Health Chats
Swine Flu: A Cause for Panic? (Part 2)
Wednesday May 06, 2009, 01:00PM - 02:00PM (EST)
Enoch Choi, MDBlank
Palo Alto Medical Foundation
Urgent Care, Palo Alto, CA
Do you have swine flu? Dr. Enoch Choi, MD from Palo Alto Medical Foundation Urgent Care will help answer questions on how to tell swine flu from a cold, and from seasonal influenza. Swine flu has not yet been proven to be a serious enough virus to declare this to be a pandemic, but nations around the globe are discouraging travel to USA and Mexico. Just how dangerous is this virus? How can you protect yourself? How can you stay healthy? Come ask these questions and more from a physician on the front lines, treating folks coming back from Mexico with upper respiratory illnesses that match the CDC's protocols for treating suspected swine flu patients.<br><br> <img src="http://www.medhelp.org/images/email/arrow.jpg">&nbsp;&nbsp; Learn more about Swine Flu from Dr. Enoch Choi's blog post <a href="http://www.medhelp.org/user_journals/show/83652">Do I have Swine Flu?</a> <br><br> <img src="http://www.medhelp.org/images/email/arrow.jpg">&nbsp;&nbsp; Read the chat transcript from Dr. Enoch Choi's first <a href="http://www.medhelp.org/health_chats/archive/17">Swine Flu Health Chat</a> on April 29, 2009. <div style="margin: 10px; float: none; height: 85px; border: 1px solid #E5E5E5; padding:10px 25px;"> <div style="background: transparent url('http://video.nbcuni.com/healthology/thumb/ee8a6d86032c7e85009980d59151bee7_large.jpg') no-repeat scroll 9px 10px; float: left; padding-right: 25px;"> <a href="health_videos/Swine-Flu-Update/show/1870" style="color:#006CC8; text-decoration:none;"><img src="http://www.medhelp.org/RoR/images/health_videos/video_overlay.gif?1" alt="Video_overlay" style="height:69px; width:94px; border: 0 none;"/></a></div> <div style='padding-top:23px;font-size:14px;'> <a href="health_videos/Swine-Flu-Update/show/1870">Swine Flu Update</a> </div> </div>
Dr. Enoch Choi:
There are different cases, and the http://www.cdc.gov/h1n1flu/ lists confirmed cases (PCR positive for H1N1).  I don't know but I'll bet that the Maine DPH is reporting "probable" cases which are "influenza A untypeable"
Dr. Enoch Choi:
As of yesterday, "probable" cases are being treated the same as confirmed cases since every probable case has become confirmed
Tatyahna:
What happens to the body and or immune system that results in death?
Dr. Enoch Choi:
Many illnesses can lead to death after H1N1 infection.  What has been reported in Mexico is young healthy adults whose immune system over-reacts to the virus, causing leakiness of the blood vessels including those in the lungs, so serum leaks into alveoli (air exchanging  part of lung) and they drown.
jsbadger:
What do you think about Egypt's decision to kill all pigs in their country?
Dr. Enoch Choi:
Not recommended by WHO or CDC.  I wish i'd been over there to enjoy the pig roasts.  or maybe not.  that's a  lot of pig.  even for a pork lover like me
4everNana:
Should we curtail our own travel plans within the US to highly populated tourist areas, or travel by planes, or is our threat of exposure about the same as within our own schools and workplaces?
Dr. Enoch Choi:
check http://www.cdc.gov/travel/ before you go.  currently, no restrictions exist.  the threat of exposure does increase when you go to areas that you have more chance of coming in contact with a sick person e.g. travel/tourist/school/work
EmmieJ:
My kids' school has implemented new policies to avoid exposure to swine flu such as mandatory hand sanitizer use upon entry and cutting off all water fountains. Why don't we all take these precautions all the time and how do we educate the public that we shouldn't stop practicing good hygeine simply because the threat seems to have subsided?
Dr. Enoch Choi:
CDC released new policies yesterday morning at 11am PST. Santa Clara PHD released update yesterday 4pm: http://bit.ly/Ctr3U  I think those are good precautions.  The public needs to know that there is still risk
Dr. Enoch Choi:
Even though theyr'e not going to close schools for 1 case, if there is a cluster of cases they may
Dr. Enoch Choi:
Good hygiene is very important
semien1260:
Please define mutatation and your thoughts of the seriousness of it.
Dr. Enoch Choi:
1918 flu pandemic was mild early on, until it mutated into a severe influenza strain.  It's possibly very serious.  That pandemic killed millions.
fvf147:
If given Tamiflu within the recommended time frame would that prevent ARDS?
Dr. Enoch Choi:
if given tamiflu within first 48 hours of symptoms, it could help decrease the severity of illness, including complications like ARDS
Geari:
So how will they make the swine flu vaccine?
Dr. Enoch Choi:
haven't seen an article on that.  juts know it should be available by september
Dr. Enoch Choi:
i'll be one of the first to get it since i'm a first responder
Kat_624:
I have 2 year old twins who attend daycare.  They are relatively healthy now with no chronic illnesses, but they were preemies (32 weekers) when they were born.  Are they still at risk of having a weakened immune system?  Should I be more concerned for them if this flu comes back in the fall?
Dr. Enoch Choi:
many preemies are thought to catch up by 2 years of age.  If they had complications with respiratory problems that continue, they're more at risk than the general population for H1N1 and other respiratory illnesses.  
Geari:
Is L-lysine a good supplement to take to build up immune system?
Dr. Enoch Choi:
haven't seen any studies on that
jsbadger:
My son had mono recently... Does this make him more at risk to have complications from H1N1?
Dr. Enoch Choi:
Infectious mononucleosis is caused by EBV virus and weakens your body.  Can't say if it will increase complications if he also caught H1N1, but if he's like other mono patients i've taken care of, he's probably resting and not going out so much so he is probably at less risk of catching it
rosslynnie:
Do you think the Asian countries that have had to deal with the SARS epidemic are better prepared than the European countries which haven't? Western countries may have stockpiled drugs, but they have no real hand experience in face of epidemic. Do you think that matters?
Med Help:
We have about 5 minutes left in this chat. Last chance to submit your questions.
Dr. Enoch Choi:
yes, my friends in hong kong and singapore report that their countries are taking this much more seriously.  If this happened to be a bad pandemic they would have done better.  for example Hong Kong has 12 times the amount of tamiflu it needs to treat every citizen.  They are more actively screening and quarrantining
fvf147:
So as Mexico goes through the back log of swabs will the number of deaths eventually match that original 159 "suspected" or have they already ruled out H1N1?
Dr. Enoch Choi:
Mexico was initially sending samples to Canada, but has received WHO assistance to do this themselves.  they should be able now to confirm with PCR within 6 hours of running a swab
Dr. Enoch Choi:
what they're reporting now should be up to date
fvf147:
They said this strain was missing some enzymes that would have caused it to be more severe, could it mutate to include what it's missing or does it not work that way?