Swine Flu Chat
Tuesday Oct 20, 2009, 12:00PM - 01:00PM (EST)
Palo Alto Medical Foundation
Urgent Care, Palo Alto, CA
Fall is here, school is back in session, and once again it’s time to gear up for flu season. This year will have special challenges, as we are preparing for both seasonal flu and H1N1 (swine) flu. Dr. Enoch Choi, MD, an Urgent Care provider in the San Francisco Peninsula, will help answer questions on how to tell swine flu from a cold, and from seasonal influenza.<br><br>
The pandemic H1N1 flu (aka “swine flu”) began in April, and circulated in daycares, schools and camps over the summer but dropped off until very recently increasing to widespread levels again in many states. Virtually all the flu around now is the pandemic H1N1 virus. The H1N1 virus also predominated in the recent winter months of the Southern Hemisphere, which typically spreads north as we have our winter. There is concern that we are now experiencing a second wave of H1N1 this fall with the return of children to school. <br><br>
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Learn more about Swine Flu from Dr. Choi's blog posts:<br>
<a href="http://www.medhelp.org/user_journals/show/124636">2nd Wave of H1N1 Widespread Across America, Get Immunized!</a><br>
<a href="http://www.medhelp.org/user_journals/show/83652">Do I have Swine Flu?</a>
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Read the chat transcript from Dr. Choi's most recent <a href="http://www.medhelp.org/health_chats/archive/19">Swine Flu Health Chat on May 8, 2009</a>.
Dr. Enoch Choi:
They will administer only 1, and you need to follow up elsewhere for a 2nd shot later. Expect enormous lines. I'm friends with Astrid, since our kids went to preschool together. She throws great parties ;)
Dr. Enoch Choi:
"My son (6) and I are both experiencing symptoms that could be H1N1. We both had the seasonal flu shot in early September. My daughter (4) appears to be healthy. Could there be any harm in having the two of them get the H1N1 vaccine today, given that my son may already have H1N1? If it’s not H1N1, I’d like to make sure neither of them gets it. They have no other complicating illnesses."
Dr. Enoch Choi:
Ask your doctor, but they won't usually give you any vaccination if you have a fever >=100 degrees
Dr. Enoch Choi:
Is it true that the intranasal H1N1 vaccine sheds once it has been administered? Transmission of vaccine virus to contacts
Available data indicate that both children and adults vaccinated with live
attenuated influenza vaccine can shed vaccine viruses for >2 days after
vaccination. Shedding should not be equated with person-to-person transmission
of vaccine viruses; although, in rare instances, shed vaccine viruses can be
transmitted from vaccinees to nonvaccinated persons.
Health care workers and other individuals who receive live attenuated influenza
virus vaccine should refrain from contact with severely immunosuppressed
patients (e.g., bone marrow or air flow restricted units) for 7 days after vaccine
receipt. Severely immunosuppressed persons should not administer live
attenuated influenza virus vaccine to other people.
Dr. Enoch Choi:
"i am pregnant (23 weeks) and have a little one (23 months) and i'd like to go the clinic on november 7th to get the vaccine injection for both of us. i've heard that the approved US vaccines do not contain adjuvants but the international versions might. do you know if the shots at the clinic will have adjuvants? and thiomersal?" There are no adjuvants in USA administered vaccines. there are 4 kinds of H1N1 vaccines: nasal w/thimerisal, nasal w/o thimerisal, injection w/thimerisal, injection w/o thimerisal. I don't know which will be used on 11/7 in santa clara.
Deligirl1:
I have chronic lyme disease and other diagnosed autoimmune disorders. My physician has requested I do not receive the seasonal vaccine or the H1N1 vaccine as it could be detrimental to my health. My physician has also requested that my family get the shots vs the mist. My biggest concern is that my girls are 5 and 8yrs old and the thimerosol and possible adjuvants in the shots are causing me great concern. I called the health dept and they assured me that the amount of thimerosol is just about the same as what you would get in a tuna fish sandwich or one helping of tuna. But i still have to ask -Is the flu shot safe enough? I do not want to put my kids at more risk by getting them the shot. What is your recommendation?
Dr. Enoch Choi:
I follow the recommendations of the CDC and they recommend your girls get immunized. There are no adjuvants in shots given in USA. CDC describes no risk with thimerisol.
jojomumof5:
Hi, I have 5 children aged between 2 yrs and 11 yrs. One of my children (Abi - 3yrs) has been dianosed with Swine flu and she has been given a 5 day supply Of Tamiflu (2 capsules per day/45mg each capsule). She has been given the capsule form and she is unable to swallow them. We have tried breaking the capsules up and mixing them with sweet things (ie syrup, honey) but she still spits it out. Any suggestions? Also, how long is it advisable to keep her off nursery? (until her course of Tamiflu is completed?). Thank you.
Dr. Enoch Choi:
You may ask your pharmacist, i've heard they have creative ways to make it palatable. Students are encouraged to remain home until 24 hours after the last fever of 100 or more, without taking fever reducing medicine.
ChitChatNine:
Hi Dr. Choi, do know where I can go to see if there is latex in the stopper of the Swine Flu Vaccine. Last time I asked my pediatrician, the info wasn't available but hoping that has changed to date. Thanks for doing this chat with us today!
Dr. Enoch Choi:
i don't know about your H1N1 vaccine, but the one we have here, and the seasonal flu vaccine we have here, says "latex-free" on the box so i think that means they have a non-latex stopper to put the needle thru
ragub6ib9:
My daughter has been throwing up has a fever and headache. Could this be the swine flu?
Dr. Enoch Choi:
Diagnosis requires temperature of 100 or more, with either sore throat or cough.
Dr. Enoch Choi:
other symptoms are possible, but not diagnostic (not required for diagnosis)
bob17987:
What is the swine flu? It sounds just like a plain old flu. My friends have had it and they said it is just the same as the regular flu??
Dr. Enoch Choi:
Brand new flu noone has ever experienced before. It's true that many with H1N1 feel like they have a mild flu, but some young people, pregnant, and with chronic illiness, are dying from it.
Crysi:
My 12 week old son was in contact with someone at (Canadian) Thanksgiving who is believed to have H1N1. What should I be watching for in my son besides fever?
Dr. Enoch Choi:
http://www.cdc.gov/h1n1flu/qa.htm What are the signs and symptoms of this virus in people?
The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may have vomiting and diarrhea. People may be infected with the flu, including 2009 H1N1 and have respiratory symptoms without a fever. Severe illnesses and deaths have occurred as a result of illness associated with this virus.
GMB08:
What are the exact ingredients in the H1N1 vaccine?
Dr. Enoch Choi:
the same vehicle and manufacturing as seasonal influenza vaccine, but using H1N1 instead of this year's seasonal which is H3N2
MDiv2009:
I'm 28 years old, in good health, working as a chaplain in a hospital in Anchorage, Alaska. I became ill while working an overnight shift on Sept 30/Oct 1. I was diagnosed as having H1N1. I had mostly just typical flu symptoms, but the fever I had was high (102.9 at the highest, fever lasted for 5 days). I was out of work 10 days, then went back for 2 days before becoming more ill. This led to a quick trip to the clinic where I was diagnosed with infected sinuses (right side), ear infection (right ear) and bronchitis. Three days after starting antibiotics, I went back because they didn't seem to be helping, and started this round of antibiotics on Thursday, Oct 15. As of yet they don't seem to be helping either, the fever (even though lower than before) won't go away. I very rarely get sick and when I do, I typically bounce back quickly...so for this to have been going on for 19 days now is concerning. Is this typical with the H1N1?
Dr. Enoch Choi:
Some people have developed secondary bacterial infections following H1N1, some are very serious if it's pneumonia. Many people with the flu cough for weeks, even after the virus is gone.
Victoria01:
I have read on the CDC site that clinical trials began in September on pregnant women and all information I have come across says that pregnant women are in the 'target' group to get the vaccine. How do they know the long term effects of the vaccine if testing only began last month?
Dr. Enoch Choi:
The same manufacturing that is used for seasonal influenza is used for H1N1 so the safety should parallel our seasonal influenza shot
sgrbisct:
I have Charcot Marie tooth disease. Would it be okay to get the nasal spray for H1N1?
Dr. Enoch Choi:
You have to ask your doctor
Suzan1975:
If you were a first time pregnant mother and living an average healthy lifestyle...in your professional opinion..Would you get yourself vaccinated with the H1N1 vaccine or recommend that your wife if she was pregnant at the time? With all the new studies and trials being conducted with this vaccine that they are so desperately trying to get out in time for flu season, doesn't it seem all a bit too rushed? And second, there are no conclusive studies out on the long term effects this vaccine may have on the babies in utero?
Dr. Enoch Choi:
If my wife were pregnant, I would absolutely get her the H1N1 shot. Safety of seasonal influenza shot has been established in pregnant women, the H1N1 should parallel the same safety history since they use the same manufacturing mechanisms
Tra101:
I think my daughter and I have had swine flu. But the symptoms listed didn't say anything about loss of voice and a croup like cough? My daughter had a fever of 103, croup-like cough, green nasal mucus and extreme fatigue. She had it for 3 days and then had a secondary infection (an ear infection). Do you think this was the swine flu?
Dr. Enoch Choi:
It's possible, ask your doctor
cpooh4va:
I have Lyme Disease and Chronic Severe Asthma, is it safe to take the H1N1 vaccine? Every website I have read says NOT to take either that vaccine or the regular flu, but the past 3 years I've taken the regular flu shot and my memory issues and other health issues have seem to have gotten worse. I guess the antibodies are busy fighting the vaccine stuff and that allows the Lyme to attack harder. Thanks for your advice in this!
