great questions. I wanted to take the time to answer as many as them as I could. They really are quite insightful.

Anonymous said...: I believe someone asked how long the virus can live OUTSIDE the body. For instance, how long is a door knob toxic after someone with the flu sneezes into his/her hand and then touches the door knob?

Dr. Smith: 2 hours or longer ... if the surface is wet, then the virus might live a bit longer.

Anonymous said...: I did have the flu/cold but more flu like. Start to finish over three weeks, still a bit of cough left. Question is How would one know if it was swine flu? Is one a carrier? Should one be tested? And finally can one get it again? Traveled=Yes. sick = one week after traveling. Down Four days before feeling better. Southern climate, Caribbean, tropics. Signed Wondering
Dr. Smith: The only way to know if you have the swine flu is to get tested ... it's a swab. But there's no reason for you to be tested because you are no longer contagious from whatever you had. Good news for anyone that does get the swine flu is that they're now likely immune to that particular strain of the virus.
Anonymous said...: Would you suggest the wearing of a mask? I heard that the germ was so small that it could penetrate through a mask.
Dr. Smith: See my previous post on if you should wear a mask. But to your point, it's not true that a mask wouldn't help. But it's not likely necessary.
Anonymous said...: once a person recovers from a
flu like illness, is here any way to tell if it was swine flue?
I was in Mexico and many people were complaining of a very bad flu, head ache, muscle pain and a cough that persisted. Could they have had swine flu?
Dr. Smith: Once you've recovered, there really is no reason to know if you had the swine flu. The symptoms you describe are certainly consistently with the swine flu but after 7 days, if you're still not sick, then you have nothing to worry about.
Anonymous said...: I'm worried since my Tamiflu packet is 5 years old and we can't get any here so the local hospitals will depend on the stockpiled antivirals. How old are the U.S. Tamiflu and Relenza stocks (or what is their age range)? Tamiflu prescriptions give a 2-year expiration date; is any of the stockpile Tamiflu older than this? And have Tamiflu or Relenza efficacity beyond their expiration dates (and to what degree)?
Dr. Smith: The expiration on your Tamiflu is going to depend on when it was manufactured. But if it was at least 5 years ago, there is certainly the chance that it might have lost some of its effectiveness. I don't know how old the Tamiflu or Relenza is in the government's stockpile but I can assure you that they're tracking expiration dates so they don't send out old medication.
Anonymous said...: My son is 6 months with a cough, but no other symptoms like the swine flu and no fever. My 2 year old has a runny nose with a cough and no fever. I have a cough, stuffy nose, and lost my voice with no cough. Should we all get looked at for the swine flu?
Dr. Smith: At this point, none of you have symptoms consistent with the swine flu, so sounds like you have nothing to worry about.
Anonymous said...: My 6 month old son has a cough, my 2 year old has a cough and runny nose, I have a cough, stuffy nose, and lost my voice. Our symptoms began on Sunday and no one has had any fever. Should we get looked at for the swine flu?

Dr. Smith: Same as above ... your symptoms are not consistent with the swine flu. Check out WebMD's Swine Flu FAQ to learn all about swine flu symptoms and more.

Anonymous said...: Donna
My sister is leaving tomorrow for a Mexican vacation....Our entire family has tried to talk her out of doing this...with no luck. Dr. Smith, do you think this is as dangerous to her health as we do? Yes she has read the information and says she has as much chance of contracting this flu here in the United States as she would in Mexico. Your response would be much appreciated. Thank you.
Dr. Smith: There's certainly a risk and that's why the gov't has recommended against unessential travel. If she decides to go, keep in mind that the overwhelming majority of people who get the swine flu are recovering just fine. Thankfully, serious illness and deaths are very rare. We're still holding at 1 death in the U.S. At a minimum, your sister should call her doctor to see about getting antiviral medications, particularly if she has any other health conditions.
Anonymous said...: I have a bad cough, and for the last 4 days I have woken up with numbness in my hands. I dont feel anything for at least an hour. Are these symptoms of the swine flu?

Dr. Smith: Numbness is not a symptom of swine flu. I would suggest getting this checked out to see what might be going on.

Lesley said...: Lesley said I am planning a trip to Canada in July. Since we do not know what the situation will be, and because it is not always easy to get to a doctor while travelling, a doctor in Europe suggested it might be a good idea to buy one of the two antiviral drugs to keep at hand. It might be in short supply if things get bad. If I don't get the flu and have to throw the things out when they expire, well put it down to very good luck. What do you think?

Dr. Smith: That's really a question you need to pose to your doctor. For some people it's warranted to take antiviral medications if they're exposed to the swine flu. But you have to figure out what's right for you with your doctor. See my post on Swine Flu; Who's Most at Risk?

Mary said...: I am a 55 y.o. female with RA. I am due to take an immunosuppressant (rituxan) via I.V. on May 8th. Should I do this treatment or look for something else? I am due to travel to New Mexico then 3rd week in May.

Dr. Smith: You need to address this with your doctor. If you have severe RA, which I assume you likely do if you're taking Rituxan, then that treatment is vitally important to help prevent flares and possible disability down the road. You should talk to your doctor about whether you should have antiviral medications on hand.

Steve said...: If the W.H.O. has raised the pandemic level to Level 5, why are they not making the vaccines available right now at Dr.'s offices and clinics before we all get the flu and it's too late for a vaccine?

Dr. Smith: Because there is no swine flu vaccine unfortunately. It takes quite a bit of time to create a flu vaccine. As of yesterday, the CDC was saying that it might be available in September. Let's hope it's not needed by then but time will tell. They may decide to include it as one of the strains in this year's flu vaccine, which we typically start getting in November or so.

Anonymous said...: If I am scheduled for surgery (not an emergency) over the summer and a pandemic is declared, should I postpone the surgery (since hospitals won't be the safest place to be during the pandemic?

Dr. Smith: I can't accurately answer this question because I don't know nearly enough about your medical history or the surgery. You need to address this issue with your doctor.

Anonymous said...: How long do these types of things usually last is this the beginning of a year long or a month long or how long of an ordeal is this? And how is it going to stop. I know for the regular flu there is a "flu season" but we are well past that. And we know everyone is not going to follow the standards of staying home if they are sick.

Dr. Smith: Unfortunately, there is no "usual" when it comes to these things. They're all different. Let's hope with the upcoming summer (a time during which the flu is very unusual) and our vigilant efforts to prevent swine flu (you are being vigilant about washing your hands, right), that this outbreak will pass quickly. But at this point, we really just don't know.

Robert Oliveira said...: While the continued spread of Swine Flu (H1N1) is no laughing matter, I strongly believe that someone in an official government capacity needs to reign in the media outlets. At least one FOX affiliate in my part of the U.S. is providing sound bites which will only cause more fear and panic. Right now what we need is well-informed citizens who can take the lead in preventing the spread of the disease and sensational newsreporting isn't going to do it.

Dr. Smith: Robert, you hit the nail on the head about us, American citizens, leading the charge of preventing the spread of swine flu! The government can only do so much and they have admitted that their ability to contain the virus is quite limited. But yours isn't. Take every precaution with frequent handwashing and steer clear of anyone with flu-type symptoms. Keep alcohol-based hand gels or wipes around, particularly if you touch public places, like doorknobs, phones etc.

Anonymous said...: Since this is a new virus I know it will take time to develop and produce a vaccine. About how long will that probably take? When do you think will get the vaccine?
Dr. Smith: The earliest the CDC says is September. It actually takes months to develop even the annual flu vaccine that we hopefully all get. Maybe this outbreak will cause more people to get next year's flu vaccine since it is the most effective strategy for preventing the flu (that, and handwashing).
Anonymous said...: I have to fly to care for my parents this weekend. My mom is on remicade (sp?) which compromises her immune system. Should I wear a mask while travelling to prevent contracting the flu and possible passing it to her? I am flying from Dallas to Orlando. I am concerned about the time on the plane in the confined space - especially in light of VP Biden's comments this morning!

Dr. Smith: I completely understand your concern, but let me just put things in perspective. In total, there are just over 100 cases of confirmed swine flu in the U.S and one death. In an average flu season, 200,000 people are hospitalized and 36,000 people die.

Anonymous said...: Can you provide anymore information on the age demographic that seems to be the most susceptible to this virus?

Dr. Smith: It's honestly a bit early in the outbreak in the U.S. to say for sure. But I suspect this will go the route of most flu viruses in that the very young and the very old are going to be most at risk of severe infections. For other high-risk groups, see my post on Swine Flu: Who's Most at Risk?


Anonymous said...: Who does the Swine Flu affect? Babies and the elderly? Or can anyone get it? If so, how many schools have closed because of this illness?
Dr. Smith: See my post on Swine Flu: Who's Most at Risk. As far as how many schools have closed, that number is changing all the time so I really couldn't tell you.



Anonymous said...: I was in Dallas/Ft. Worth from Monday 4/20 to Thursday 4/23. On Friday evening (24th) I started to get a sore throat. Saturday it got worse and I started having joint and muscle pain along with a "vice" like headache(is persistent to this day). Felt ill all weekend long, went to the Dr. on Monday...gave me a rapid strep test and pain relief for headache and sent me home. Dr. called Tuesday evening to see how I was, and I was actually starting to feel better. Now it is Thursday and my chest has become very heavy and I have a productive, yucky cough (and, still the headache. I have been working from home all week, which I feel so fortunate I can do that. Am a bit concerned it may be swine...now today, 16 yr old daughter has a bad sore throat...kept her home from school. I am feeling confused as to what I should do!

Dr. Smith: If you're confused, I'd suggest calling your doctor. A cold or strep throat is much more common than swine flu. It's important to get strep throat treated too, so that might be a reason to get your daughter into see the doctor if you think that's a possibility.

Paul E said...: What are the similarities / differences if any between the Swine Flu 2009 type H1N1 and the Spanish Flu of 1918 type H1N1?

Dr. Smith: Well, the viruses are different -- we know that at least. But unfortunately we don't know much more at this point. In 1918, the flu started out as mild and only later became very serious and widespread. Let's hope that today, our containment and flu prevention strategies that I hope everyone is being very vigilant about will help prevent this swine flu outbreak from going that same route.

Thanks for all the great questions and hopefully the information will help keep you calm during these uncertain times.

Swine Flu: Who's Most at Risk?

2009-04-30T10:41:00.006-04:00

I've been receiving quite a few questions about whether certain people should be more concerned about catching swine flu. The short answer is "yes."

As with the garden-variety flu, there are some people who are more likely to be severely affected by the swine flu. These people are more likely to get very ill, require hospitalization, and more likely to die.

People at higher risk have one thing in common. Their bodies are more susceptible to serious complications of the flu, such as pneumonia or even bloodstream infection.That said, most of these people recover just fine from the flu with no serious illness. But it's good for them to take steps to be extra careful in preventing the flu.

So, who's most at risk?

1. Children aged 6 months up to their 19th birthday (but the younger the child the higher the risk)
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain medical conditions, such as heart or lung disease (asthma, COPD, emphysema), diabetes or those with weakened immune systems

So what should these people do to protect themselves?

If there were a swine flu vaccine available, then they'd definitely want to get one. Unfortunately, there isn't one. The CDC says they may have one available by September. Time will tell if it's still necessary by then. Fingers crossed our aggressive efforts will take care of the problem beforehand.

We all need to be very vigilant about warding off the swine flu virus. Wash your hands, wash your hands, wash your hands! Guess you get my drift. It truly is the most effective flu prevention strategy.

Also, until this thing calms down a bit -- and it will -- high-risk people, such as pregnant women, should avoid being around sick people. If someone is coughing, has a fever or sore throat, or other symptoms that could possibly be swine flu, avoid them until they are on the mend.

Wondering about a mask? Check out my blog from earlier this week.

And what about antiviral medications? If anyone from these high-risk groups is exposed to someone with swine flu symptoms, they should call their doctor to see if they should take antiviral drugs, such as Relenza or Tamiflu. These medications can help prevent you from getting the flu, if taken early enough after exposure. Or, if you do get symptoms, they can help lessen the severity of the illness and help you feel better faster. They may also help prevent serious flu complications. The key is to start them early -- within 2 days of symptoms.

Stay tuned with WebMD's Swine Flu Guide for the latest news and tips on combating swine flu.

Do you know anyone that has had the swine flu? Have a question you can't seem to find the answer to? Let me know and we'll do our best to tackle it for you.

Tragic Swine Flu Death Expected

2009-04-29T09:19:00.012-04:00

There's no doubt that the swine flu death of a 22-month old baby is devastating. But it's important for the public to understand that this was expected and that this does not mean that the swine flu outbreak is getting exponentially worse.

We knew that there were quite a few people in Mexico that had died from swine flu. And there's no logical reason to expect that the illness would be any less severe than in the U.S. So while it's very tragic and heartbreaking to think of a little baby dying from swine flu, it's unfortunately expected with the flu.

It's important to keep in mind that in an average flu season -- and I'm talking about the normal winter flu season -- about 36,000 people die from the flu. Let me repeat that -- 36,000 people! Yes, that's a huge number and most people are shocked when I tell them that. But it helps drive home a very important point.

All types of flu are very serious and should not be taken lightly. That's why I, and the other doctors and health professionals at WebMD are always trying to drive home the point of flu prevention.

Preventing the spread of swine flu is up to us -- not the government. Sure, the government is going to do everything it can to contain the virus as much as possible -- and take steps to protect people as much as they can, such as by making antiviral medications more available.

But we -- you and me -- have the true power to prevent spread of swine flu. Swine flu prevention is not rocket science -- wash your hands, cover your mouth when you sneeze or cough, stay home if you're sick and make your child stay home if he/she is sick. While it's not foolproof, they are the most effective strategies we have for preventing spread of respiratory viruses, like swine flu.

Keep in mind that no one is suggesting that tens of thousands of people are going to die from swine flu. At this point, thankfully deaths are quite rare -- but will happen.

WebMD is staying on top of this story to keep you informed throughout the day. Our Swine Flu Guide has everything you need to know from prevention and swine flu symptoms to when you need to call your doctor.

We're hearing from our users and quickly responding to their questions with more information.

Is there something you've been wondering about swine flu but can't find anywhere? Let me know and we'll find the answer for you.

Can a Mask Prevent Swine Flu?

2009-04-28T15:56:00.007-04:00

While a mask could theoretically help prevent swine flu, it’s a bit much for most people and really not necessary at this point.

Sure, if someone is coughing or sneezing in your face, a mask might help. Also, if you know that you're going to be around someone with swine flu, such as a loved one, a mask might be warranted. But otherwise, that’s not the most effective strategy for preventing swine flu because you don't catch most respiratory viruses from people coughing in your face.

Here's what generally happens. Someone with a virus sneezes or coughs in their hand. Then, they touch something like an elevator button or a doorknob. You come along a few minutes later and touch that same button or knob. Then, without thinking about it, you touch your face – your mouth, nose, or eyes – and the virus takes hold of you.

As mundane as it sounds, the most effective way to prevent getting respiratory viruses like swine flu is washing your hands. But most of us don’t do it often enough and don’t do it the right way.

Obviously, the biggest risk is when you’re in a public place. So, I do whatever I can to not touch anything when I’m out and about – or at least make double sure not to touch my face out in public.

To be more specific, here’s my strategy when I go into a public restroom. It goes without saying that I make sure to not touch my face once entering the restroom. But after I’ve taken care of my business, I wash my hands for a good 20 seconds. I know it feels like a long time, but believe me, it’s worth it. Need to occupy yourself? Sing happy birthday -- twice -- to pass the right amount of time.

Then, when you’re done, don’t touch a thing but a paper towel. Contort yourself or do whatever you need to do to get that paper towel without touching anything else. Turn the water off using the paper towel. Open the door to leave the restroom with the paper towel. And don’t touch anything else with your hands – without the paper towel. I throw the paper towel away when I get back in my office.

Washing your hands is extremely important after you sneeze or cough into your hands. Not around soap and water? Alcohol-based hand gels are also very effective for killing flu viruses.

And if you have any swine flu symptoms, the CDC says call your docto r. It's also a good idea to practice social isolation. Keep to yourself until you’re all better to prevent spreading your germs around. To stay up to date on the latest swine flu news and for more strategies of staying healthy, check out WebMD’s Swine Flu Guide.

So did I convince you to wash your hands or are you still hankering for a mask? Let me know your thoughts.

Swine Flu: Your Guide to WebMD Coverage

2009-04-27T14:13:00.004-04:00

The swine flu story is changing by the hour, and in order to keep you up to date on the latest, please check this blog where we'll continue to post information as it becomes available to us.

What We Know Today

In a press conference this morning with the World Health Organization in Geneva, we found out that the number of confirmed cases of swine flu in the U.S. has doubled since yesterday to 40, in five states. There are also cases in Spain and Canada, but the worst cases are still in Mexico, where of the 1,000 or so people sick with flu-like symptoms, there are 26 confirmed cases of swine flu.

In a press conference later in the afternoon, WHO officials raised the pandemic threat level from 3 to 4.

The only place where anyone has died is in Mexico, and officials are still trying to determine why that is ... as of yet, they don't know.

The CDC also just wrapped up a press conference, where they confirmed the 40 U.S. cases, with the additional new ones today coming from a single school in New York. That school is closed today and tomorrow. In California there's a media report of a school closing in Fair Oaks due to a sick student.

The CDC is also recommending that people avoid non-essential travel to Mexico.

WebMD's Coverage

Along with our news coverage, we are also planning to bring you much more information to help keep you informed:

We have a video interview with a CDC official.

We are creating a slideshow to help further explain the virus.

A new reference piece is being written to help explain the difference between a pandemic and an outbreak.

We are working on a map to show you the areas of the country affected, and how many people in each area have the flu.

We will combine all this into one page for your ease of use. You will even be able to sign up for an RSS feed or getting the latest news by Twitter.

Those Involved

This is now a global issue, and groups around the world are working together to track this virus and protect the public's health.

The main groups:

Centers for Disease Control and Prevention

The World Health Organization

The U.S. Department of Health and Human Services

The U.S. Department of Homeland Security

You can also check with your local board of health

More Background Information

It is easy to hear all this and start to panic, especially since the U.S. declared a public health emergency yesterday, but it's important to remember there's a lot you can do, and the cases so far in the U.S. have been relatively mild.

If you want to know more about the symptoms, or find answers to other questions, check out our FAQ.

We will continue to do more on this topic to bring you the latest information, and the best explanations about what you need to know.

If you have questions, please ask them here and we'll do our best to find answers for you. What are you doing to protect yourself, and what concerns you most?

Sean Swint
Executive Editor, WebMD